Insomnia is a common disorder in which there is a problem in initiating or maintaining sleep or both. It may be due to inadequate quality or quantity of sleep.
Insomnia leads to a feeling of being unfresh when awake, affects the energy level and mood, affects overall health and quality of life.
Medications and medical conditions – medications like anxiolytics, antidepressants, antiallergens and medical conditions like arthritis, diabetes, congestive heart failure, gastroesophageal reflux disease (GERD) may all cause insomnia
Circadian rhythm changes – this is seen in situations like jet lag, late night or early morning shifts leading to upsetting of the body’s wake sleep cycle and to insomnia
Poor sleep hygiene – this includes an irregular sleep schedule, uncomfortable sleep environment, some stimulating activities before bed.
Acute insomnia is the inability to consistently sleep well for a period of between three weeks to six months.
Chronic insomnia lasts for years at a time. It can be caused by another disorder, or it can be a primary disorder. Its effects can vary according to its causes. They might include sleepiness, muscular fatigue, hallucinations, and/or mental fatigue.
Transient insomnia lasts from days to weeks. It can be caused by another disorder, by changes in the sleep environment, by the timing of sleep, severe depression, or by stress.
Age above 60 years, being woman, traveling for long distances, excessive stress, mental disorder, night shifts, changing shifts and jetlags are the risk factors for insomnia.
Insomnia is diagnosed based on medical and personal history, detailed questionnaire, sleep diary of approximately two weeks, physical examination and blood tests to check for other disorders.
If there are symptoms of other sleep disorders like restless leg syndrome or sleep apnea then detailed tests are done at the sleep center.
Treatment is aimed at changing the sleep habits and treats the underlying causes.
Behavioral treatments are suggested first. They include relaxation techniques, cognitive therapy, instruction about good sleeping practices, spending limited time awake in the bedroom (stimulus control) and light therapy. Many prescription medications are also available for insomnia.
Insomnia can cause complications like overweight and obesity, reduced performance at work or school, reduced immunity, higher risk of accidents due to slow reaction time, psychiatric disorders like anxiety and depression and chronic diseases like diabetes, high blood pressure and heart disease.
Learning relaxation techniques, having a proper sleep schedule, not lying in bed when not sleeping, avoiding daytime naps, controlled intake of alcohol, caffeine and nicotine and avoiding too much eating before bedtime can help in preventing insomnia.
