Insomina
What is Insomnia
Lack of sleep, or insomnia, is the commonest of sleep disorders. Most of us would have had insomnia at some point in our lives. Usually it occurs during times of stress and subsides in a few days/weeks without treatment.
Most of us would have had insomnia at some point in our lives. Acute insomnia lasting for less than three months affects 35% of the population. Usually it occurs during times of stress and subsides in a few days/weeks without treatment.
Insomnia lasting for three months or more is known as Chronic Insomnia Disorder. Approximately 10% of the population report having chronic insomnia.
Patients with insomnia presents with one or more of the following symptoms:
- Difficulty falling asleep
- Difficulty staying asleep
- Waking up too early
- Feeling not refreshed after sleep
Insomnia often causes daytime symptoms such as fatigue, irritability, and difficulty with attention, concentration and memory, poor performance at work . Long-term, chronic insomnia may be associated with depression and drug and alcohol abuse.
Diagnosis of Insomnia:
Insomnia may occur on its own, or can be associated with other sleep disorders, medical conditions or psychological/psychiatric conditions. Patients with Restless Legs Syndrome often present with insomnia as their main complaint. Obstructive sleep apnoea, particularly in women may manifest as difficulty in staying asleep. Patients with Circadian Rhythm Sleep Disorders, particularly Delayed Sleep-Wake Phase Disorder often present with difficulty in falling asleep. Many general medical conditions interrupt sleep and cause insomnia. Various psychiatric disorders particularly anxiety, depression, psychotic conditions and others can have insomnia as an associated symptom.
A thorough clinical history is essential to find out the underlying causes of insomnia. This should be followed by a detailed sleep diary, which will help to closely assess various sleep parameters and guide treatment.
If other sleep disorders are suspected, one may need to do appropriate sleep studies to confirm the diagnosis.
The Insomnia Severity Index (ISI) is a self-reported questionnaire measure to assess the severity of insomnia. Please click here to access the ISI.
Treatment of insomnia:
Hypnotic Medications:
Insomnia may be treated with hypnotic medications. Hypnotics are recommended for short term treatment, but are not advisable for long term use.
Cognitive Behavioural Therapy for Insomnia (CBT-I): The National Institute for Health and Care Excellence recommends Cognitive Behavioural Therapy for Insomnia (CBT-I). Please click here to access the page on CBT-I
Diagnosis of Insomnia:
Insomnia may occur on its own, or can be associated with other sleep disorders, medical conditions or psychological/psychiatric conditions. Patients with Restless Legs Syndrome often present with insomnia as their main complaint. Obstructive sleep apnoea, particularly in women may manifest as difficulty in staying asleep. Patients with Circadian Rhythm Sleep Disorders, particularly Delayed Sleep-Wake Phase Disorder often present with difficulty in falling asleep. Many general medical conditions interrupt sleep and cause insomnia. Various psychiatric disorders particularly anxiety, depression, psychotic conditions and others can have insomnia as an associated symptom.
A thorough clinical history is essential to find out the underlying causes of insomnia. This should be followed by a detailed sleep diary, which will help to closely assess various sleep parameters and guide treatment.
If other sleep disorders are suspected, one may need to do appropriate sleep studies to confirm the diagnosis.
The Insomnia Severity Index (ISI) is a self-reported questionnaire measure to assess the severity of insomnia. Please click here to access the ISI.
Treatment of insomnia:
Hypnotic Medications:
Insomnia may be treated with hypnotic medications. Hypnotics are recommended for short term treatment, but are not advisable for long term use.
Cognitive Behavioural Therapy for Insomnia (CBT-I): The National Institute for Health and Care Excellence recommends Cognitive Behavioural Therapy for Insomnia (CBT-I). Please click here to access the page on CBT-I
