Insomnia is a symptom, not a stand-alone diagnosis or a
disease. By definition, insomnia is "difficulty initiating or maintaining
sleep, or both" and it may 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 generally:
Symptoms lasting less than one week are classified as Transient
Symptoms between one to three weeks are classified as Short-term
Those longer than three weeks are classified as Chronic
Insomnia may be caused by a host of different reasons. These causes may be
divided into situational factors, medical or psychiatric conditions, or primary
sleep problems. Insomnia could also be classified by the duration of the
symptoms into Transient, Short-term, or Chronic. Transient insomnia generally
last less than seven days; short-term insomnia usually lasts for about one to
three weeks, and chronic insomnia lasts for more than three weeks.
Many of the causes of Transient and Short-term Insomnia are similar and
Changes in shift work
Excessive or unpleasant noise
Uncomfortable room temperature (too hot or too cold)
Stressful situations in life (exam preparation,
unemployment, divorce, or separation)
Presence of an acute medical or surgical illness or
Withdrawal from drug, alcohol, sedative, or stimulant
Insomnia related to high altitude (mountains)
Causes of Chronic or long-term Insomnia
The majority of causes of chronic or long-term insomnia are usually linked to an
underlying psychiatric or physiologic (medical) condition.
Psychological related insomnia
The most common psychological problems that may lead to insomnia include:
In fact, insomnia may be an indicator of depression. Many
people will have insomnia during the acute phases of a mental illness.
Medication related Insomnia
Certain medications have also been associated with insomnia. Among them are:
Certain over-the-counter cold and asthma preparations.
The prescription varieties of these medications may also
contain stimulants and thus produce similar effects on sleep.
Certain medications for high BP have also been associated
with poor sleep.
Some medications used to treat depression, anxiety, and
Other causes of Insomnia
Common stimulants associated with poor sleep include caffeine and nicotine. You
should consider not only restricting caffeine and nicotine use in the hours
immediately before bedtime but also limiting your total daily intake.
People often use alcohol to help induce sleep, as a nightcap. However, it is a
poor choice. Alcohol is associated with sleep disruption and creates a sense of
nonrefreshed sleep in the morning.
A disruptive bed partner with loud snoring or periodic leg movements also may
impair your ability to get a good night's sleep.
High risk groups for Insomnia
In addition to the above medical conditions, certain groups may be at higher
risk for developing insomnia:
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