Summary about Disease
Insomnia disorder is a common sleep disorder that makes it hard to fall asleep, hard to stay asleep, or causes you to wake up too early and not be able to get back to sleep. It can be acute (short-term) or chronic (long-term). Chronic insomnia is defined as having trouble sleeping at least three nights per week for three months or longer, despite having the opportunity to sleep. The disorder can significantly impact daily functioning, mood, concentration, and overall quality of life.
Symptoms
Difficulty falling asleep at night
Waking up during the night
Waking up too early
Feeling tired upon waking
Daytime fatigue or sleepiness
Difficulty concentrating or remembering things
Irritability, depression, or anxiety
Increased errors or accidents
Tension headaches
Worrying about sleep
Causes
Insomnia can be caused by a variety of factors, including:
Stress: Work, school, family, or financial stress can lead to temporary insomnia.
Anxiety or Depression: Mental health conditions often disrupt sleep patterns.
Medical Conditions: Chronic pain, heart disease, breathing problems (like sleep apnea), nocturia (frequent urination), restless legs syndrome, and hyperthyroidism can contribute to insomnia.
Medications: Some medications, such as those for high blood pressure, asthma, depression, and over-the-counter cold remedies, can interfere with sleep.
Poor Sleep Habits: Irregular sleep schedules, a non-conducive sleep environment, or daytime naps can disrupt the sleep-wake cycle.
Caffeine, Alcohol, and Nicotine: These substances can interfere with sleep.
Shift Work or Jet Lag: Changes in sleep schedule can cause temporary insomnia.
Aging: Sleep patterns naturally change with age, often leading to lighter and more fragmented sleep.
Medicine Used
Prescription Sleep Medications: These include drugs like eszopiclone (Lunesta), ramelteon (Rozerem), zaleplon (Sonata), and zolpidem (Ambien). These should be used under the guidance of a doctor due to potential side effects and dependency.
Antidepressants: Some antidepressants, such as trazodone or mirtazapine, are prescribed off-label to help with sleep.
Melatonin Supplements: Melatonin is a hormone that helps regulate the sleep-wake cycle.
Over-the-Counter Sleep Aids: These often contain antihistamines like diphenhydramine or doxylamine. They are generally not recommended for long-term use.
Doxepin (Silenor): This medication is a low-dose tricyclic antidepressant that is specifically approved for insomnia.
Suvorexant (Belsomra) and Lemborexant (Dayvigo): Orexin receptor antagonists that block orexin, a neurotransmitter that promotes wakefulness.
Is Communicable
No, insomnia disorder is not communicable. It is not caused by an infectious agent and cannot be spread from person to person.
Precautions
Establish a regular sleep schedule: Go to bed and wake up at the same time every day, even on weekends.
Create a relaxing bedtime routine: This might include taking a warm bath, reading, or listening to calming music.
Make your bedroom conducive to sleep: Keep it dark, quiet, and cool.
Avoid caffeine and alcohol before bed: These substances can interfere with sleep.
Avoid large meals or heavy snacks before bed: This can disrupt sleep.
Get regular exercise: But avoid exercising too close to bedtime.
Limit daytime naps: Naps can disrupt your nighttime sleep.
Manage stress: Practice relaxation techniques such as meditation or yoga.
Consider cognitive behavioral therapy for insomnia (CBT-I): CBT-I is a type of therapy that can help you change the thoughts and behaviors that contribute to insomnia.
Only use your bed for sleep and sex: Avoid watching TV, reading, or working in bed.
How long does an outbreak last?
Insomnia doesn't occur in outbreaks like infectious diseases. Insomnia can be:
Acute Insomnia: Lasts for a few days or weeks. Often triggered by a stressful event.
Chronic Insomnia: Lasts for three months or longer and occurs at least three nights per week. The duration depends entirely on the underlying cause and whether it is addressed effectively.
How is it diagnosed?
Physical Exam: To rule out underlying medical conditions.
Medical History: Includes questions about sleep habits, medical conditions, medications, and lifestyle factors.
Sleep Diary: A record of sleep patterns, including bedtime, wake time, nap times, and sleep quality.
Polysomnography (Sleep Study): A test that monitors brain waves, heart rate, breathing, and eye movements during sleep. Typically reserved for more complex cases or when sleep apnea is suspected.
Actigraphy: A wrist-worn device that tracks movement to estimate sleep patterns.
Timeline of Symptoms
The development and progression of insomnia symptoms can vary significantly.
Acute Insomnia: Symptoms often start abruptly after a stressful event, change in environment, or temporary illness. The duration is short-lived, typically resolving within days or weeks once the trigger is removed.
Chronic Insomnia: Symptoms develop over time, often gradually worsening. It persists for at least three months, with symptoms occurring at least three nights per week. The timeline can fluctuate, with periods of more severe symptoms followed by periods of relative improvement, but the underlying sleep disturbance remains. Factors like stress, lifestyle, and co-existing conditions can influence the severity and progression.
Important Considerations
Rule out underlying medical or psychiatric conditions: Insomnia is often a symptom of another problem.
CBT-I is considered the first-line treatment for chronic insomnia: It is effective and has few side effects.
Medications should be used cautiously and under the guidance of a doctor: They can have side effects and may not be a long-term solution.
Address any modifiable risk factors: Such as poor sleep hygiene, caffeine consumption, and stress.
Consistent sleep schedule is crucial: Even on weekends.
Seek professional help: If insomnia is significantly impacting your daily life.
Long-term use of sleep medications can lead to tolerance and dependence. Discuss the risks and benefits with your doctor.