Conditions InDepth: Insomnia
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Insomnia is defined as inadequate or poor-quality sleep. Types of insomnia include:
- Transient insomnia— lasts from one night to a few weeks
- Intermittent insomnia—happens from time to time
- Chronic insomnia—happens on most nights and lasts a month or more
Insomnia may take the form of difficulty falling asleep, or middle-of-the-night or early-morning awakening.
Over the course of a year about one third of adults experience some level of insomnia, and 10%-15% have more severe or chronic insomnia. Insomnia may cause problems during the day, such as tiredness, a lack of energy, difficulty concentrating, and irritability. Insomnia is not a disease. Instead, it is a result of a behavior or a symptom of an underlying mental or physical problem. There are many causes of insomnia.
Transient and intermittent insomnia generally occur in people who are temporarily experiencing one or more of the following:
- A life crisis or stress
- A change in the sleep environment, including factors such as noise, light, or temperature
- Sleep/wake schedule problems, such as those due to jet lag or temporary shift work
- Side effects of medication
Chronic insomnia often results from a combination of factors. Medical conditions or factors that may disrupt sleep include:
- Depression
- Anxiety
- Arthritis
- Conditions that cause chronic pain
- Kidney disease
- Heart failure
- Asthma
- Sleep apnea
- Narcolepsy
- Restless legs syndrome
- Parkinson's disease
- Dementia or Alzheimer’s Disease
- Hyperthyroidism
- Gastroesophageal reflux disease
- Pregnancy
- Menopause
- Aging
- Sickle cell disease
Chronic insomnia may also be due to behavioral factors. These include:
- Misuse of nicotine , caffeine , alcohol , or other substances
- Disrupted sleep/wake cycles from shift work or other nighttime activity schedules
- Chronic stress
For some people, insomnia is aggravated by:
- Expecting to have difficulty sleeping and worrying about it
- Excessive napping in the afternoon or evening
What are the risk factors for insomnia?
What are the symptoms of insomnia?
How is insomnia diagnosed?
What are the treatments for insomnia?
Are there screening tests for insomnia?
How can I reduce my risk of insomnia?
What questions should I ask my doctor?
What is it like to live with insomnia?
Where can I get more information about insomnia?
References:
Morgenthaler T, Kramer M, Alessi C, et al. Practice parameters for the psychological and behavioral treatment of insomnia: an update. An American Academy of Sleep Medicine report. Sleep. 2006;29:1415-1419.
National Center on Sleep Disorders Research website. Available at: http://www.nhlbi.nih.gov/about/ncsdr/index.htm .
National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/ .
National Sleep Foundation website. Available at: http://www.sleepfoundation.org/ .
Your guide to healthy sleep. National Center on Sleep Disorders Research. National Heart, Lung, and Blood Institute website. November 2005. NIH Publication No. 06-5271. National Heart Lung and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/public/sleep/healthy_sleep.pdf . Accessed February 11, 2009.
Last reviewed February 2009 by Rimas Lukas, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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