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Insomnia: Overview and Risk Factors

Insomnia is a term that describes difficulty falling asleep, difficulty staying asleep through the night, or not feeling rested after sleep. It is the most common sleep disorder, affecting about one–third of adults at some point in their lives.

Insomnia can be described as transient (lasting less than one week), short–term (one to three weeks), and chronic (longer than three weeks).

Insomnia lasting only a few days to a few weeks may be the result of poor sleep environments, such as excessive noise or light and unpleasant room temperature, or recent lifestyle changes, such as jet lag, change in work shifts, illness, and stressful life events. Also, medications with stimulant properties, such as asthma medicines, antidepressants, caffeine–containing pain relievers, or methylphenidate (Ritalin) may contribute to impaired sleep.

Insomnia lasting more than a few weeks may be associated with sleep apnea, restless legs syndrome, or other sleep disorders. In addition, chronic drug, alcohol, or caffeine use, lack of exercise, and various medical or psychiatric disorders may contribute to insomnia.

In addition to difficulty sleeping, symptoms may include daytime sleepiness, fatigue, inability to concentrate, irritability, anxiety, depression, forgetfulness, and aches and pains. Individuals with insomnia also have an increased risk of automobile accidents.

Risk Factors

Insomnia occurs more commonly in women than men, and is particularly common in people who are divorced, widowed, or separated. Additional risk factors include:

  • Age: Insomnia increases with age.
  • Psychiatric diseases: Sleep disturbances are common in patients with depression, bipolar disorder, anxiety disorders, schizophrenia, and acute stress.
  • Drugs and alcohol: Use of these agents may be associated with impaired sleep.
  • Stimulants: Use of medications and other substances that have stimulant properties is a common cause of insomnia. These include caffeine, asthma medications (e.g., theophylline), cold medications, steroids, and thyroid hormone.
  • Nicotine withdrawal can cause insomnia, as can use of nicotine patches and bupropion (Wellbutrin), an antidepressant often used for smoking cessation.
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Insomnia: Diagnosis and Treatment >>