​​​​​Overview:

• Insomnia is difficulty falling asleep, or staying asleep as long as desired.
  
• Insomnia is not a natural disorder associated with life stress; it must be taken seriously and treated.
  
• It may be a symptom of another problem.
  
• There is no specific test to diagnose insomnia, doctors use many methods to exclude other problems. 
  
• The best way to prevent insomnia is to follow a bedtime routine in a suitable environment.
  

Definition:

Insomnia is a common sleep disorder in adults that can make it hard to fall asleep, hard to stay asleep for adequate hours even though the environment is good and the time is right. People with insomnia often feel dissatisfied with their sleep and inadequate sleep hours. It may affect many people and in most cases ends without treatment. Many people think that insomnia is normal with the stresses of life, but it is important to take it seriously because it is closely related to physical health. 

Types:

• Transient insomnia: It is sleep disorders which last for a short period.
  
• Chronic Insomnia: It is disrupted sleep that occurs at least three nights per week and lasts at least three months.
  

Causes:

Insomnia can be a symptom of another problem, the causes of chronic insomnia include:

• Psychological factors:
  
• Anxiety and tension.
• Stress.
• Psychological trauma.
• Depression.
• Sleep pattern and environment:
  
• Travel.
• Changes in work hours (shifts), and night duty even at home.
• Siesta (may cause insomnia for some people).
• Inappropriate sleeping environment.
• Eating heavy meal late in the evening, which may cause you to feel physically uncomfortable or experience gastroesophageal reflux. 
• Caffeine such as coffee and others.
• Nicotine (smoking).
• Medical Conditions:
  
• Respiratory problems (such as: asthma and obstructive pulmonary disease).
• Muscle and joint problems (such as: arthritis).
• Chronic pains.
• Some types of medications:
  

Symptoms:

• Difficulty falling asleep at night.
  
• Waking up during the night and having trouble getting back to sleep. 
  
• Waking up too early.
  
• Feeling unrefreshed upon waking.
  
• Daytime tiredness or sleepiness.
  
• Mental disorders (such as: difficulty concentrating).
  
• Mood swings.
  
• Problems at work or school. 
  
• Social problems. 
  

​When to see a doctor?

• If insomnia affects your lifestyle.  
  
• Feeling tiredness and sluggishness. 
  
• If insomnia limits your productivity and enjoying companionship of your friends and family or hobbies. 
  
• Failure to adjust your sleep pattern. 
  

Diagnosis:

• There is no definitive test for insomnia. Doctors use many different tools to diagnose insomnia: 
  
• Personal history.
  
• Sleep log and questionnaires. 
  
• Lab tests: blood tests to rule out insomnia associated with some medications and health problems. 
  
• Sleep planning. 
  
• These tests to help your doctor develop an appropriate treatment plan.
  

Risk Factors:

1. Mental disorders and stress and anxiety. 
   
2. Failure to adjust sleep times. 
   

Most vulnerable categories:

1. Women.
   
2. Older adults (over age 60).
   
3. Having a chronic disease. 
   

Complications:

• Low quality of public life
  
• Poor physical performance.
  
• Negative impact on social performance. 
  
• Low job performance. 
  
• Mental health disorders.
  
• Increased rate of diseases associated with mental diseases in patients with chronic insomnia.  
  

Treatment:

1. Non-Medical Treatment: There are psychological and behavioral techniques that can be helpful for treating insomnia such as:
• Relaxing training: (Breathing exercises, mindfulness, meditation techniques, and guided imagery and listening to audio recordings), they can work to help you fall asleep and also return to sleep in the middle of the night.
• Stimulus Control: It helps to build an association between the bedroom and sleep by limiting the type of activities allowed in the bedroom, they include: Arranging the bed room, using comfortable bed, limiting time in bed and getting out of bed if you've been awake for 20 minutes or more.
• Cognitive behavioral therapy (CBT): Includes behavioral changes (such as keeping a regular bedtime and wake up time, and eliminating afternoon naps) but it adds a cognitive or "thinking" component. CBT works to challenge unhealthy beliefs and fears around sleep and teach rational, positive thinking.
2. Medical Treatments: There are many different types of sleep aids for insomnia, and it is important to consult with a doctor before taking a sleep aid, and in the event other methods are unsuccessful. 

Prevention:

• Stick to a sleep schedule, and make sure to get adequate sleep. 
  
• Create a comfortable sleep environment and avoid lights and noises. 
  
• Limit stimuli before bedtime (such as: TV, home works, using computer and electronic games).
  
• Minimize stimuli in food and drink before bedtime (such as: soft drinks, coffee or tea).
  

Frequently Asked Questions (FAQs):

• What is sleep log?
  
• A sleep log is a simple diary that keeps track of details about your sleep. It can help your doctor figure out what might be causing insomnia.
• Do sedatives and hypnotics have effects in the long run?
  
• The main problem is the increased dependence on them especially common stress drugs and associated mental disorders.
  

​Misconceptions:

• Counting helps you to fall asleep.
  
• Fact: Spending time on bed staring at the ceiling will not lull you to sleep. In this case, it is advised to get up and leave the room.
• Adults should get 8 hours of sleep.
  
• Fact: An individual's need for sleep varies according to his lifestyle and activity.