Insomnia Overview

Insomnia is characterized by the inability to fall asleep or stay asleep throughout the night, resulting in poor quality sleep. On an average, 30% to 50% of the American population is affected by insomnia, of which 10% have chronic insomnia. It affects all age groups, with more incidences seen in women than in men. Insomnia results in drowsiness during the day, a feeling of general tiredness, memory problems and irritability. If left untreated, it may manifest into chronic insomnia that eventually leads to headaches, severe depression and a weak immune system, and susceptibility to illnesses. It even leads to a poor state of alertness, raising the risk of auto accidents. Mild insomnia can be treated easily by following healthy sleeping habits. But, chronic insomnia needs to be taken care of by a qualified health care provider. 

Insomnia is more of a symptom than a disease. Based on its duration of occurrence, insomnia can be classified into 3 categories: transient, short term and chronic. Transient insomnia lasts for less than 7 days, short term insomnia lasts from 1 to 3 weeks, and chronic insomnia lasts longer than 3 weeks.

Emotional and physical factors causing insomnia are severe stress from certain situations in life (exam stress, unemployment, relationship problems etc.), jet lag, changes in work shift, a terminal illness, complicated surgery or hospitalization, physical discomfort while sleeping. Environmental factors like noise, insects, climate etc and withdrawal from drugs and alcohol can also induce insomnia.

Insomnia can be properly diagnosed using sleep studies and carefully examining the history of the patient. Sleep history of the patient is noted down over a certain period of time. This includes making a note of bed times, estimated time needed to go to sleep, number of awakenings at night, and the total amount of time the patient is asleep. The patient may be referred to a sleep laboratory if insomnia has not responded to medical or behavioral treatment, or if a breathing disorder related to sleep is suspected. All this helps in correct diagnosis as well as monitoring the treatment of insomnia.

Insomnia, if left untreated, affects the quality of life and general health of the patient. Insomnia can be treated with and without medicines. Treatment without medicines incorporates lifestyle changes, like following healthy sleep habits and change in food habits in addition to cognitive behavioral therapy (CBT). CBT offers long term results. This is suitable for mild to moderate insomnia. Medicines are prescribed in case of chronic insomnia, for both short term and long term use. These include sleep inducers, anti-histamines and hypnotics.

A few prescription medicines and over the counter drugs can lead to dependency, and may have other psychological or physiological side effects like dizziness, decreased sex drive, nausea or constipation. These medications must be taken only in consultation with a qualified health care provider. 

Insomnia in its early stages can be taken care of by the patient him/herself. In case of chronic insomnia, he/she may require the assistance of his/her immediate family in addition to a proper health care provider. Proper diagnosis and treatment, in addition to good food and relaxation techniques, can provide relief from insomnia.