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Insomnia

This article is about the sleeping disorder. For other uses, see Insomnia (disambiguation).
"Trouble sleeping" redirects here. For other uses, see Trouble sleeping (disambiguation).

Insomnia
Other namesSleeplessness, trouble sleeping
Depiction of insomnia from the 14th century medical manuscript Tacuinum Sanitatis
Pronunciation
SpecialtyPsychiatry, Clinical Psychology, Sleep Medicine
SymptomsTrouble sleeping, daytime sleepiness, low energy, irritability, depressed mood[1]
CausesUnknown, psychological stress, chronic pain, heart failure, hyperthyroidism, heartburn, restless leg syndrome, obstructive sleep apnea, others[2]
Diagnostic methodBased on symptoms, sleep study[3]
Differential diagnosisDelayed sleep phase disorder, restless leg syndrome, sleep apnea, psychiatric disorder[4]
TreatmentSleep hygiene, cognitive behavioral therapy, sleeping pills[5][6][7]
Frequency~20%[8][9][10]

Insomnia, also known as sleeplessness, is a sleep disorder where people have difficulty sleeping.[1][11] They may have difficulty falling asleep, or staying asleep for as long as desired.[1][9][12] Insomnia is typically followed by daytime sleepiness, low energy, irritability, and a depressed mood.[1] It may result in an increased risk of accidents of all kinds as well as problems focusing and learning.[9] Insomnia can be short term, lasting for days or weeks, or long term, lasting more than a month.[1] The concept of the word insomnia has two distinct possibilities: insomnia disorder (ID) or insomnia symptoms, and many abstracts of randomized controlled trials and systematic reviews often underreport on which of these two possibilities the word refers to.[13]

Insomnia can occur independently or as a result of another problem.[2] Conditions that can result in insomnia include psychological stress, chronic pain, heart failure, hyperthyroidism, heartburn, restless leg syndrome, menopause, certain medications, and drugs such as caffeine, nicotine, and alcohol.[2][8] Insomnia is also common in people with ADHD,[14] and children with autism.[15] Other risk factors include working night shifts and sleep apnea.[9] Diagnosis is based on sleep habits and an examination to look for underlying causes.[3] A sleep study may be done to look for underlying sleep disorders.[3] Screening may be done with questions like "Do you experience difficulty sleeping?" or "Do you have difficulty falling or staying asleep?"[9]

Although their efficacy as first line treatments is not unequivocally established,[16] sleep hygiene and lifestyle changes are typically the first treatment for insomnia.[5][7] Sleep hygiene includes a consistent bedtime, a quiet and dark room, exposure to sunlight during the day and regular exercise.[7] Cognitive behavioral therapy may be added to this.[6][17] While sleeping pills may help, they are sometimes associated with injuries, dementia, and addiction.[5][6] These medications are not recommended for more than four or five weeks.[6] The effectiveness and safety of alternative medicine are unclear.[5][6]

Between 10% and 30% of adults have insomnia at any given point in time, and up to half of people have insomnia in a given year.[8][9][10] About 6% of people have insomnia that is not due to another problem and lasts for more than a month.[9] People over the age of 65 are affected more often than younger people.[7] Women are more often affected than men.[8] Descriptions of insomnia occur at least as far back as ancient Greece.[18]

  1. ^ a b c d e f "What Is Insomnia?". Health Topics. NHLBI. 24 March 2022. Archived from the original on 28 July 2016. Retrieved 26 November 2023.
  2. ^ a b c "What Causes Insomnia?". NHLBI. 13 December 2011. Archived from the original on 28 July 2016. Retrieved 9 August 2016.
  3. ^ a b c "How Is Insomnia Diagnosed?". NHLBI. 13 December 2011. Archived from the original on 11 August 2016. Retrieved 9 August 2016.
  4. ^ Watson NF, Vaughn BV (2006). Clinician's Guide to Sleep Disorders. CRC Press. p. 10. ISBN 978-0-8493-7449-4.
  5. ^ a b c d "How Is Insomnia Treated?". NHLBI. 13 December 2011. Archived from the original on 28 July 2016. Retrieved 9 August 2016.
  6. ^ a b c d e Qaseem A, Kansagara D, Forciea MA, Cooke M, Denberg TD (July 2016). "Management of Chronic Insomnia Disorder in Adults: A Clinical Practice Guideline From the American College of Physicians". Annals of Internal Medicine. 165 (2): 125–133. doi:10.7326/M15-2175. PMID 27136449.
  7. ^ a b c d Wilson JF (January 2008). "In the clinic. Insomnia". Annals of Internal Medicine. 148 (1): ITC13–1–ITC13–16. doi:10.7326/0003-4819-148-1-200801010-01001. PMID 18166757. S2CID 42686046.
  8. ^ a b c d "Dyssomnias" (PDF). WHO. pp. 7–11. Archived from the original (PDF) on 18 March 2009. Retrieved 25 January 2009.
  9. ^ a b c d e f g Roth T (August 2007). "Insomnia: definition, prevalence, etiology, and consequences". Journal of Clinical Sleep Medicine (Supplement). 3 (5 Suppl): S7–10. doi:10.5664/jcsm.26929. PMC 1978319. PMID 17824495.
  10. ^ a b Tasman A, Kay J, Lieberman JA, First MB, Riba M (2015). Psychiatry, 2 Volume Set (4 ed.). John Wiley & Sons. p. 4253. ISBN 978-1-118-75336-1. Archived from the original on 2023-01-12. Retrieved 2017-09-01.
  11. ^ "Insomnia: Causes, symptoms, and treatments". www.medicalnewstoday.com. 2020-07-16. Retrieved 2024-07-25.
  12. ^ Punnoose AR, Golub RM, Burke AE (June 2012). "Insomnia". JAMA (JAMA patient page). 307 (24): 2653. doi:10.1001/jama.2012.6219. PMID 22735439.
  13. ^ Banno M, Tsujimoto Y, Kohmura K, Dohi E, Taito S, Someko H, et al. (September 2022). "Unclear Insomnia Concept in Randomized Controlled Trials and Systematic Reviews: A Meta-Epidemiological Study". International Journal of Environmental Research and Public Health. 19 (19): 12261. doi:10.3390/ijerph191912261. PMC 9566752. PMID 36231555.
  14. ^ Wynchank D, Ten Have M, Bijlenga D, Penninx BW, Beekman AT, Lamers F, et al. (2018-03-15). "The Association Between Insomnia and Sleep Duration in Adults With Attention-Deficit Hyperactivity Disorder: Results From a General Population Study". Journal of Clinical Sleep Medicine. 14 (3): 349–357. doi:10.5664/jcsm.6976. ISSN 1550-9397. PMC 5837836. PMID 29458702.
  15. ^ Cortesi F, Giannotti F, Ivanenko A, Johnson K (July–August 2010). "Sleep in children with autistic spectrum disorder". Sleep Medicine. 11 (7): 659–664. doi:10.1016/j.sleep.2010.01.010. PMID 20605110.
  16. ^ Edinger JD, Arnedt JT, Bertisch SM, Carney CE, Harrington JJ, Lichstein KL, et al. (February 2021). "Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment". Journal of Clinical Sleep Medicine. 17 (2): 263–298. doi:10.5664/jcsm.8988. PMC 7853211. PMID 33164741.
  17. ^ Trauer JM, Qian MY, Doyle JS, Rajaratnam SM, Cunnington D (August 2015). "Cognitive Behavioral Therapy for Chronic Insomnia: A Systematic Review and Meta-analysis". Annals of Internal Medicine. 163 (3): 191–204. doi:10.7326/M14-2841. PMID 26054060. S2CID 21617330.
  18. ^ Attarian HP (2003). "chapter 1". Clinical Handbook of Insomnia. Springer Science & Business Media. ISBN 978-1-59259-662-1.

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