Insomnia

Insomnia, which is Latin for "no sleep," is the inability to fall asleep, remain asleep or waking up not feeling restored or refreshed.

Insomnia refers to the inability to get the amount or quality of sleep you as an individual need to wake up feeling rested. Insomnia is the most common sleep complaint among humans. In the US alone, almost 60 million complain of insomnia. It can be either acute, lasting one to several nights, or chronic, even lasting months to years. When insomnia persists for longer than a month, it is considered chronic. According to many international surveys, about 30-40% of adults say they have some symptoms of insomnia within a given year, while approximately 10 percent have associated symptoms of daytime functional impairment and about 10-15 percent of adults say they have chronic insomnia. The effects of insomnia can include daytime fatigue, impaired mood and judgment, poor performance, and an increased likelihood of accidents at home, in the workplace, and while driving.

Insomnia can be a disorder in its own right, also known as primary, or comorbid with some other disease or condition such as depression, heartburn, cancer, asthma, or arthritis, or as a result of medications or drugs, including alcohol and caffeine.

In some people insomnia is transient, can last up to one month and may be caused by many things, among them jet lag, stress, a major life change such as a new job or loss of a relationship, environmental factors like noise, or even consuming too much caffeine.

Chronic insomnia occurs when a person has insomnia a minimum of three nights a week for a month or longer. Chronic insomnia is present in either the primary or secondary forms mentioned above. In the secondary forms it usually is caused by a medical condition or medication taken for other disorders, or by alcohol consumption. Patients with chronic insomnia should be evaluated to ensure the sleep problem is not due to an underlying medical or psychiatric condition that may require treatment. Depression and anxiety are the most common causes of insomnia.

In addition, certain behaviors can contribute to insomnia, such as excessive caffeine intake, drinking alcohol or smoking cigarettes before bedtime, excessive daytime napping, and irregular or continually disrupted sleep-wake cycles. As yet, little is known about the neurobiology of insomnia; however, hyperactivity of the systems in the brain that cause arousal is believed to be involved.

As evidence mounts on the importance of sleep, the development of safe and effective treatment for insomnia continues to be a priority for sleep researchers. The approach to treatment for poor sleep generally falls into two categories: behavioral and pharmacologic. Half of all those who have experienced insomnia blame the problem on stress and worry. In the case of stress-induced insomnia, the degree to which sleep is disturbed depends on the severity and duration of the stressful situation. Sometimes this may be a disturbing occurrence like loss of a loved one, loss of a job, marital or relationship discord or a tragic occurrence. Anticipation of such things as weddings, vacations, or holidays can also disturb sleep. Insomnia can also occur with jet lag, shift work and other major schedule changes.

If your sleep trouble is confined to difficulty falling asleep, the time you are choosing to go to sleep may not be synchronized with your biological clock. The biological processes that initiate and maintain sleep in humans are active throughout the night. Opposing this sleep tendency, however, is the alerting action of the biological clock that is active throughout the day.

The prevalence of insomnia is higher among older people and women. Women suffer loss of sleep in connection with menstruation, pregnancy, and menopause. Rates of insomnia increase as a function of age but most often the sleep disturbance is attributable to some other medical condition. Some medications can lead to insomnia, including those taken for:

· colds and allergies

· high blood pressure

· heart disease

· thyroid disease

· birth control

· asthma

· pain medications

· depression (especially SSRI antidepressants)

Some common sleep disorders such as restless legs syndrome and sleep apnea can also lead to insomnia.