Insomnia

Insomnia is defined as a condition in which a person fails to get sufficient sleep despite having the opportunity to sleep. Inclusive in this definition of insomnia are the following important features:

• Difficulty falling asleep
• Difficulty staying asleep
• Not getting enough sleep
• Poor quality of sleep (unrefreshing sleep)

Insomnia is the most common type of sleep disorder and is among the most frequent complaints brought to the attention of health care providers. Although estimates of the prevalence of insomnia vary among different studies, insomnia is thought to be an occassional problem for at least 33% of the general population and is a chronic problem for at least 10% of adults. Studies have shown that insomnia is more common among women, older individuals, and people with underlying medical or psychiatric problems.

In general, insomnia can be grouped into two distinct types: acute and chronic. Acute insomnia is a sleep disorder that lasts for a short period of time (less than 2-weeks) and is usually due to some type of stressful trigger such as loss of a job or the death of a family member or close friend. Chronic insomnia is a disorder of sleep that lasts for one-month or longer and most commonly affects women, older people, and those with a chronic medical problem or psychiatric disturbance.

The goals of treatment for people with insomnia include:

• Reduce the risks of insomnia-related problems such as depression, diability, and impaired quality of life.

• Improve the patient\'s productivity, cognition, and overall quality of life.

• Reduce the patient\'s risk for suffering insomnia-related accidents such as motor vehicle accidents and falls.

In general, the treatment options for insomnia can be grouped into the following two broad categories:

• Nonpharmacologic therapy - refers to treatments or interventions that are designed to achieve a specific outcome without the use of medications. Nonpharmacologic therapies for insomnia primarily involve a form of psychotherapy called cognitive-behavioral therapy
• Pharmacologic therapy - refers to the use of medications to treat a specific condition such as insomnia. Pharmacologic therapy is usually reserved for patients with chronic insomnia, defined as insomnia that occurs at least 3 times per week lasting for one month or longer.

Medications that may be prescribed for the treatment of chronic insomnia include:

• Benzodiazepine medications
• Non-benzodiazepine medications
• Antidepressant medications
• Non-prescription medications