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February 8, 2012
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Insomnia Medications

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Acute & Chronic Insomnia

Insomnia (in-SOM-ne-ah) is a common sleep disorder. People who have insomnia have trouble falling asleep, staying asleep, or both. As a result, they may get too little sleep or have poor-quality sleep. They may not feel refreshed when they wake up.

Insomnia can be acute (short-term) or chronic (ongoing). Acute insomnia is common and often is brought on by situations such as stress at work, family pressures, or a traumatic event. Acute insomnia lasts for days or weeks.

Chronic insomnia lasts for a month or longer. Most cases of chronic insomnia are secondary, which means they are the symptom or side effect of some other problem. Certain medical conditions, medicines, sleep disorders, and substances can cause secondary insomnia.

In contrast, primary insomnia isn't due to medical problems, medicines, or other substances. It is its own distinct disorder, and its cause isn’t well understood. Many life changes can trigger primary insomnia, including long-lasting stress and emotional upset.

Insomnia can cause daytime sleepiness and a lack of energy. It also can make you feel anxious, depressed, or irritable. You may have trouble focusing on tasks, paying attention, learning, and remembering. These problems can prevent you from doing your best at work or school.

Insomnia also can cause other serious problems. For example, you may feel drowsy while driving, which could lead to an accident.

SOURCE:
National Heart, Lung, and Blood Institute. What is 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 stressors occur. Causes of short-term (acute) insomnia are typically related to more significant or persistent stress sources, which may be environmental factors such as too much noise, light, temperature extremes, or an uncomfortable bed ,or situational factors including relationship concerns or losses (for example, death of a family member).

Causes of chronic insomnia are more variable and are associated with underlying causes which include the following:

Medical disorders

Neurologic disorders

Psychiatric disorders

Drug-related insomnia

Sleep disorders causing insomnia
  • Restless leg syndrome (RLS) is characterized by the urge to move the legs usually accompanied by an uncomfortable sensation in the legs such a crawling, burning, aching or cramping sensations. RLS often occurs at night while sitting and relaxing, and the sensation and the urge to move is often relieved by movement.
  • Periodic limb movement disorder (PLMD) occurs during sleep and involves periodic movements of the lower legs, causing brief mini-awakenings (arousals from sleep). Severe cases can cause significant sleep interruption and insomnia.
  • Sleep apnea is a less common cause of insomnia. This condition is associated with loud snoring and frequent brief awakenings during the night. Many factors, including abnormalities or altered anatomy of the structures in the nose or throat, may cause this condition.
  • Circadian rhythm disorders (disruption of an individual's "biological clock") may occur when a person stays up later and sleeps later, then has difficulty returning to a more normal sleep schedule. People who work during the night ("graveyard shift") frequently have problems with insomnia. Insomnia due to jet lag is also a disruption of the normal Circadian rythym.

Primary insomnia

Primary insomnia may be diagnosed when all other disorders have been excluded. Primary insomnia is often referred to as psychophysiologic insomnia. This disorder often results from a period of stress in a person's life. Normally, this condition resolves over time, but for some, insomnia results in ongoing tension and an inability to sleep. Bad sleep habits develop, and the person begins to worry about his or her sleep, worsening the symptoms of insomnia. The bad habits must be "unlearned," and the person educated regarding good sleep hygiene practices.

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Insomnia Medications

Insomnia Overview

Most adults have experienced insomnia or sleeplessness at one time or another in their lives. An estimated 30%-50% of the general population are affected by insomnia, and 10% have chronic insomnia.

Insomnia is a symptom, not a stand-alone diagnosis or a disease. By definition, insomnia is "difficulty initiating or maintaining sleep, or both" or the perception of poor quality sleep. Insomnia may therefore be due to inadequate quality or quantity of sleep. Insomnia is not defined by a specific number of hours of sleep that one gets, since individuals vary widely in their sleep needs and practices. Although most of us know what insomnia is and how we feel and perform after one or more sleepless nights, few seek medical advice. Many people remain unaware of the behavioral and medical options available to treat insomnia.

Insomnia is generally classified based on the duration of the problem. Not everyone agrees on one definition, but general...

Read the Insomnia article »


Read What Your Physician is Reading on Medscape

Insomnia »

Insomnia is defined as repeated difficulty with the initiation, duration, maintenance, or quality of sleep that occurs despite adequate time and opportunity for sleep that results in some form of daytime impairment.

Read More on Medscape Reference »

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