Primary Insomnia Glossary of Terms
The following are health and medical definitions of terms that appear in the Primary Insomnia article.
Allergy: A misguided reaction to foreign substances by the immune system, the body system of defense against foreign invaders, particularly pathogens (the agents of infection). The allergic reaction is misguided in that these foreign substances are usually harmless. The substances that trigger allergy are called allergen. Examples include pollens, dust mite, molds, danders, and certain foods. People prone to allergies are said to be allergic or atopic. Ambien: Brand name for the sedative hypnotic drug zolpidem used for sleep. For more information, see: zolpidem. Amnesia: Lack of memory. Amnesia after trauma can be antegrade or retrograde, depending upon whether the lack of memory relates to events occurring after or before the trauma. Amnesia is as compared to hypermnesia and hypomnesia. From a- + the Greek mneme, memory. Anticonvulsant: A medication used to control (prevent) seizures (convulsions) or stop an ongoing series of seizures. There are a large number of anticonvulsant drugs today including, but not limited to: phenobarbital, phenytoin (Dilantin), carbamazepine, ethosuximide (Zarontin), clonazepam (Klonopin), diazepam (Valium), lorazepam (Ativan), and midazolam (Versed). Anticonvulsant drugs taken during pregnancy put the baby at risk of major birth defects -- growth retardation, microcephaly (a small head) and deformities of the face and fingers -- a condition known as anticonvulsant embryopathy. Antidepressants: Anything, and especially a drug, used to prevent or treat depression. Antihistamines: Drugs that combat the histamine released during an allergic reaction by blocking the action of the histamine on the tissue. Antihistamines do not stop the formation of histamine nor do they stop the conflict between the IgE and antigen. Therefore, antihistamines do not stop the allergic reaction but protect tissues from some of its effects. Antihistamines frequently cause mouth dryness and sleepiness. Newer "non sedating" antihistamines are generally thought to be somewhat less effective. Antihistamine side effects that very occasionally occur include urine retention in males and fast heart rate. Anxiety: A feeling of apprehension and fear characterized by physical symptoms such as palpitations, sweating, and feelings of stress. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults. These disorders fill people's lives with overwhelming anxiety and fear. Unlike the relatively mild, brief anxiety caused by a stressful event such as a business presentation or a first date, anxiety disorders are chronic, relentless, and can grow progressively worse if not treated. Apnea: An apnea is a period of time during which breathing stops or is markedly reduced. There are two types of apneas, the more common obstructive sleep apnea and the less common central sleep apnea. Arthritis: Inflammation of a joint. When joints are inflamed they can develop stiffness, warmth, swelling, redness and pain. There are over 100 types of arthritis. (see osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, lupus, gout, pseudogout). Atypical: Not typical, not usual, not normal, abnormal. Atypical is often used to refer to the appearance of precancerous or cancerous cells. Benzodiazepines: A class of drugs that act as tranquilizers and are commonly used in the treatment of anxiety. Benzodiazepines can cause drowsiness. Biofeedback: A method of treatment that uses monitors to feed back to patients physiological information of which they are normally unaware. By watching the monitor, patients can learn by trial and error to adjust their thinking and other mental processes in order to control "involuntary" bodily processes such as blood pressure, temperature, gastrointestinal functioning, and brain wave activity. Blindness: Loss of useful sight. Blindness can be temporary or permanent. Damage to any portion of the eye, the optic nerve, or the area of the brain responsible for vision can lead to blindness. There are numerous (actually, innumerable) causes of blindness. The current politically correct terms for blindness include visually handicapped and visually challenged. Blurred vision: Lack of sharpness of vision with, as a result, the inability to see fine detail. Blurred vision can occur when a person who wears corrective lens is without them. Blurred vision can also be an important clue to eye disease. Brain: That part of the central nervous system that is located within the cranium (skull). The brain functions as the primary receiver, organizer and distributor of information for the body. It has two (right and left) halves called "hemispheres." 
Breathing: The process of respiration, during which air is inhaled into the lungs through the mouth or nose due to muscle contraction, and then exhaled due to muscle relaxation. Caffeine: A stimulant found naturally in coffee beans, tea leaves, cocoa beans (chocolate) and kola nuts (cola) and added to soft drinks, foods, and medicines. A cup of coffee has 100-250 milligrams of caffeine. Black tea brewed for 4 minutes has 40-100 milligrams. Green tea has one-third as much caffeine as black tea. Cancer: An abnormal growth of cells which tend to proliferate in an uncontrolled way and, in some cases, to metastasize (spread). Chronic: This important term in medicine comes from the Greek chronos, time and means lasting a long time. Chronic insomnia: See Insomnia, chronic. Circadian: Refers to events occurring within a 24-hour period, in the span of a full (24-hour) day, as in a circadian rhythm. Circadian rhythmicity is a fundamental property possessed by all organisms. These rhythms are driven by an internal time-keeping system: a clock. Changes in the external environment, particularly in the light-dark cycle, entrain this biologic clock. Under constant environmental conditions devoid of time cues, rhythms driven by the clock show a period near, but usually not exactly equal to, 24 hours. Cognition: The process of knowing and, more precisely, the process of being aware, knowing, thinking, learning and judging. The study of cognition touches on the fields of psychology, linguistics, computer science, neuroscience, mathematics, ethology and philosophy. Cognitive: Pertaining to cognition, the process of knowing and, more precisely, the process of being aware, knowing, thinking, learning and judging. The study of cognition touches on the fields of psychology, linguistics, computer science, neuroscience, mathematics, ethology and philosophy. Cognitive therapy: A relatively short-term form of psychotherapy based on the concept that the way we think about things affects how we feel emotionally. Cognitive therapy focuses on present thinking, behavior, and communication rather than on past experiences and is oriented toward problem solving. Cognitive therapy has been applied to a broad range of problems including depression, anxiety, panic, fears, eating disorders, substance abuse, and personality problems. Depression: An illness that involves the body, mood, and thoughts, that affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. A depressive disorder is not the same as a passing blue mood. It is not a sign of personal weakness or a condition that can be wished away. People with a depressive disease cannot merely "pull themselves together" and get better. Without treatment, symptoms can last for weeks, months, or years. Appropriate treatment, however, can help most people with depression. Dry mouth: The condition of not having enough saliva to keep the mouth wet. This is due to inadequate function of the salivary glands. Everyone has dry mouth once in a while when they are nervous, upset or under stress. But if someone has a dry mouth most all of the time, it can be uncomfortable and lead to serious health problems. Effective dose: The dose of a drug that will achieve the desired effect. Epilepsy (seizure disorder): When nerve cells in the brain fire electrical impulses at a rate of up to four times higher than normal, this causes a sort of electrical storm in the brain, known as a seizure. A pattern of repeated seizures is referred to as epilepsy. Known causes include head injuries, brain tumors, lead poisoning, maldevelopment of the brain, genetic and infectious illnesses. But in fully half of cases, no cause can be found. Medication controls seizures for the majority of patients. Fatigue: A condition characterized by a lessened capacity for work and reduced efficiency of accomplishment, usually accompanied by a feeling of weariness and tiredness. Fatigue can be acute and come on suddenly or chronic and persist. FDA: The Food and Drug Administration, an agency within the U.S. Public Health Service, which is a part of the Department of Health and Human Services. Feedback: Many biologic processes are controlled by feedback, just as the temperature in a home from a furnace is regulated by a thermostat. Geriatric medicine: The branch of medicine concerned with the diagnosis, treatment and prevention of disease in older people and the problems specific to aging. Also called geriatrics. Geriatrics: The branch of medicine concerned with the diagnosis, treatment and prevention of disease in older people and the problems specific to aging. Gland: 1. A group of cells that secrete a substance for use in the body. For example, the thyroid gland. 2. A group of cells that removes materials from the circulation. For example, a lymph gland. Heart: The muscle that pumps blood received from veins into arteries throughout the body. It is positioned in the chest behind the sternum (breastbone; in front of the trachea, esophagus, and aorta; and above the diaphragm muscle that separates the chest and abdominal cavities. The normal heart is about the size of a closed fist, and weighs about 10.5 ounces. It is cone-shaped, with the point of the cone pointing down to the left. Two-thirds of the heart lies in the left side of the chest with the balance in the right chest. Heart rate: The number of heart beats per unit time, usually per minute. The heart rate is based on the number of contractions of the ventricles (the lower chambers of the heart). The heart rate may be too fast (tachycardia) or too slow (bradycardia). The pulse is bulge of an artery from the wave of blood coursing through the blood vessel as a result of the heart beat. The pulse is often taken at the wrist to estimate the heart rate. Hepatic: Having to do with the liver. Pronounced hi-'pa-tik. From the Latin hepaticus derived from the Greek hepar meaning (not too surprisingly) the liver. Herbal: 1. An adjective, referring to herbs, as in an herbal tea. Hormone: A chemical substance produced in the body that controls and regulates the activity of certain cells or organs. Hygiene: The science of preventive medicine and the preservation of health. From the name of Hygeia, the daughter of Asklepios, the Greek god of medicine (whose staff with entwined snake is the symbol of medicine). Asklepios (known to the Romans as Aesculapius) had a number of children including not only Hygeia but also Panaceia, the patroness of clinical medicine. Hygeia also followed her father into medicine. As the patroness of health, Hygeia was charged with providing a healthy environment to prevent illness. In Greek, "hygieia" means health. Hyperactivity: A higher than normal level of activity. An organ can be described as hyperactive if it is more active than usual. Behavior can also be hyperactive. Hypochondriasis: The belief and fear of serious illness which lasts for six months, beyond and despite medical reassurance. Hypochondriacs were once viewed unsympathetically as comical figures in the way Moliere depicted them in his classic (1673) play "Le Malade Imaginaire" (The Imaginary Invalid). Hypochondriasis is now generally recognized to be a psychiatric disorder. This disorder is characterized by a preoccupation with body functions and by the interpretation of normal body sensations such as sweating and minor abnormalities such as aches as major problems of medical importance. Hypochondriasis usually begins in the teen-age years and young adulthood. Its onset is sometimes associated with an experience in which someone close, often a loved one, becomes seriously ill or dies. Idiopathic: Of unknown cause. Any disease that is of uncertain or unknown origin may be termed idiopathic. For example, acute idiopathic polyneuritis, diffuse idiopathic skeletal hyperostosis, idiopathic pulmonary fibrosis, idiopathic scoliosis, etc. Imagery: Both a mental process (as in imagining) and a wide variety of procedures used in therapy to encourage changes in attitudes, behavior, or physiological reactions. As a mental process, it is often defined as "any thought representing a sensory quality." It includes, as well as the visual, all the senses - aural, tactile, olfactory, proprioceptive, and kinesthetic. Insomnia: The perception or complaint of inadequate or poor-quality sleep because of one or more of the following: difficulty falling asleep; waking up frequently during the night with difficulty returning to sleep; waking up too early in the morning; or unrefreshing sleep. Insomnia is not defined by the number of hours of sleep a person gets or how long it takes to fall asleep. Individuals vary normally in their need for, and their satisfaction with, sleep. Insomnia may cause problems during the day, such as tiredness, a lack of energy, difficulty concentrating, and irritability. Internal medicine: A medical specialty dedicated to the diagnosis and medical treatment of adults. A physician who specializes in internal medicine is referred to as an internist. A minimum of seven years of medical school and postgraduate training are focused on learning the prevention, diagnosis, and treatment of diseases of adults. Subspecialties of internal medicine include allergy and immunology, cardiology (heart), endocrinology (hormone disorders), hematology (blood disorders), infectious diseases, gastroenterology (diseases of the gut), nephrology (kidney diseases), oncology (cancer), pulmonology (lung disorders), and rheumatology (arthritis and musculoskeletal disorders). Jet lag: A temporary disorder that causes fatigue, insomnia, and other symptoms as a result of rapid air travel across time zones. Laboratory: A place for doing tests and research procedures and preparing chemicals, etc. Although "laboratory" looks very like the Latin "laboratorium" (a place to labor, a work place), the word "laboratory" came from the Latin "elaborare" (to work out, as a problem, and with great pains), as evidenced by the Old English spelling "elaboratory" designating "a place where learned effort was applied to the solution of scientific problems." Lesion: Pronounced "lee-sion" with the emphasis on the "lee," a lesion can be almost any abnormality involving any tissue or organ due to any disease or any injury. Medical school: A school with a curriculum leading to a medical degree. The mission of every medical school includes medical teaching, research, and patient care. All medical schools share the goal of preparing students in the art and science of medicine, and providing them with the background necessary to enter the period of graduate medical education. The years of medical school preceding graduate medical education are typically divided into a preclinical phase and a clinical phase. Melatonin: A hormone produced by the pineal gland, melatonin is intimately involved in regulating the sleeping and waking cycles, among other processes. Melatonin supplements are sometimes used by people who have chronic insomnia. Always see your doctor before taking melatonin, as it is not recommended for all patients with sleep problems. Mouth: 1. The upper opening of the digestive tract, beginning with the lips and containing the teeth, gums, and tongue. Foodstuffs are broken down mechanically in the mouth by chewing and saliva is added as a lubricant. Saliva contains amylase, an enzyme that digests starch. 2. Any opening or aperture in the body. The mouth in both senses of the word is also called the os, the Latin word for an opening, or mouth. The o in os is pronounced as in hope. The genitive form of os is oris from which comes the word oral. Muscle: Muscle is the tissue of the body which primarily functions as a source of power. There are three types of muscle in the body. Muscle which is responsible for moving extremities and external areas of the body is called "skeletal muscle." Heart muscle is called "cardiac muscle." Muscle that is in the walls of arteries and bowel is called "smooth muscle." Muscle relaxant: Muscle relaxant is a term usually used to refer to skeletal muscle relaxants (drugs), which act on the central nervous system (CNS) to relax muscles. These drugs are often prescribed to reduce pain and soreness associated with sprains, strains, or other types of muscle injury. Some examples of commonly prescribed skeletal muscle relaxant medications include carisoprodol (Soma), cyclobenzaprine (Flexeril), and metaxalone (Skelaxin), which are taken in tablet form. Muscle relaxant drugs are only available by prescription in the U.S. Neurology: The medical specialty concerned with the diagnosis and treatment of disorders of the nervous system -- the brain, the spinal cord, and the nerves. Nicotine: An alkaloid (a nitrogen-containing chemical) made by the tobacco plant or produced synthetically. In the plant kingdom, nicotine is not restricted to tobacco but is widespread. The tobacco plant, Nicotiana tabacum, belongs to the nightshade family, which also includes potatoes, tomatoes, eggplant and red peppers. All contain nicotine. However, the concentration of nicotine in those vegetables is far lower than the level in tobacco. Nicotine has powerful pharmacologic effects (including increased heart rate, heart stroke volume, and oxygen consumption by the heart muscle) as well as powerful psychodynamic effects (such as euphoria, increased alertness, and a sense of relaxation). As is now well known, nicotine is also powerfully addictive. When someone becomes habituated to nicotine and then stops using it, they experience the symptoms of withdrawal, including anxiety, irritability, restlessness, shortened attention span and an intense, sometimes irresistible, craving for nicotine. Objective: In a microscope, the objective (also called the objective lens) is the lens nearest to the object being examined whereas the lens closest to the eye is termed the ocular (the eyepiece). Obstructive sleep apnea (OSA): Sleep apnea is a breathing disorder characterized by brief interruptions of breathing during sleep. It owes its name to a Greek word, apnea, meaning "want of breath." Onset: In medicine, the first appearance of the signs or symptoms of an illness as, for example, the onset of rheumatoid arthritis. There is always an onset to a disease but never to the return to good health. The default setting is good health. Pain: An unpleasant sensation that can range from mild, localized discomfort to agony. Pain has both physical and emotional components. The physical part of pain results from nerve stimulation. Pain may be contained to a discrete area, as in an injury, or it can be more diffuse, as in disorders like fibromyalgia. Pain is mediated by specific nerve fibers that carry the pain impulses to the brain where their conscious appreciation may be modified by many factors. Pharmacy: A location where prescription drugs are sold. A pharmacy is, by law, constantly supervised by a licensed pharmacist. Pineal gland: A small gland located deep within in the brain. It is believed to secrete melatonin, and may therefore be part of the body's sleep-regulation apparatus. Polysomnography: Continuous recording of specific physiologic variables during sleep. Polysomnography typically records brain wave changes (electroencephalogram), eye movements (electrooculogram), muscle tone (electromyogram), respiration, electrocardiogram (EKG), and leg movements. Pregnancy: The state of carrying a developing embryo or fetus within the female body. This condition can be indicated by positive results on an over-the-counter urine test, and confirmed through a blood test, ultrasound, detection of fetal heartbeat, or an X-ray. Pregnancy lasts for about nine months, measured from the date of the woman's last menstrual period (LMP). It is conventionally divided into three trimesters, each roughly three months long. Prescription: A physician's order for the preparation and administration of a drug or device for a patient. A prescription has several parts. They include the superscription or heading with the symbol "R" or "Rx", which stands for the word recipe (meaning, in Latin, to take); the inscription, which contains the names and quantities of the ingredients; the subscription or directions for compounding the drug; and the signature which is often preceded by the sign "s" standing for signa (Latin for mark), giving the directions to be marked on the container. Prescription drug: A drug requiring a prescription, as opposed to an over-the-counter drug, which can be purchased without one. The word "prescription" comes from the Latin "praescriptus" compounded from "prae", before + scribere, to write = to write before. Historically, a prescription was written before the drug was prepared and administered. Progressive: Increasing in scope or severity. Advancing. Going forward. In medicine, a disease that is progressive is going from bad to worse. Psychiatric: Pertaining to or within the purview of psychiatry, the medical specialty concerned with the prevention, diagnosis, and treatment of mental illness. Pulmonary: Having to do with the lungs. (The word comes from the Latin pulmo for lung). Rebound: Return of the original symptoms when maneuvers or treatment is discontinued. Relaxant: Something that relaxes, relieves, reduces tension. For example, a muscle relaxant is often administered during abdominal surgery to relax the diaphragm and keep it from moving during the surgery. Renal: Having to do with the kidney. From the Latin renes (the kidneys), which gave the French les reins which mean both the kidneys and the lower back. Residual: Something left behind. With residual disease, the disease has not been eradicated. Rule out: A term much used in medicine, meaning to eliminate or exclude something from consideration. The ACB (albumin cobalt binding) test helps rule out a heart attack in the differential diagnosis of severe chest pain. Sleep: The body's rest cycle. Sleep apnea: The temporary stoppage of breathing during sleep, often resulting in daytime sleepiness. Apnea is a Greek word that means "want of breath." Sleep disorders: Any disorder that affects, disrupts, or involves sleep. The most common sleep disorder is probably snoring, although it is usually not medically significant. Insomnia, sleep apnea, restless leg syndrome, and sleepwalking are also sleep disorders. Most large medical centers have diagnostic and treatment facilities dedicated to sleep disorders. Sleep hygiene: A series of practices and non-medical treatments for insomnia. Sleep hygiene includes simple steps that may improve initiation and maintenance of sleep, such as maintaining a regular sleep schedule, making the bedroom an inviting place to sleep, avoiding alcohol or smoking prior to going to bed, and exercising regularly (but not in the 4-5 hours prior to bedtime). Sleep restriction therapy: A type of therapy in which the number of hours of sleep are restricted. Sleeplessness: Insomnia. See also Fatal familial insomnia. Sleepwalking: Purposeful moving, usually but not always including walking, while in a deep stage of sleep. Sleepwalking occurs most frequently in children, particularly boys. Sedatives tend to exacerbate rather than cure sleepwalking. The best measures are preventative: ensure that the sleepwalker is in a safe room for walking, and cannot accidentally fall through an open window or down stairs. Some types of sleepwalking are related to seizure disorders , bipolar disorder, or other neurological conditions, but most cases are transitory and due to unknown causes. Also called somnambulism. Somnambulism: Sleepwalking. Purposeful moving, usually but not always including walking, while in a deep stage of sleep. Sleepwalking occurs most frequently in children, particularly boys. Sedatives tend to exacerbate rather than cure sleepwalking. The best measures are preventative: ensure that the sleepwalker is in a safe room for walking, and cannot accidentally fall through an open window or down stairs. Some types of sleepwalking are related to seizure disorders, bipolar disorders, or other neurological conditions, but most cases are transitory and due to unknown causes. Sonata: Sonorous brand name for the sedative hypnotic drug generically known as zaleplon, used for sleep. For more pharmaceutical information, see: zaleplon. Stress: Forces from the outside world impinging on the individual. Stress is a normal part of life that can help us learn and grow. Conversely, stress can cause us significant problems. Substance: 1. Material with particular features, as a pressor substance. Substance abuse: The excessive use of a substance, especially alcohol or a drug. (There is no universally accepted definition of substance abuse.) Symptomatic: 1 With symptoms, as a symptomatic infection. 2 Characteristic, as behavior symptomatic of Huntington disease. 3 Directed at the symptoms, as symptomatic treatment. Tension: 1) The pressure within a vessel, such as blood pressure: the pressure within the blood vessels. For example, elevated blood pressure is referred to as hypertension. 2) Stress, especially stress that is translated into clenched scalp muscles and bottled-up emotions or anxiety. This is the type of tension blamed for tension headaches. Therapy: The treatment of disease. Tobacco: A South American herb, formally known as Nicotiana tabacum, whose leaves contain 2-8% nicotine and serve as the source of smoking and smokeless tobacco. Urinary: Having to do with the kidneys, ureters, and bladder. The urinary system represents the functional and anatomic aspects of the kidneys, ureters, and bladder. Voluntary: Done in accordance with the conscious will of the individual. The opposite of involuntary. Zaleplon: Brand name: Sonata. A sedative hypnotic drug in a class closely related the benzodiazepines, affecting the central nervous system, used as a sleep drug. For more information, see: zaleplon. Zolpidem: Brand name: Ambien. A sedative hypnotic drug in a class closely related the benzodiazepines, affecting the central nervous system, used as a sleep drug. For more information, see: zolpidem.
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Primary Insomnia
What Is Insomnia?
Insomnia is the most common sleep complaint among people. Insomnia is defined as difficultly falling asleep, staying asleep, or both, resulting in inadequate length of sleep and/or poor quality of sleep, which may affect a person's ability to function during the day. Insomnia also may affect quality of life, work performance, and overall health. Insomnia is not a disease, but a symptom associated with a variety of medical, psychiatric, or sleep disorders.
What Causes Insomnia?
Insomnia is usually a transient or short-term condition (lasting less than 3 months). In some cases insomnia can become chronic (more than 6 months).
Transient insomnia specifically lasts up to 1 week and is associated with acute situational stress factors such as a job interview or exam. It usually resolves once the person has adjusted to stress factor, or it is no longer a concern. It can however reemerge when new or similar stres...
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