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Insomnia

What is insomnia
Insomnia Insomnia is a very common and debilitating disease with major morbidity and social consequences. Despite the negative impact on the ability to function well during the day, insomnia is underdiagnosed and undertreated. Insomnia is therefore, important to treat.

Treatment
However, treatment has been difficult due to concerns over current treatment options, both from a patient and physician perspective.

Various methods are used to monitor the different stages of sleep. Sleep is not homogenous – its structure, characterised by a sequence of sleep stages, is referred to as ‘sleep architecture’

Traditionally insomnia has been diagnosed on the basis of quantity of sleep

  • Sleep latency (time taken to get to sleep)
  • Sleep duration (length of time spent asleep)

While it is important not to ignore quantity of sleep, epidemiological surveys show that poor quality of sleep has a greater negative impact on health, well-being and satisfaction with life than the quantity of sleep a person gets.1,2

Hormones released in the body are involved in certain aspects of homeostasis, including regulating the circadian rhythms established by the SCN of the hypothalamus. Melatonin is an endocrine hormone that is principally produced and released into the blood by the pineal gland. The levels of melatonin fluctuate according to light exposure (highest during darkness and sleep, and lowest in bright sunlight) and it is proposed that melatonin acts as a time ‘cue’, entraining the body’s circadian rhythm to conventional environmental patterns.

Although behavioural and psychological factors have been shown to play an important causative role in many sleep disorders, non-pharmacological/behavioural approaches are underused in the management of these conditions.3,4

Useful links:

  • European Sleep Research Society (ESRS)
    The European Sleep and Research Society is an international scientific non-profit organization and promotes all aspects of sleep research.
  • Associated Professional Sleep Societies (APSS)
    All presenters at SLEEP 2009 23rd Annual Meeting of the Associated Professional Sleep Societies, LLC are required to disclose any conflicts of interest. The Associated Professional Sleep Societies, LLC has compiled a spreadsheet containing these disclosures for all presenters.
  • Journal of Clinical Sleep Medicine
    The scope of the Journal of Clinical Sleep Medicine is clinical sleep medicine. Its emphasis is the publication of papers with direct applicability and/or relevance to the clinical practice of sleep medicine. This includes some original manuscripts such as clinical trials as well as clinical reviews, clinical commentary and debate, medical economic/practice perspectives, case series and novel/interesting case reports.
  • World Association of Sleep Medicine
    WASM is an international organization comprised of healthcare professionals primarily active in the field of sleep medicine. The goal of the World Association of Sleep Medicine (WASM) is to advance knowledge about sleep and sleep disorders among health care personnel and among the public worldwide.
  • Sleep advice for people with insomnia
    Sleeping is often taken for granted, but when it is hard to come by it can place a burden on life. Sleep is necessary to maintain a healthy and balanced life. Poor sleep may have a knock-on effect on other parts of daily life, such as work, home and social life.

Source: EPG guide- www.epgonline.org/insomnia/insomnia.cfm

References:
1. Zammit GK, Weiner J, Damato N et al. Quality of life in people with insomnia. Sleep 1999; 22 Suppl 2: S379-85
2. Pilcher JJ. Sleep quality versus sleep quantity: relationships between sleep and measures of health, well-being and sleepiness in college students. J Psychosom Res. 1997; 42(6): 583-96
3. National Institute of Health. NIH State of the Science Conference statement on manifestations and management of chronic insomnia in adults statement. J Clin Sleep Med 2005; 1 (4): 412–421.
4. Subramanian S, Surani S. Sleep disorders in the elderly. Geriatrics 2007; 62 (12): 10–32.

Last Updated 25-05-2010