Insomnia is a sleep disorder in which people have difficulty falling asleep, staying asleep, early morning awakening or unrefreshing sleep in the setting of an adequate opportunity for sleep. About 50 percent of adults experience occasional bouts of insomnia, and one in 10 suffers from chronic insomnia. It is twice as common in women as men, and is more common in older than younger people.
There are two kinds of insomnia: Primary insomnia – sleep problems not associated with other health problems Comorbid insomnia – sleep problems due to another health condition, pain, medicine or substance abuse
What are the symptoms of insomnia? Insomnia can cause sleepiness during the day, general tiredness, irritability and problems with concentration
or memory. Insomnia varies in how long it lasts and how often it occurs. It may be short-term (acute) or long-term (chronic). Insomnia is considered chronic when it occurs at least three nights a week for a month or longer. Psychophysiological (mind-body) insomnia is a disorder in which people cannot sleep because their minds or bodies are not relaxed.
How is insomnia diagnosed? Insomnia is diagnosed by a clinical evaluation, including a physical exam, medical history and sleep history. You may be asked to keep a sleep diary for a week or two, and your doctor may want to ask your partner about the quantity and quality of your sleep. In some cases, you may be referred to a sleep laboratory for special tests.
How is insomnia treated? Insomnia is treated by practicing good sleep habits and cognitive behavioral strategies with or without the use of short-term sleep aids. In addition to treating comorbid health problems that you also may be experiencing, the most effective treatment for chronic insomnia is cognitive behavioral therapy. Cognitive
behavioral therapy for insomnia (CBT-I) is a multi-component treatment that addresses your thoughts and behaviors related to sleep. The behavioral aspects of treatment consist of two well-developed and research-supported treatment components — sleep restriction therapy and stimulus control therapy — which are aimed at improving sleep quality and quantity. The cognitive component of the treatment focuses on restructuring or changing sleep-related thoughts. These can include thoughts that increase arousal and beliefs that may interfere with insomnia treatment. Most of the evidence supporting CBT-I is from studies by
expert practitioners who have worked with patients over a specific number of sessions. Research also supports the effectiveness of CBT-I when administered in a group setting.