insomnia

Introduction

Insomnia is a prevalent sleep disorder characterized by difficulty falling asleep, staying asleep, or waking up too early, leading to poor-quality sleep and various daytime impairments. It affects a significant portion of the population and is associated with numerous health and socio-professional consequences.

Key Insights

Prevalence and Risk Factors
- Insomnia affects 1 in 3 adults intermittently and 1 in 10 adults chronically, with higher prevalence in women, the elderly, and individuals with lower socioeconomic status .
- Risk factors include stress, depression, anxiety, night shift work, frequent travel, and certain medical conditions such as pulmonary disease, heart failure, and chronic pain .
Health Consequences
- Long-term insomnia is linked to depression, anxiety, cognitive difficulties (memory, attention, concentration), and workplace underperformance .
- Insomnia is associated with an increased risk of cardiovascular diseases, including hypertension and myocardial infarction, as well as diabetes .
Pathophysiology
- Insomnia is often considered to result from a state of physiological hyperarousal, involving increased secretion of stress-related hormones like cortisol and cytokines such as interleukin-6 (IL-6) and tumor necrosis factor (TNF) .
- Chronic insomnia is associated with a shift in the secretion of IL-6 and TNF from nighttime to daytime, contributing to daytime fatigue and performance decrements.
Socio-Professional Impact
- Insomniacs report more medical problems, higher rates of absenteeism, decreased concentration, and more work-related accidents compared to good sleepers.
- Insomnia has significant socio-professional consequences, including increased healthcare utilization and reduced productivity.
Diagnosis and Screening
- Comprehensive sleep history and assessment, including sleep diaries and standardized questionnaires, are essential for diagnosing insomnia and identifying underlying causes .
- Screening for insomnia should be part of regular patient care due to its high prevalence and impact on well-being, even though evidence for improved outcomes through screening is limited .
Treatment Approaches
- Cognitive-behavioral therapy for insomnia (CBT-I) is the first-line treatment due to its efficacy, safety, and durability of benefit .
- Modern hypnotics can be used if CBT-I is ineffective or not available, but they should be used with caution .
- Good sleep hygiene practices are crucial for managing insomnia and include maintaining regular sleep schedules, avoiding stimulants, and creating a conducive sleep environment .

Conclusion

Insomnia is a widespread disorder with significant health, emotional, and socio-professional impacts. Effective management requires a comprehensive approach, including accurate diagnosis, addressing underlying conditions, and employing evidence-based treatments like cognitive-behavioral therapy and good sleep hygiene practices. Understanding the physiological mechanisms and socio-professional consequences of insomnia can help clinicians better serve their patients and improve overall quality of life.

Summary

Introduction

Key Insights

Conclusion

Sources and full results

Insomnia

Screening for insomnia as part of regular patient care is recommended due to its high prevalence and potential impact on wellbeing.

Insomnia

Chronic insomnia is a common sleep disorder with a variety of causes, and cognitive-behavioral therapies are effective first-line treatments.

Evaluation of chronic insomnia

Chronic insomnia requires detailed history, medical, psychological, and psychiatric assessment, and understanding of unique presentation and etiologies associated with specific age groups.

Insomnia

Insomnia is common and associated with depression, anxiety, cognitive difficulties, and increased risk for cardiovascular disease and diabetes.

Chronic insomnia is associated with a shift of interleukin-6 and tumor necrosis factor secretion from nighttime to daytime.

Chronic insomnia is associated with a shift of IL-6 and TNF secretion from nighttime to daytime, which may explain the daytime fatigue and performance decrements experienced by insomniacs.

Medical and socio-professional impact of insomnia.

Insomnia has socio-professional consequences and is correlated with lower medical status, leading to increased absenteeism, decreased concentration, and more work-related accidents.

Insomnia

Insomnia disorder is a specific type of insomnia that requires specific treatment, with cognitive behavioral therapy being the preferred approach.

Insomnia disorder: State of the science and challenges for the future

Insomnia disorder affects quality of life and wellbeing, and future research should focus on understanding the brain and behavioral mechanisms underlying insomnia, as well as developing tailored interventions to combat the global burden of mental disorders.

Chronic insomnia is associated with nyctohemeral activation of the hypothalamic-pituitary-adrenal axis: clinical implications.

Chronic insomnia is associated with increased ACTH and cortisol secretion, but maintains a normal circadian pattern, suggesting a need for therapeutic interventions to decrease overall arousal levels.

Sleep and emotions: a focus on insomnia.

Disruptive emotional reactivity contributes to insomnia maintenance and reinforces the relationship between insomnia, depression, and anxiety, with poor sleep quality correlated to high negative and low positive emotions.

Try another search