Insomnia disorder affects a large proportion of the population on a situational, recurrent or chronic basis and is among the most common complaints in medical practice. The disorder is predominantly characterized by dissatisfaction with sleep duration or quality and difficulties initiating or maintaining sleep, along with substantial distress and impairments of daytime functioning. Insomnia is more than a simple lack of sleep (Annual Review of Clinical Psychology).
Sleep disturbance is entwined with our sense of well-being, health, emotion regulation, performance and productivity, memory and cognitive functioning, and social interaction.
Harvard Medical School, reports chronic sleep problems to affect 50% to 80% of patients in a typical psychiatric practice, compared with 10% to 18% of adults in the general U.S. population. Sleep problems are particularly common in patients with anxiety, depression, bipolar disorder, and attention deficit hyperactivity disorder (ADHD). A simple step to improve one’s mental health is a consistent balance of sleep. This condition occurs significantly more frequently in women than in men (Science Direct).
How to treat insomnia?
Treatment should begin with non-pharmacologic therapy, addressing sleep hygiene issues and exercise. There is good evidence supporting the effectiveness of cognitive behavior therapy. Exercise is recommended for patients with insomnia as it has been shown to improve sleep. (Family Practice). Hypnotics generally should be prescribed for short periods only, with the frequency and duration of use customized to each patient\’s circumstances. Routine use of over-the-counter drugs containing antihistamines should be discouraged. Alcohol has the potential for abuse and should not be used as a sleep aid. Opiates are valuable in pain-associated insomnia.
There is no universal pill to cure insomnia but multiple options.
Despite its high prevalence and burden, the etiology and pathophysiology of insomnia is poorly understood. Nature Reviews Disease published that psychological and pharmacological therapies effectively reduce the time it takes to fall asleep and the time spent awake after sleep onset, and produce a modest increase in total sleep time; these are outcomes that correlate with improvements in daytime functioning. Despite this progress, several challenges remain, including the need to improve our knowledge of the mechanisms that underlie insomnia and to develop more cost-effective, efficient, and accessible therapies.
Linked to depression and mental health challenges.
In Behavioral Sleep Medicine, insomnia was consistently predictive of depression, anxiety disorders, other psychological disorders, alcohol abuse or dependence, drug abuse or dependence, and suicide, indicating insomnia is a risk factor for these difficulties. Additionally, insomnia was related to decreased immune functioning. The data were inconclusive regarding insomnia as a risk factor for cardiovascular disease and mortality, but sleep medication use was predictive of mortality. If you want to improve your quality of sleep and overall health set up a virtual appointment with Zen’s Medicine Staff CLICK HERE.
Supportive Links:
“Insomnia disorder in adolescence: diagnosis, impact, and treatment.” Sleep medicine reviews 39 (2018): 12-24. https://www.sciencedirect.com/science/article/abs/pii/S1087079217300783
“Economic effects of insomnia.” Clinical Therapeutics: The International Peer-Reviewed Journal of Drug Therapy (1994). https://psycnet.apa.org/record/1999-00939-003
“Management of insomnia.” New England Journal of Medicine 336.5 (1997): 341-346. https://www.nejm.org/doi/full/10.1056/nejm199701303360506
“Insomnia as a health risk factor.” Behavioral sleep medicine 1.4 (2003): 227-247 https://www.tandfonline.com/doi/abs/10.1207/S15402010BSM0104_5
“Insomnia disorder.” Nature Reviews Disease Primers 1.1 (2015): 1-18.
Note: “Western Pharmaceutical” is defined as a system in which medical doctors and other healthcare professionals (such as nurses, pharmacists, and therapists) treat symptoms and diseases using drugs, radiation, or surgery. Quote from National Cancer Institute: http://www.cancer.gov

Holistic Health: is mindfulness of one’s mind, body, emotions, spirit, environment & social group.
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