Insomnia is difficulty in falling asleep or staying asleep or both. It is a term that is often used to indicate any and all stages and types of sleep loss. Insomnia is not a disorder, it is a symptom.
There are different kinds of insomnia:
- Sleep onset insomnia (delayed sleep phase syndrome) – A disorder in which the major sleep episode is delayed in relation to the desired clock time. For example, sleeping routinely between 4 am and noon. Delayed sleep phase syndrome (DSPS) is believed to be a disorder of the body's timing system – the biological clock. DSPS is found in persons who get a normal or nearly normal amount of sleep, but the entire sleep cycle is shifted later than normal.
- Diopathic insomnia – A lifelong inability to obtain adequate sleep that is presumably due to an abnormality of the neurological control of the sleep-wake system. The insomnia is long-standing, commonly beginning in early childhood, sometimes since birth.
- Psychophysiological insomnia – A disorder of somatized tension (conversion of anxiety into physical symptoms) and learned sleep-preventing association that results in a complaint of insomnia and associated decreased functioning during wakefulness.
- Childhood insomnia (limit-setting sleep disorder) – Primarily a childhood disorder that is characterized by the inadequate enforcement of bedtimes by a caretaker with resultant stalling or refusal to go to bed at the appropriate time.
Causes of Insomnia
Insomnia is often categorized by how long it lasts. Transient insomnia lasts a few days; short-term (acute) insomnia lasts several weeks; long-term (chronic) insomnia lasts for a month or longer.
Causes of transient or short-term insomnia can include:
- Extremes in weather
- Travel, particularly across time zones
- Female hormonal fluctuations
- Light and other environmental disruptions
- Partner’s sleep habits
- Certain medications
Causes of long-term insomnia can include:
- Other mental health disorders
- Medical conditions and their treatments
- Substance abuse
Insomnia Risk Factors
More than a quarter of all Americans experience short-term insomnia at some point during a year, and nearly 10 percent have long-term insomnia. Overall, insomnia is more common in women that in men. The elderly are particularly at risk for insomnia.
Insomnia itself is not life threatening, but it can increase the risk of accidents, psychiatric problems, and certain medical conditions. It can affect school and work performance, and significantly interfere with quality of life. Lack of sleep can also cause weight gain and lead to obesity.
To diagnose insomnia, your health care provider will take your medical history and do a physical exam. A diagnosis often relies mainly on the patient's description of symptoms. Your doctor may ask you to keep a sleep diary and record all sleep-related information.
If unexplained insomnia persists after treatment or there is evidence of a primary sleep disorder, such as sleep apnea or narcolepsy, your doctor may refer you to a sleep specialist at an accredited sleep disorders center.
The American Academy of Sleep Medicine (AASM) recommends a number of behavioral methods, non-prescription medications, and prescription medications as the main treatments for insomnia – behavioral methods being the first-line treatment option. According to the AASM, all of these treatment options can improve both quality and quantity of sleep for people with insomnia.
Wake Forest Baptist Sleep Disorders Center
The Wake Forest Baptist Sleep Disorders Center is accredited by the American Academy of Sleep Medicine. Our multidisciplinary team is made up of board-certified sleep specialists from neurology, pulmonary disease and pediatrics. Our team of sleep experts performs sleep studies and multiple sleep latency tests (MSLT), and provides education, advice and assistance to patients and referring physicians regarding the latest testing and treatments available for all types of sleep disorders.