Insomnia | |
---|---|
Other names | Sleeplessness, trouble sleeping |
Depiction of insomnia from the 14th century medical manuscript Tacuinum Sanitatis | |
Pronunciation | |
Specialty | Psychiatry, sleep medicine |
Symptoms | Trouble sleeping, daytime sleepiness, low energy, irritability, depressed mood[1] |
Complications | Motor vehicle collisions[1] |
Causes | Unknown, psychological stress, chronic pain, heart failure, hyperthyroidism, heartburn, restless leg syndrome, others[2] |
Diagnostic method | Based on symptoms, sleep study[3] |
Differential diagnosis | Delayed sleep phase disorder, restless leg syndrome, sleep apnea, psychiatric disorder[4] |
Treatment | Sleep 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 trouble 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 possibilities: insomnia disorder (ID) and insomnia symptoms, and many abstracts of randomized controlled trials and systematic reviews often underreport on which of these two possibilities the word insomnia refers to.[13]
Insomnia can occur independently or as a result of another problem.[2] Conditions that can result in insomnia include ADHD, psychological stress, chronic pain, heart failure, hyperthyroidism, heartburn, restless leg syndrome, menopause, certain medications, and drugs such as caffeine, nicotine, and alcohol.[2][8] 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 two questions: "do you experience difficulty sleeping?" and "do you have difficulty falling or staying asleep?"[9]
Although their efficacy as first line treatments is not unequivocally established,[14] 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][15] 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 is 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.[16]
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