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What is insomnia?

Insomnia is too little or very poor-quality sleep caused by one or more of the following:
Trouble falling asleep
Waking often during the night and finding it hard to returning to sleep
Waking up too early in the morning
Having un-refreshing sleep (not feeling well rested), even after sleeping 7 to 9 hours at night

Insomnia will cause problems during the day, such as excessive sleepiness, fatigue, trouble thinking clearly or staying focused, or feeling depressed and  irritable. It is not defined by the number of hours you sleep every night. Although the amount of sleep a person needs varies, most people need between 7 and 8 hours of sleep a night.

Most adults have experienced insomnia or sleeplessness at one time or another in their lives. An estimated 30-50% of the general population is affected by insomnia, and 10% have
chronic insomnia.
Insomnia is characterized by an inability to sleep and/or inability to remain asleep for a reasonable period. Insomniacs typically complain of being unable to close their eyes or "rest their mind" for more than a few minutes at a time. Both organic and nonorganic insomnia constitute a sleep disorder.[1][2] It is often caused by fear, stress, anxiety, medications, herbs, caffeine, depression or sometimes for no apparent reason. An overactive mind or physical pain may also be causes. Finding the underlying cause of insomnia is usually necessary to cure it.
Three different types of insomnia exist: transient, acute, and chronic
1. Transient Insomnia lasts from one night to a few weeks. Most people occasionally suffer from transient insomnia due to such causes as jet lag or short-term anxiety. If this form of insomnia continues to occur from time to time, the insomnia is classified as intermittent.

2.
Acute Insomnia is the inability to consistently sleep well for a period of between three weeks to six months.

3.
Chronic Insomnia is regarded as the most serious; persists almost nightly for at least a month.
Treatment for insomnia

In many cases, insomnia is caused by another disease or psychological problem. In this case, medical or psychological help may be useful.

All sedative drugs have the potential of causing psychological dependence where the individual can't psychologically accept that they can sleep without drugs. Certain classes of sedatives such as benzodiazepines and newer non-benzodiazepine drugs can also cause physical dependence which manifests in withdrawal symptoms if the drug is not carefully titrated down.
What are non-drug treatments for insomnia?

Appropriate sleep habits are important in the management of insomnia. In some instances, changing sleep habits may correct the problem without the need for medications. Good sleep habits should include:
 
  
Regular sleep times;
  • A comfortable bed and quiet room at a comfortable temperature;
 
Appropriate lighting;
 
Regular exercise but not close to bedtime or late in the evening;
  • A bedroom that is not used for work or other activities that are not related to sleep;
 
Avoidance of stimulants (e.g. caffeine, tobacco), alcohol, and large meals close to bedtime;
  • Relaxation techniques such as breathing exercises; and
 
Avoidance of naps during the day.

Causes of Insomnia: Certain conditions seem to make individuals more likely to experience insomnia. Examples of these conditions include: advanced age (insomnia occurs more frequently in those over age 60); female gender; and a history of depression. If other conditions (such as stress, anxiety, a medical problem, or the use of certain medications) occur along with the above conditions, insomnia is more likely.

There are many causes of insomnia. Transient and intermittent insomnia generally occur in people who are temporarily experiencing one or more of the following: stress, environmental noise, extreme temperatures, a change in the surrounding environment, sleep/wake schedule problems such as those due to jet lag, or medication side effects.

Chronic insomnia is more complex and often results from a combination of factors, including underlying physical or mental disorders. One of the most common causes of chronic insomnia is depression. Other underlying causes are including arthritis, kidney disease, heart failure, asthma, sleep apnea, narcolepsy, restless leg syndrome, Parkinson disease, and hyperthyroidism. However, chronic insomnia may also be due to behavioral factors, including the misuse of caffeine, alcohol, or other substances; disrupted sleep/wake cycles as may occur with shift work or other nighttime activity schedules; and chronic stress.
Symptoms of insomnia

People who have insomnia do not start the day refreshed from a good night's sleep. They are tired. They may have difficulty falling asleep, and commonly lie in bed tossing and turning for hours. Or the individual may go to sleep without a problem but wakes in the early hours of the morning and is either unable to go back to sleep, or drifts into a restless unsatisfying sleep. This is a common symptom in the elderly and in those suffering from depression. Sometimes sleep patterns are reversed, and the individual has difficulty staying awake during the day and takes frequent naps. The sleep at night is fitful and frequently interrupted.
Prevention
Prevention of insomnia centers on promotion of a healthy lifestyle. A balance of rest, recreation and exercise in combination with stress management, regular physical examinations, and a healthy diet can do much to reduce the risk.
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