Insomnia

Insomnia, also known as sleeplessness, is a sleep disorder causing difficulty falling asleep or staying asleep for as long as desired. Insomnia is typically followed by daytime sleepiness, low energy, irritability, and a depressed mood. It may result in an increased risk of accidents as well as problems focusing and learning. Insomnia can be short-term, lasting for days or weeks, or long-term, lasting more than a month. The concept of the word insomnia has two distinct possibilities: insomnia disorder or insomnia symptoms. Insomnia can occur independently or as a result of another problem. Conditions that can result in insomnia include psychological stress, chronic pain, heart failure, hyperthyroidism, heartburn, restless leg syndrome, perimenopause, menopause, certain medications, and use of drugs such as caffeine, nicotine, and alcohol. Risk factors include working night shifts and sleep apnea. Diagnosis is based on sleep habits and an examination to look for underlying causes. A sleep study may be done to look for underlying sleep disorders. Screening may be done with questions like "Do you experience difficulty sleeping?" or "Do you have difficulty falling or staying asleep?" Cognitive behavioral therapy is considered the first-line treatment. Sleep hygiene and lifestyle changes are also recommended for insomnia, though their efficacy is not definitely established. Sleep hygiene includes a consistent bedtime, a quiet and dark room, exposure to sunlight during the day and regular exercise. Sleeping pills can improve sleep, though some are associated with falls, cognitive impairment, and dependence. These medications are not recommended for more than four or five weeks but can be used longer in certain instances. Among these, lemborexant and eszopiclone have the most favorable efficacy and safety profiles. The efficacy and safety of alternative medicine treatments are unclear. Between 10% and 30% of adults have insomnia at any given point in time, and up to half of people have insomnia in a given year. About 6% of people have insomnia that is not due to another problem and lasts for more than a month. People over the age of 65 are affected more often than younger people. Women are more often affected than men. Descriptions of insomnia occur at least as far back as ancient Greece. Anthropological research has also examined how insomnia and sleep disturbance may be influenced by cultural, social, and biological factors working together. Research on industrialisation has considered the effects of artificial light, urban development, and changing work habits on sleep, suggesting that experiences of insomnia are not shaped solely by biological processes. Cross-cultural research has also shown that ideas about what constitutes ‘normal’ sleep can vary between societies, influencing how sleep difficulties are understood and experienced.

Signs and symptoms

Symptoms of insomnia:

Difficulty falling asleep, including difficulty finding a comfortable sleeping position Waking during the night, being unable to return to sleep, and waking up early Not able to focus on daily tasks, difficulty in remembering Daytime sleepiness, irritability, depression or anxiety Feeling tired or having low energy during the day Trouble concentrating Being irritable, acting aggressive, or impulsive Memory impairment Sleep onset insomnia is difficulty falling asleep at the beginning of the night, often a symptom of anxiety disorders. Delayed sleep phase disorder can be misdiagnosed as insomnia, as sleep onset is delayed much later than normal, while awakening spills over into daylight hours. It is common for people who have difficulty falling asleep to also have nocturnal awakenings with difficulty returning to sleep. Two-thirds of these people wake up in the middle of the night, with more than half having trouble falling back to sleep after a middle-of-the-night awakening. Early morning awakening occurs earlier (more than 30 minutes) than desired, with an inability to go back to sleep and before total sleep time reaches 6.5 hours. Early morning awakening is often a characteristic of depression. Anxiety symptoms may well lead to insomnia. Some of these symptoms include psychological stress, compulsive worrying about the future, feeling overstimulated, and overanalyzing past events. Chronic insomnia may take a mental toll, affecting social interactions, work, and lifestyle.

Poor sleep quality Poor sleep quality can occur as a result of, for example, restless legs, sleep apnea, or major depression. Poor sleep quality is defined as the individual not reaching stage 3 or delta sleep, which has restorative properties. Major depression leads to alterations in the function of the hypothalamic–pituitary–adrenal axis, causing excessive release of cortisol, which can lead to poor sleep quality. Nocturnal polyuria, excessive night-time urination, can also result in a poor quality of sleep.

Subjectivity

Sleep state misperception is a condition where people believe that they have been awake all night even though sleep tests prove that they have slept for hours. Also called paradoxical insomnia or subjective insomnia, paradoxical insomnia may affect only about 5% of people with insomnia. Despite sleeping for multiple hours each night and typically not experiencing significant daytime sleepiness or other symptoms of sleep loss, patients feel like they have not slept very much, if at all. They incorrectly believe it takes them an abnormally long time to fall asleep, and they underestimate how long they stay asleep.

Problematic digital media use

Causes While insomnia can be caused by many conditions, it can also occur without any identifiable cause. This is known as Primary Insomnia. Primary Insomnia may also have an initial identifiable cause but continues after the cause is no longer present. For example, a bout of insomnia may be triggered by a stressful work or life event. However, the condition may continue after the stressful event has been resolved. In such cases, the insomnia is usually perpetuated by the anxiety or fear caused by the sleeplessness itself, rather than any external factors. Symptoms of insomnia can be caused by or associated with:

… excerpt ends here. Continue reading the full article.