Insomnia is an experience of inadequate or poor quality
sleep characterized by one or more of the following:
- difficulty falling asleep
- difficulty maintaining sleep
- waking up too early in the morning
- nonrefreshing sleep
Insomnia also involves daytime consequences such as:
- lack of energy
- difficulty concentrating
As many as one-third of patients seen in the primary care
setting may experience occasional difficulties in sleeping,
and 10 percent of those may have chronic sleep problems.
About 30 to 40 percent of adults indicate some level of
insomnia within any given year, and about 10 percent to
15 percent indicate that the insomnia is chronic and/or
severe. The prevalence of insomnia increases with age and
is more common in women.
Types of Insomnia
Acute Insomnia: Periods of sleep difficulty
lasting between one night and a few weeks are referred to
as acute insomnia. Acute insomnia is often caused
by emotional or physical discomfort. Some common examples
include significant life stress; acute illness; and environmental
disturbances such as noise, light, and temperature. Sleeping
at a time inconsistent with the daily biological rhythm,
such as occurs with jet lag, also can cause acute insomnia.
Chronic insomnia refers to sleep difficulty at least
three nights per week for one month or more. Chronic insomnia
can be caused by many different factors acting singly or
in combination, and often occurs in conjunction with other
health problems. In other cases sleep disturbance is the
major or sole complaint, and involves abnormal sleep-wake
regulation or physiology during sleep.
Insomnia associated with psychiatric, medical and neurological
disorders. Although psychiatric disorders are a common
source of chronic insomnia, they account for less than 50
percent of cases. Mood and anxiety disorders are the most
common psychiatric diagnoses associated with insomnia. Insomnia
can also be associated with a wide variety of medical and
neurological disorders. Factors that cause problems throughout
the day such as pain, immobility, difficulty breathing,
dementia, and hormonal changes associated with pregnancy,
peri-menopause, and menopause can also cause insomnia. Many
medical disorders worsen at night, either from sleep per
se, circadian influence (e.g., asthma), or lying down (e.g.
Insomnia associated with medication and substance use.
A variety of prescription drugs, non-prescription drugs,
and drugs of abuse can lead to increased wakefulness and
poor-quality sleep. The likelihood of any given drug contributing
to insomnia is unpredictable and may be related to dose,
lipid solubility, individual genomic differences, and other
factors. Some drugs commonly related to insomnia are stimulating
antidepressants, steroids, decongestants, beta blockers,
caffeine, alcohol, nicotine, and recreational drugs such
At the Sleep Medicine group of sleep centres we offer a
specialised treatment service for patients who have insomina
associated with substance abuse please contact
us for further information.
Insomnia associated with specific sleep disorders.
Insomnia can be associated with specific sleep disorders,
including restless legs syndrome (RLS), periodic limb movement
disorder (PLMD), sleep apnoea, and circadian rhythm sleep
Primary Insomnia: When other causes of insomnia
are ruled out or treated, remaining difficulty with sleep
may be classified as primary insomnia. Factors such as chronic
stress, hyper-arousal, poor sleep hygiene, and behavioural
conditioning may contribute to Primary Insomnia.
If you have any questions regarding Insomnia please contact
us for further information.