Insomnia is the feeling of inadequate or poor-quality sleep because of one or more of the following:

trouble falling asleep (initial insomnia); trouble remaining asleep through the night (middle insomnia);
waking up too early (terminal insomnia); or nonrestorative sleep that does not leave a person feeling
rested after an adequate duration of sleep. For insomnia disorder to be diagnosed, these symptoms
must be present at least three nights per week and the sleep difficulty is present for at least one month.
All of these symptoms can lead to daytime drowsiness, poor concentration, irritability, and the inability
to feel refreshed and rested upon awakening.

Insomnia is not defined by the hours of sleep a person gets or how long it takes to fall asleep. Individuals
vary in their need for and satisfaction with sleep. A key feature of insomnia is that individuals experience
distress or impairment in functioning as a result of their poor sleep.

Insomnia can be classified as episodic, persistent, or recurrent. Insomnia lasting from one month to
three months is referred to as episodic. If the symptoms last three months or longer, the insomnia is said
to be persistent. Insomnia is considered to be recurrent if it two or more episodes occur within the space
of one year. A diagnosis of insomnia can be given regardless of whether it occurs as an independent
condition or occurs alongside another condition, such as depression.

The diagnostic criteria of insomnia disorder include difficulty initiating sleep, difficulty maintaining sleep,
and early-morning awakening with inability to return to sleep. These sleep disturbances cause significant
distress and impairment in many areas of functioning, including social, academic, behavioral, and
occupational functioning.

Insomnia may cause a reduction in energy level, irritability, disorientation, dark circles under the eyes,
posture changes, and fatigue. Insomnia is also associated with factors that interfere with sleep, such as
physiological and cognitive arousal. For example, a person experiencing insomnia may be preoccupied
with an inability to sleep, and the more he or she tries to sleep, the more frustration builds and sleep is
impaired. Behaviors such as spending too much time in bed and napping and thoughts such as fear of
sleeplessness and clock monitoring can further perpetuate sleep difficulties.

Patients with insomnia are evaluated by obtaining a detailed medical history and sleep history. The sleep
history may be obtained from a sleep diary filled out by the patient or through an interview with the
patient's bed partner concerning the quantity and quality of the patient's sleep. Specialized sleep studies
may also be recommended.

Certain conditions seem to make individuals more likely to experience insomnia. Examples of these
conditions include:
Advanced age (insomnia occurs more frequently in those over age 60)

Female gender

A history of depression

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Insomnia

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Definition

Symptoms
Causes

Treatments

The glow of the alarm clock is all too familiar for many. Insomnia refers to an inability to fall asleep or
stay asleep, or a tendency to wake up too early or experience poor sleep.

Definition

Insomnia is the feeling of inadequate or poor-quality sleep because of one or more of the following:
trouble falling asleep (initial insomnia); trouble remaining asleep through the night (middle insomnia);
waking up too early (terminal insomnia); or nonrestorative sleep that does not leave a person feeling
rested after an adequate duration of sleep. For insomnia disorder to be diagnosed, these symptoms
must be present at least three nights per week and the sleep difficulty is present for at least one month.
All of these symptoms can lead to daytime drowsiness, poor concentration, irritability, and the inability
to feel refreshed and rested upon awakening.

Insomnia is not defined by the hours of sleep a person gets or how long it takes to fall asleep. Individuals
vary in their need for and satisfaction with sleep. A key feature of insomnia is that individuals experience
distress or impairment in functioning as a result of their poor sleep.

Insomnia can be classified as episodic, persistent, or recurrent. Insomnia lasting from one month to
three months is referred to as episodic. If the symptoms last three months or longer, the insomnia is said
to be persistent. Insomnia is considered to be recurrent if it two or more episodes occur within the space
of one year. A diagnosis of insomnia can be given regardless of whether it occurs as an independent
condition or occurs alongside another condition, such as depression.

Women, the elderly and individuals with a history of depression are more likely to experience insomnia.
Factors such as stress, anxiety, a medical problem, or the use of certain medications make its occurrence
more likely.

Approximately one third of adults experience some symptoms of insomnia, and 6 to 10 percent have
symptoms that are severe enough to meet criteria for a diagnosis of insomnia disorder.

Symptoms
The diagnostic criteria of insomnia disorder include difficulty initiating sleep, difficulty maintaining sleep,
and early-morning awakening with inability to return to sleep. These sleep disturbances cause significant
distress and impairment in many areas of functioning, including social, academic, behavioral, and
occupational functioning.

People with insomnia have difficulty carrying out their daily responsibilities, either because they are too
tired or because they have trouble concentrating due to lack of restful sleep.

Insomnia may cause a reduction in energy level, irritability, disorientation, dark circles under the eyes,
posture changes, and fatigue. Insomnia is also associated with factors that interfere with sleep, such as
physiological and cognitive arousal. For example, a person experiencing insomnia may be preoccupied
with an inability to sleep, and the more he or she tries to sleep, the more frustration builds and sleep is
impaired. Behaviors such as spending too much time in bed and napping and thoughts such as fear of
sleeplessness and clock monitoring can further perpetuate sleep difficulties.

Patients with insomnia are evaluated by obtaining a detailed medical history and sleep history. The sleep
history may be obtained from a sleep diary filled out by the patient or through an interview with the
patient's bed partner concerning the quantity and quality of the patient's sleep. Specialized sleep studies
may also be recommended.

Causes

Certain conditions seem to make individuals more likely to experience insomnia. Examples of these
conditions include:

Advanced age (insomnia occurs more frequently in those over age 60)

Female gender

A history of depression

There are a number of possible causes of insomnia:

Jet lag

Shift work
Wake-sleep pattern disturbances

Grief

Depression or major depression

Stress

Anxiety

Exhilaration or excitement

A bed or bedroom not conducive to sleep

Nicotine, alcohol, caffeine, food, or stimulants at bedtime

Aging

Excessive sleep during the day

Excessive physical or intellectual stimulation at bedtime

Overactive thyroid

Taking a new drug

Alcoholism

Inadequate bright-light exposure during waking hours

Abruptly stopping a medication

Medications or illicit drugs

Withdrawal of medications

Interference with sleep by various diseases

Restless leg syndrome

Stroke

Menopause and hot flashes

Gastrointestinal conditions, such as heartburn

Conditions that make it hard to breathe

Conditions that cause chronic pain, such as arthritis

Anxiety or worry-prone personality or cognitive style

Situational or episodic insomnia can resolve on their own and generally occur in people who are
temporarily experiencing one or more of the following:

Stress

Environmental noise

Extreme temperatures

Change in the surrounding environment

Sleep/wake schedule problems such as those due to jet lag

Medication side effects

Chronic insomnia is more complex and often results from a combination of factors, including underlying
physical or mental disorders. One of the most common causes of chronic insomnia is depression. Other
underlying causes include arthritis, kidney disease, heart failure, asthma, sleep apnea, narcolepsy,
restless legs syndrome, Parkinson's disease, and hyperthyroidism. However, chronic insomnia may also
be due to behavioral factors, including the misuse of caffeine, alcohol, or other substances; disrupted
sleep/wake cycles that may occur with shift work or other nighttime lifestyles; and chronic stress.

Some behaviors may prolong existing insomnia, and they can also be responsible for causing the sleeping
problem in the first place:

Worrying about the upcoming difficulty sleeping

Ingesting excessive amounts of caffeine

Drinking alcohol before bedtime

Smoking cigarettes before bedtime

Excessive napping in the afternoon or evening

Irregular or continually disrupted sleep/wake schedules

Stopping these behaviors may eliminate the insomnia.

Treatments

Situational or episodic insomnia may not require treatment since episodes typically last only a few days
or weeks at a time. For example, if insomnia is due to a temporary change in schedule, as with jet lag,
the person's biological clock will often get back to normal on its own. However, for some people who
experience daytime sleepiness and impaired performance as a result of episodic insomnia, the use of
short-acting sleeping pills may improve sleep and next-day alertness. As with all drugs, there are
potential side effects. The use of over-the-counter sleep medicines is not usually recommended for the
treatment of insomnia.

Some types of insomnia resolve when the underlying cause is treated or wears off. In general, insomnia
treatment focuses on determining the cause.

Once identified, this underlying cause can be properly treated or corrected.

faktor resiko

Insomnia can affect people of any age; it is more common in adult females than adult males. It can
undermine school and work performance, as well as contributing to obesity, anxiety, depression,
irritability, concentration problems, memory problems, poor immune system function, and reduced
reaction time.