Insomnia
Charles Theisler in Adjuvant Medical Care, 2023
Insomnia is a common sleep disorder that makes it hard to fall asleep (sleep latency), hard to stay asleep, and/or hard to get back to sleep. Insomnia has also been associated with a higher risk of developing chronic diseases.1 There are many possible psychological and medical causes of insomnia. Psychological causes can be bipolar disorder, depression, and anxiety or psychotic disorders. Some medical causes include chronic pain, chronic fatigue syndrome, congestive heart failure, angina, acid-reflux disease (GERD), chronic obstructive pulmonary disease, asthma, sleep apnea, Parkinson’s and Alzheimer’s diseases, hormonal imbalances, hyperthyroidism, arthritis, brain lesions, tumors, and stroke.1 Certain medications (e.g., corticosteroids, alpha or beta blockers, statins, ACE, or cholinesterase inhibitors) can also cause insomnia.
Digital Therapeutics for Sleep and Mental Health
Oleksandr Sverdlov, Joris van Dam in Digital Therapeutics, 2023
The currently available treatments for insomnia can be broadly categorized into psychological (e.g., cognitive behavioral therapy) and pharmacological (e.g., sleep-promoting medications) approaches. Their use is dependent, amongst other factors, on whether treatment is being administered in the short ( weeks) or longer-term (Xu and Anderson, 2019). Short-term treatment of insomnia may include pharmacological approaches if cognitive behavioral therapy (CBT) for insomnia is not available. However, the efficacy of sleep-promoting medications for treating insomnia in the longer term is limited and generally not recommended because of the potential for harm (Qaseem et al., 2016; Riemann et al., 2017). This is why CBT is considered the first-line treatment for insomnia (Qaseem et al., 2016).
The Sleeping Brain
Hanno W. Kirk in Restoring the Brain, 2020
Insomnia in some form or another is likely the most common presenting sleep complaint at a doctor’s office. It often results in symptoms of sleep deprivation. In some clinical studies, as many as 20% of adults are affected with insomnia and its consequences. According to the latest International Classification of Sleep Disorders, insomnia is defined as a persistent difficulty with sleep onset, maintenance, consolidation or quality that occurs despite adequate opportunity and circumstances for sleep and results in some form of impairment of daytime functioning.19 To diagnose chronic insomnia, the reported sleep complaints must occur at least three nights a week for a minimum of three months. In adults, insomnia typically leads to poor performance in one’s job or impairs social relationships. These persons often exhibit physical complaints such as increased muscular tension, gastrointestinal disturbances and palpitations. The Penn State Cohort study of insomnia with short sleep time in men indicates that such individuals are at increased risk of all-cause mortality.20 Insomnia with objective short sleep is significantly associated with incident hypertension and type 2 diabetes.21 Those affected are more likely to suffer from mental illness.22 In children, insomnia often leads to reduced academic performance and behavioral problems.
Insomnia management in Dutch general practice: a routine care database study
Published in Scandinavian Journal of Primary Health Care, 2023
Mette H. Bakker, Nina A. Oldejans, Jacqueline G. Hugtenburg, Henriëtte E. van der Horst, Pauline Slottje
We explored insomnia management by GPs in the context of the current Dutch insomnia guideline, published in 2014 [2]. In this guideline, insomnia is defined as sleep difficulties for at least three times a week, accompanied by daytime consequences, such as impaired functioning, fatigue, sleepiness, irritability, reduced concentration and performance. For insomnia it recommends non-pharmacological interventions. This should include education about normal sleep and, in cases insomnia persists for three weeks or longer, a behaviural approach in which ‘sleep hygiene’ advises (i.e. healthy sleep habits), stimulus control, sleep restriction, relaxation exercises, cognitive therapy and physical exercises are combined. It advises to only prescribe sleep medication for a short term (a short-acting BZRA up to 10 tablets) in exceptional situations: i.e. (1) as temporarily relief when the sleep disturbance is of recent origin and has an identifiable cause of transitory nature or (2) as temporarily relief when the sleep disturbance is chronic and leads to dysfunctions in daily life, and improvement is not otherwise expected.
A Scoping Study of Insomnia Symptoms in School Teachers
Published in Behavioral Sleep Medicine, 2023
Madelaine Gierc, Robyn A. Jackowich, Sandra Halliday, Judith R. Davidson
Symptoms of insomnia include difficulty falling asleep, staying asleep, and/or waking too early in the morning. Chronic insomnia disorder applies when these symptoms occur at least three times per week, are associated with impaired functioning, and persist for at least three months (American Academy of Sleep Medicine, 2014). People with chronic insomnia often experience irritability and depressive symptoms (Baglioni et al., 2011) and show impairments in cognitive functioning, especially attention, reaction time, problem solving, and working memory (Wardle-Pinkston et al., 2019). Over time, insomnia increases the likelihood of developing major depressive disorder, cardiovascular disease, and type 2 diabetes (Baglioni et al., 2011; LeBlanc et al., 2018; Sofi et al., 2014). These difficulties may have negative repercussions on teachers’ classroom performance given that teachers’ emotional wellbeing predicts effective classroom management, positive teacher-student interactions, and an enhanced learning environment (Jennings & Greenberg, 2009).
Implicit and Explicit Stigma of Chronotype in Emerging Adults
Published in Behavioral Sleep Medicine, 2023
Jessica R. Dietch, Megan Douglas, Kelly Kim
Insomnia disorder has substantial overlap with delayed sleep-phase type in both symptomatology and co-occurrence. Insomnia symptoms include difficulty initiating or maintaining sleep, and insomnia disorder is diagnosed when these symptoms occur at least 3 nights per week for at least 3 months and are accompanied by a sleep-related difficulty in daytime functioning (American Psychiatric Association, 2013). Delayed sleep-phase type can co-occur with or be diagnosed independently from insomnia disorder. The primary differentiating feature is the involvement of the schedule in the sleep-wake pathology; individuals with delayed sleep-phase type without co-occurring insomnia disorder do not experience insomnia symptoms when they are allowed to sleep on their preferred schedule (American Psychiatric Association, 2013). Because of the similarity between symptoms experienced by individuals with delayed sleep-phase type and insomnia disorder, and the high rate of co-occurrence between these disorders, it is possible that similar experiences of stigma may also be common to individuals with both disorders.
Related Knowledge Centers
- Chronic Pain
- Heartburn
- Hyperthyroidism
- Irritability
- Psychological Stress
- Sleep
- Sleep Disorder
- Depression
- Traffic Collision
- Heart Failure