Insomnia is defined as difficulty initiating or maintaining sleep, or both, despite adequate opportunity and time to sleep, leading to impaired daytime functioning. Insomnia may be due to poor quality or quantity of sleep. Insomnia is very common and occurs in 30% to 50% of the general population. Approximately 10% of the population may suffer from chronic (long-standing) insomnia.
Insomnia may be divided into three classes based on the duration of symptoms.
- Insomnia lasting one week or less may be termed transient insomnia;
- short-term insomnia lasts more than one week but resolves in less than three weeks; and
- long-term or chronic insomnia lasts more than three weeks.
- Short duration sleep may be normal in some individuals who may require less time for sleep without feeling daytime impairment, the central symptom in the definition of insomnia.
- In insomnia, adequate time and opportunity for sleep is available, whereas in sleep deprivation, lack of sleep is due to lack of opportunity or time to sleep because of voluntary or intentional avoidance of sleep.
What causes insomnia?
Insomnia may have many causes and, as described earlier, it can be classified based upon the underlying cause.Situational and stress factors leading to insomnia may include:
- jet lag,
- physical discomfort (hot, cold, lighting, noise, unfamiliar surroundings),
- working different shifts,
- stressful life situations (divorce or separation, death of a loved one, losing a job, preparing for an examination),
- illicit drug use,
- cigarette smoking,
- caffeine intake prior to going to bed,
- alcohol intoxication or withdrawal, or
- certain medications.
Sleep hygiene
Sleep hygiene can play an important role in insomnia. Poor sleep hygiene includes physical factors such as:
- using the bedroom for things other than sleeping,
- eating or exercising prior to sleep,
- going to bed hungry,
- sleeping in a room with too much noise or lighting, or
- doing work in bed.
Medical and psychiatric conditions may also contribute to insomnia.
Some of these common medical conditions may include:
- breathing problems from chronic heart or lung disease (asthma, chronic obstructive pulmonary disease (COPD),
- congestive heart failure,
- obstructive sleep apnea,
- obesity,
- acid reflux,
- hyperthyroidism,
- urinary problems (frequent urination, urinary incontinence),
- chronic pain,
- fibromyalgia,
- Parkinson's disease, or
- dementia.
- depression,
- psychosis,
- mania,
- anxiety, or
- posttraumatic stress disorder (PTSD).
- menopause,
- menstrual cycle,
- pregnancy,
- fever, or
- pain.
- sleep walking,
- sleep apnea,
- restless leg syndrome (creeping sensations in the leg during sleep, relieved by leg movement),
- periodic limb movement disorder (involuntary repeated leg movement during sleep), or
- circadian sleep disturbance (unusual sleep time due to disturbed biological clock)
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