Insomnia

Insomnia

Insomnia is a sleep disorder characterised by dissatisfaction with sleep quantity or quality and difficulty either falling asleep or maintaining sleep. Accompanying these sleep complaints is clinically significant distress or impairment of important areas of social, occupational or physiological functioning.

Insomnia can occur at different times in the sleep period:

• Sleep onset – involves difficulty falling sleep at bedtime
• Sleep maintenance – involves numerous or extended awakenings through the night
• Late –  involves early morning awakenings with an inability to return to sleep

Insomnia can be categorised into four different types:

• Primary – describes sleep problems not associated with any other medical condition.
• Secondary – describes sleep problems caused by other factors such as pain, medication use or a medical condition.
• Acute – is short-term and describes sleep problems lasting a few days to a few weeks.  Often caused by situation specific factors, which are unlikely to remain long term. Stress, physical discomfort and environmental variables (ie; altered light, noise, temperature) or a disruption to normal sleep habits and cycles through night shift or jetlag can all contribute to acute insomnia.
• Chronic – describes long-term sleep problems and may last anywhere from a few months to many years. Long-term pain, stress, anxiety or depressions are often contributing factors.

Effectively treatment requires careful evaluation to identify underlying causes. Your doctor or sleep specialist would collect a detailed history which may include the following:

• Review of a self report sleep diary
• Review of an insomnia severity questionnaire
• Assessment of sleep hygiene issues
• Conducting a sleep study to exclude other sleep disorders such as sleep apnea or leg movements during sleep

Treatment may involve thought and behaviour changing therapies or short term medication where appropriate and are sometimes used in conjunction with each other.