Insomnia is an inability
to get the amount of sleep needed to function efficiently during the daytime.
It is caused by difficulty falling asleep, difficulty staying asleep or waking
up too early in the morning. Insomnia is
rarely a “primary disease” meaning an isolated medical or mental illness but
rather a symptom of another illness. It
significant distress or impairment in daily functioning. When this occurs, an individual may develop a
preoccupation with sleep and become more and more distressed as a cycle of
striving to sleep, being frustrated and distressed at the inability to do so,
and then being less and less able to sleep.
Long-term insomnia can lead to deterioration of mood or motivation;
decreased attention, energy and concentration; and increased fatigue, body
weakness, and lethargy.
things put a person at higher risk of experiencing insomnia?
is a very common problem with over one-third of all Americans reporting
difficulty sleeping and approximately one-fifth of Americans with significant
sleep disturbances. One in 20 Americans
is prescribed a medication with the sole purpose of improving their sleep.
However, it can be dangerous to take a medication to improve one’s sleep
without further investigating the underlying cause of the symptom with one’s
variables could place a person at risk of experiencing insomnia. Insomnia is more often a symptom or a
presenting complaint, rather than an independent diagnosis,
mental health conditions could place one at higher risk of insomnia:
depression, mania, anxiety to name a few;
existence of a general medical condition, for example, pain, breathing
problems, other neurological disorders;
use or abuse;
problems such as sleep apnea.
insomnia be treated? How?
treatment of insomnia should be directed at the identifiable causes.
Psychosocial, behavioral, and pharmacological approaches may be helpful. Cognitive behavioral therapy as well as other
therapies may be helpful.
“sleep hygiene” (or sleeping habits or routines) is a “first-line” treatment of
choice for most people with insomnia. Relaxation techniques may
be useful in helping people to feel “ready to go to sleep” and in decreasing
the anxiety experienced by many people with insomnia associated with falling
asleep. Medications may be effective,
but one must be aware of side effects, tolerance, and addiction issues with
many of these medications. Melatonin may
have a role in prevention and treatment of sleep disturbances, but your physician
should be watchful and prudent about its use until its effectiveness is proven.
does insomnia progress?
typically begins in adolescence or early adulthood and has a fairly sudden
onset at a time of psychological, social, or medical stress. Its course may be limited to several months,
but in 50% - 75% of the cases, chronic symptoms may last for more than 1
year. In some cases, the course is
episodic with periods of better or worse sleep occurring in response to life
events such as vacations or stress.
people with insomnia get better?
prognosis of insomnia is variable and depends on the duration and cause. The prognosis for insomnia due to rapid
travel across time zones (that is jet lag) is good and the symptoms usually go
away within a few days. Outcomes of short term insomnia like insomnia caused
due to stress are usually very good and related to improvement of the stressful
condition. Chronic insomnia can
sometimes be difficult to treat. People with chronic insomnia usually need
detailed evaluation for proper diagnosis and treatment. Prognosis or outcome of
chronic insomnia can be influenced by other medical conditions, such as
arthritis, mental health disorders, congestive heart failure, chronic
obstructive pulmonary disease (COPD), and chronic pain syndromes. Insomnia due to mental health disorder like
depression or anxiety will need treatment of the underlying cause.
Sources and Links
· For a good listing of the diagnostic criteria of insomnia see http://psychcentral.com/disorders/sleep/insomnia.htm
· If you were in physical pain, you’d see a doctor to find out what’s wrong. Your mental health is just as important. Learn more here about how to check yourself, from getting a mental health screening to visiting a counseling center. You can use the anonymous Self Evaluator to learn if a treatable mental health problem, including insomnia, could be affecting you or a friend. Be proactive about your mental health: it’s the first step to feeling better. http://www.ulifeline.org/COD/self_evaluator
· The United States National Center for Complementary and Alternative Medicine (NCCAM) mission is to define, through rigorous scientific investigation, the usefulness and safety of complementary and alternative medicine interventions and their roles in improving health and health care. They do that by advancing the science and practice of symptom management; developing effective, practical, personalized strategies for promoting health and well-being; and enabling better evidence-based decision making regarding CAM use and its integration into health care and health promotion. Information available there about complementary and alternative treatments for insomnia, for example, can be found at http://nccam.nih.gov/health/sleep.