The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) by American Psychiatric Association defines an insomnia disorder as one with a predominant complaint of dissatisfaction with sleep quantity or quality that causes clinically significant distress or impairment in social, occupational, educational, academic, behavioral, or other important areas of functioning.
The recommended amount of sleep for adults for the best health and wellbeing is seven or more hours per night. Short sleep duration is defined as less than seven hours of sleep per 24-hour period.
What Are Symptoms of Insomnia?
Symptoms of insomnia include:
- Difficulty falling asleep
- Difficulty staying asleep
- Early-morning awakening with inability to return to sleep
- Variable sleep
- Daytime fatigue or sleepiness
- Difficulty concentrating
- Decreased motivation or energy
- Increased errors or accidents
- Persistent worry about sleep
What Causes Insomnia?
Insomnia may be caused by multiple factors. The main cause of insomnia is believed to be a state of mental and/or physical hyperarousal that interferes with falling asleep or staying asleep.
Causes of insomnia include:
- Changes in sleeping environment
- Illnesses, especially those that cause stress or difficulty breathing
- Unhealthy lifestyle habits
- Unhealthy diet choices
- Use of or withdrawal from some medications and illegal drugs
- Irregular sleep habits
- Irregular sleep schedules that disrupt the circadian rhythm such as jet lag or shift work
- Mental health problems
- Neurological disorders
- Other sleep disorders
- Age: teenagers and elderly experience insomnia more frequently
- May not have a known cause
How Is Insomnia Diagnosed?
Sleep disorders are diagnosed with a patient history and physical exam. Tests or procedures that may be used to diagnose sleep disorders or to rule out other underlying conditions include:
- Daily sleep log
- Sleep study (polysomnography)
- Record of activity and movement with a monitor or motion detector, generally worn on the wrist throughout the day and night (actigraphy)
- Home devices that monitor breathing, oxygen saturation, position, and heart rate
- Home sleep apnea testing
- Melatonin sampling
- Core body temperature measurements
- Hormone tests
- Computerized tomography (CT) scan
- Magnetic resonance imaging (MRI) of the brain
- Electrocardiogram (“ECG”)
- Pulmonary function tests
What Is the Treatment for Insomnia?
Treatment for insomnia includes:
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