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Insomnia

Overview of Insomnia

-Inadequate or poor quality of sleep, inability to sleep
-Difficulty getting or staying asleep
-Waking up too early
-Having non-restorative sleep

Insomnia Types

There are two types of insomnia: primary insomnia and secondary insomnia.

  • Primary insomnia: Primary insomnia means that a person is having sleep problems that are not directly associated with any other health condition or problem.
  • Secondary insomnia: Secondary insomnia means that a person is having sleep problems because of something else, such as a health condition (like asthma, depression, arthritis, cancer, or heartburn); pain; medication they are taking; or a substance they are using (like alcohol).

Acute vs. Chronic Insomnia

It can be short-term (acute insomnia) or can last a long time (chronic insomnia). Acute insomnia can last from one night to a few weeks. Insomnia is called chronic when a person has insomnia at least three nights a week for a month or longer.

Causes of Acute Insomnia:

  • Significant life stress (job loss or change, death of a loved one, divorce, moving). Illness.
  • Emotional or physical discomfort, Environmental factors like noise, light, or extreme temperatures (hot or cold) that interfere with sleep.
  • Some medications (for example those used to treat colds, allergies, depression, high blood pressure, and asthma) may interfere with sleep.
  • Interferences in normal sleep schedule (jet lag or switching from a day to night shift, for example).

Causes of Chronic Insomnia:

  • Depression and/or anxiety.
  • Chronic stress.
  • Pain or discomfort at night.

Either type can be treated by medication along with Cognitive Behavioral Therapy for Insomnia (CBT)

-which is just as effective as medication (short term)
-Better than medication (long term)

Combines strategies specifically to target chronic insomnia.

Factors Contributing to Chronic Insomnia

  1. Personal factors
    -Situational, high-stress
    -Born with increased risk of chronic insomnia
  2. Physiologic Factors
    -Hyper arousal of the mind
    -Strong alert system, weak sleep drive system
    -Altered sleep/wake cycle rhythm
  3. Cognitive Factors
    -Thoughts, thinking styles: excessive worry and rumination
    -Worrying about not getting enough sleep
    -Worrying about sleep long before bedtime
  4. Behavioral Factors
    -Going to bed earlier, staying in bed longer
    -Spending time worrying in bed
    -Napping during the day

These behaviors may result in “conditioning” (The pairing of two things often over time so that they become associated with one another).

Treatment using Cognitive Behavioral Therapy helps address these problems