Insomnia is caused by many different things. Anxiety, stress, coffee, and alcohol are the most common causes of insomnia.
About 25% of elderly people and about 10% of the general population have insomnia.
Secondary insomnia is insomnia caused by a underlying medical condition. Depression is a very common cause of secondary insomnia. Often, insomnia is the symptom for which people with depression seek medical attention.
People who have primary insomnia tend to be preoccupied with getting enough sleep. The more they try to sleep, the greater the sense of frustration and distress, and the more difficult sleep becomes.
Signs and tests
The health care provider will perform a physical exam. Questions regarding current medications, recreational drug use, and medical history will be asked. Usually, these are the only methods needed to make a diagnosis of insomnia.
Polysomnography, an overnight sleep study, can help rule out other types of sleep disorders (such as sleep apnea).
Insomnia(Doctor-Reviewed information)
Definition Insomnia is the inability to obtain an adequate amount or quality of sleep. The difficulty can be in falling asleep, remaining asleep, or both. People with insomnia do not feel refreshed when they wake up. Insomnia is a common symptom affecting millions of people that may be caused by many conditions, diseases, or circumstances. Description Sleep is essential for mental and physical restoration. It is a cycle with two separate states: rapid eye movement (REM), the stage in which most dreaming occurs; and non-REM (NREM). Four stages of sleep take place during NREM: stage I, when the person passes from relaxed wakefulness; stage II, an early stage of light sleep; stages III and IV, which are increasing degrees of deep sleep. Most stage IV sleep (also called delta sleep), occurs in the first several hours of sleep. A period of REM sleep normally follows a period of NREM sleep. Insomnia is more common in women and older adults. People who are divorced, widowed, or separated are more likely to have the problem than those who are married, and it is more frequently reported by those of lower socioeconomic status. Short-term, or transient, insomnia is a common occurrence and usually lasts only a few days. Long-term, or chronic, insomnia lasts more than three weeks and increases the risk for injuries in the home, at the workplace, and while driving because of daytime sleepiness and decreased concentration. Chronic insomnia can also lead to mood disorders like depression. Causes and symptoms Transient insomnia is often caused by a temporary situation in a person's life, such as an argument with a loved one, a brief medical illness, or jet lag . When the situation is resolved or the precipitating factor disappears, the condition goes away, usually without medical treatment. Chronic insomnia usually has different causes, and there may be more than one. These include: a medical condition or its treatment, including sleep apnea use of substances such as caffeine , alcohol, and nicotine psychiatric conditions such as mood or anxiety disorders stress , such as sadness caused by the loss of a loved one or a job disturbed sleep cycles caused by a change in work shift sleep-disordered breathing, such as snoring periodic jerky leg movements ( nocturnal myoclonus ), which happen just as the individual is falling asleep repeated nightmares or panic attacks during sleep Another cause is excessive worrying about whether or not a person will be able to go to sleep, which creates so much anxiety that the individual's bedtime rituals and behavior actually trigger insomnia. The more one worries about falling asleep, the harder it becomes. This is called psychophysiological insomnia.
Insomnia concerns (1 image)(Doctor-Reviewed information) Reviewer: Paul Ballas, D.O., Department of Psychiatry, Thomas Jefferson University Hospital, Philadelphia, PA. Review provided by VeriMed Healthcare Network.Date: 12/22/2006
Sleep disorders (2 images)
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(Doctor-Reviewed information)
Sleep disorders involve any difficulties related to sleeping, including difficulty falling or staying asleep, falling asleep at inappropriate times, excessive total sleep time, or abnormal behaviors associated with sleep. Reviewer: Paul Ballas, D.O., Department of Psychiatry, Thomas Jefferson University Hospital, Philadelphia, PA. Review provided by VeriMed Healthcare Network.Date: 07/25/2006
Anti-Insomnia Drugs(Doctor-Reviewed information)
Definition Anti-insomnia drugs are medicines that help people fall asleep or stay asleep. Purpose Physicians prescribe anti-insomnia drugs for short-term treatment of insomnia—a sleep problem in which people have trouble falling asleep or staying asleep or wake up too early and can't go back to sleep. These drugs should be used only for occasional treatment of temporary sleep problems and should not be taken for more than a week or two at a time. People whose sleep problems last longer than this should see a physician. Their sleep problems could be a sign of another medical problem. Description The anti-insomnia drug described here, zolpidem (Ambien), is a classified as a central nervous system (CNS) depressant. CNS depressants are medicines that slow the nervous system. Physicians also prescribe medicines in the benzodiazepine family, such as flurazepam (Dalmane), quazepam (Doral), triazolam (Halcion), estazolam (ProSom), and temazepam (Restoril), for insomnia . Benzodiazepine drugs are described in the essay on antianxiety drugs . Zaleplon (Sonata) is another anti-insomnia drug that is not related to other drugs with the same effect. The barbiturates , such as pentobarbital (Nembutal) and secobarbital (Seconal) are no longer commonly used to treat insomnia because they are too dangerous if they are taken in overdoses. For patients with mild insomnia, some antihistamines , such as diphenhydramine (Benadryl) or hydroxyzine (Atarax) may be used, since these also cause sleepiness. Zolpidem is available only with a physician's prescription and comes in tablet form. Recommended dosage The recommended dose for adults is 5-10 mg just before bedtime. The medicine works quickly, often within 20 minutes, so it should be taken right before going to bed. For older people and others who may be more sensitive to the drug's effects, the recommended starting dosage is 5 mg just before bedtime. Never take more than 10 mg of zolpidem in one 24-hour period. Overdoses can lead to excessive sleepiness or coma. Zolpidem may be taken with food or on an empty stomach, but it may work faster when taken on an empty stomach. Check with a physician or pharmacists for instructions on how to take the medicine. Precautions Zolpidem is meant only for short-term treatment of insomnia. If sleep problems last more than seven to 10 days, check with a physician. Longer-lasting sleep problems could be a sign of another medical problem. Also, this drug may lose its effectiveness when taken every night for more than a few weeks. Anti-Insomnia Drugs Brand Name (Generic Name) Possible Common Side Effects Include: Ambien (zolpidem tartrate) Daytime drowsiness, dizziness, headache Dalmane (flurazepam hydrochloride) Decreased coordination, lightheadedness, dizziness Doral (quazepam) Daytime drowsiness, headache, dry mouth, fatigue Halcion (triazolam) Decreased coordination, chest pain, memory impairment ProSom (estazolam) Dizziness, headache, nausea, weakness Restoril (temazepam) Dizziness, fatigue, nausea, headache, sluggishness Some people feel drowsy, dizzy, confused, light-headed, or less alert the morning after they have taken zolpidem. The medicine may also cause clumsiness, unsteadiness, double vision, or other vision problems the next day. For these reasons, anyone who takes these drugs should not drive, use machines or do anything else that might be dangerous until they have found out how zolpidem affects them. This medicine has caused cause behavior changes in some people, similar to those seen in people whose behavior changes when they drink alcohol. Examples include giddiness and rage. More extreme changes, such as confusion, agitation, and hallucinations , also are possible. Anyone who starts having strange or unusual thoughts or behavior while taking this medicine should get in touch with his or her physician. Zolpidem and other sleep medicines may cause a special type of temporary memory loss, in which the person does not remember what happens betwe
Sleeping difficulty (1 image)(Doctor-Reviewed information)
Sleeping problems, called insomnia, can take several forms: Difficulty falling asleep when you first go to bed at night; Waking up too early in the morning; Waking up frequently throughout the night. All types of insomnia can lead to daytime drowsiness, poor concentration, and the inability to feel refreshed and rested in the morning. Reviewer: Daniel Kantor, M.D., Director of the Comprehensive MS Center, Neuroscience Institute, University of Florida Health Science Center, Jacksonville, FL. Review provided by VeriMed Healthcare Network.Date: 03/22/2007
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