Insomnia

January 2017


Definition


Insomnia is defined as a difficulty sleeping, which affects the life of the individual, especially on the socio-professional level. Insomnia may be caused by difficulty falling asleep or problems to stay asleep with frequent waking up during the night or too early. Insomnia can also refer to when sleep is not restful. Insomnia can be primary, i.e. occurring unexpectedly with no real trigger, or secondary to diseases that can be of a mental or physical order. Thus, insomnia can sometimes last only a few days, under unusual stress caused by a concern or due to a change of pace like jet lag. Acute insomnia can also be secondary to isolated pain, or acute illness, and disappear once the latter are cured. Insomnia is however sometimes more chronic and may form part of a psychiatric disorder, such as depression with, typically, early awakening, anxiety, difficulty falling asleep or a manic syndrome where the patient almost never rests. Pathologies may be responsible for these sleep problems such as restless legs that cause the patient to get up and walk. Insomnia can also be caused by sleep apnea syndrome, causing pauses in breathing during the night. Drugs or toxic substances may also be responsible for insomnia. In some cases, insomnia is chronic, with no cause being found.

Symptoms


Symptoms of insomnia can therefore take the form of:
  • difficulty falling asleep;
  • too frequent awakenings;
  • difficulty in maintaining sleep;
  • a non-restful sleep;

and thereby generate during the day:
  • headache;
  • Fatigue;
  • a significant decrease of attention;
  • sleepiness;
  • some irritability accompanied by mood disorders.

Diagnosis


The diagnosis of insomnia arises through an examination in which the doctor will try to determine the habits and lifestyle of the patient: his bedtime, activities before going to bed, average time of sleep, number of awakenings per night, wake-up time in the morning, his profession, smoking or the consumption of coffee and alcohol. A questioning of the spouse is also important, so that the doctor can know if there is snoring, pauses in breathing, movements, etc. during sleep. Blood tests may also be performed. A clinical observation during which the patient sleeps overnight with electrodes placed on the body is also possible: it is called polysomnography.

Treatment


The treatment of insomnia depends on the cause. The lifestyle of the patient may need to be modified, by reducing the amount of coffee consumed, avoiding large meals at night, sleeping at fixed hours, and by focusing on relaxing activities before bedtime. If insomnia is caused by a psychological disorder such as anxiety or depression, a doctor will consider the possibility of prescribing an appropriate medical treatment to these problems. If other conditions are discovered, their support will be necessary. In the absence of an identified pathology or improvement of life despite following the recommended instructions, treatment can be implemented for the shortest period possible.

Prevention


To prevent insomnia, it is better to sleep at regular hours, perform physical activity, sleep in a quiet environment, avoid large meals and exciting substances such as coffee or tea, especially before bedtime, to reduce consumption of cigarettes and favor a quiet activity before bedtime.

Related

Original article published by . Translated by Jeff. Latest update on November 12, 2013 at 04:43 AM by Jeff.
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