Editing Insomnia (section)

{{Short description|Disorder causing trouble with sleeping}}
{{About|the sleeping disorder|other uses}}
{{Redirect|Trouble sleeping}}
{{cs1 config|name-list-style=vanc|display-authors=6}}
{{Infobox medical condition (new)
| name            = Insomnia
| synonyms        = Sleeplessness, trouble sleeping
| image           = 53-aspetti di vita quotidiana, insonnia, Taccuino Sanitatis,.jpg
| caption         = Depiction of insomnia from the 14th century medical manuscript ''[[Tacuinum Sanitatis]]''
| field           = [[Psychiatry]], [[Clinical Psychology]], [[Sleep Medicine]]
| pronounce       = {{IPAc-en|ɪ|n|ˈ|s|ɒ|m|n|i|ə}}<ref name=NIH2011Ov/>
| symptoms        = Trouble [[sleeping]], daytime sleepiness, low energy, irritability, [[depression (mood)|depressed mood]]<ref name=NIH2011Ov/>
| onset           = 
| duration        = 
| causes          = Unknown, [[psychological stress]], [[chronic pain]], [[heart failure]], [[hyperthyroidism]], [[heartburn]], [[restless leg syndrome]], [[obstructive sleep apnea]], others<ref name=NIH2011Ca/>
| risks           = 
| diagnosis       = Based on symptoms, [[sleep study]]<ref name=NIH2011Diag/>
| differential    = [[Delayed sleep phase disorder]], [[restless leg syndrome]], [[sleep apnea]], [[psychiatric disorder]]<ref>{{cite book| vauthors = Watson NF, Vaughn BV |title=Clinician's Guide to Sleep Disorders|date=2006|publisher=CRC Press|isbn=978-0-8493-7449-4 |page=10|url=https://books.google.com/books?id=M9zKBQAAQBAJ&pg=PA10|language=en}}</ref>
| prevention      = 
| treatment       = [[Sleep hygiene]], [[Cognitive behavioral therapy for insomnia|cognitive behavioral therapy]], [[sleeping pills]]<ref name=NIH2011Tx/><ref name=AC2016/><ref name=Wil2008/>
| medication      = 
| prognosis       = 
| frequency       = ~20%<ref name=WHO2009/><ref name=Th2007/><ref name=Tas2015/>
| deaths          = 
}}

<!-- Definition and symptoms -->
'''Insomnia''', also known as '''sleeplessness''', is a [[sleep disorder]] where people have difficulty [[sleeping]].<ref name="NIH2011Ov">{{cite web |date=24 March 2022 |title=What Is Insomnia? |url=https://www.nhlbi.nih.gov/health/health-topics/topics/inso |url-status=live |archive-url=https://web.archive.org/web/20160728012148/http://www.nhlbi.nih.gov/health/health-topics/topics/inso |archive-date=28 July 2016 |access-date=26 November 2023 |website=Health Topics |publisher=[[NHLBI]]}}</ref><ref>{{Cite web |date=2020-07-16 |title=Insomnia: Causes, symptoms, and treatments |url=https://www.medicalnewstoday.com/articles/9155 |access-date=2024-07-25 |website=www.medicalnewstoday.com |language=en}}</ref> They may have difficulty falling asleep, or staying asleep for as long as desired.<ref name="NIH2011Ov" /><ref name="Th2007">{{cite journal |vauthors=Roth T |date=August 2007 |title=Insomnia: definition, prevalence, etiology, and consequences |journal=[[Journal of Clinical Sleep Medicine]] |type=Supplement |volume=3 |issue=5 Suppl |pages=S7–10 |doi=10.5664/jcsm.26929 |pmc=1978319 |pmid=17824495 |doi-access=free}}</ref><ref name="Pun2012">{{cite journal |vauthors=Punnoose AR, Golub RM, Burke AE |date=June 2012 |title=Insomnia |journal=[[JAMA]] |type=JAMA patient page |volume=307 |issue=24 |pages=2653 |doi=10.1001/jama.2012.6219 |pmid=22735439 |doi-access=free}}</ref> Insomnia is typically followed by daytime [[sleepiness]], low energy, [[irritability]], and a [[depression (mood)|depressed mood]].<ref name="NIH2011Ov" /> It may result in an increased risk of accidents of all kinds as well as problems focusing and learning.<ref name="Th2007" /> Insomnia can be short term, lasting for days or weeks, or long term, lasting more than a month.<ref name="NIH2011Ov" /> The concept of the word ''insomnia'' has two distinct possibilities: insomnia disorder (ID) or insomnia symptoms, and many abstracts of randomized controlled trials and systematic reviews often underreport on which of these two possibilities the word refers to.<ref name="Banno2022">{{cite journal | vauthors = Banno M, Tsujimoto Y, Kohmura K, Dohi E, Taito S, Someko H, Kataoka Y | title = Unclear Insomnia Concept in Randomized Controlled Trials and Systematic Reviews: A Meta-Epidemiological Study | journal = International Journal of Environmental Research and Public Health | volume = 19 | issue = 19 | pages = 12261 | date = September 2022 | pmid = 36231555 | doi = 10.3390/ijerph191912261 | pmc = 9566752 | doi-access = free }}</ref>

<!-- Cause and diagnosis -->
Insomnia can occur independently or as a result of another problem.<ref name=NIH2011Ca>{{cite web |title=What Causes Insomnia? |url=https://www.nhlbi.nih.gov/health/health-topics/topics/inso/causes |website=NHLBI |access-date=9 August 2016 |date=13 December 2011 |url-status=live |archive-url=https://web.archive.org/web/20160728012201/http://www.nhlbi.nih.gov/health/health-topics/topics/inso/causes |archive-date=28 July 2016 }}</ref> Conditions that can result in insomnia include [[psychological stress]], [[chronic pain]], [[heart failure]], [[hyperthyroidism]], [[heartburn]], [[restless leg syndrome]], [[menopause]], certain [[medication]]s, and drugs such as [[caffeine]], [[nicotine]], and [[Alcohol (drug)|alcohol]].<ref name=NIH2011Ca/><ref name=WHO2009>{{cite web |url=https://www.who.int/selection_medicines/committees/expert/17/application/Section24_GAD.pdf |title=Dyssomnias |access-date=25 January 2009 |publisher=WHO |pages=7–11 |url-status=dead |archive-url=https://web.archive.org/web/20090318104517/http://www.who.int/selection_medicines/committees/expert/17/application/Section24_GAD.pdf |archive-date=18 March 2009 }}</ref> Insomnia is also common in people with [[Attention deficit hyperactivity disorder|ADHD]],<ref>{{Cite journal |last1=Wynchank |first1=Dora |last2=Ten Have |first2=Margreet |last3=Bijlenga |first3=Denise |last4=Penninx |first4=Brenda W. |last5=Beekman |first5=Aartjan T. |last6=Lamers |first6=Femke |last7=de Graaf |first7=Ron |last8=Kooij |first8=J. J. Sandra |date=2018-03-15 |title=The Association Between Insomnia and Sleep Duration in Adults With Attention-Deficit Hyperactivity Disorder: Results From a General Population Study |journal=Journal of Clinical Sleep Medicine |volume=14 |issue=3 |pages=349–357 |doi=10.5664/jcsm.6976 |issn=1550-9397 |pmc=5837836 |pmid=29458702}}</ref> and children with [[autism]].<ref>{{Cite journal |last1=Cortesi |first1=Flavia |last2=Giannotti |first2=Flavia |last3=Ivanenko |first3=Anna |last4=Johnson |first4=Kyle |date=July–August 2010 |title=Sleep in children with autistic spectrum disorder |url=https://linkinghub.elsevier.com/retrieve/pii/S1389945710001759 |journal=Sleep Medicine |language=en |volume=11 |issue=7 |pages=659–664 |doi=10.1016/j.sleep.2010.01.010|pmid=20605110 |url-access=subscription }}</ref> Other risk factors include working [[night shifts]] and [[sleep apnea]].<ref name=Th2007/> Diagnosis is based on sleep habits and an examination to look for underlying causes.<ref name=NIH2011Diag/> A [[sleep study]] may be done to look for underlying sleep disorders.<ref name=NIH2011Diag>{{cite web |title=How Is Insomnia Diagnosed? |url=https://www.nhlbi.nih.gov/health/health-topics/topics/inso/diagnosis |website=NHLBI |access-date=9 August 2016 |date=13 December 2011 |url-status=dead |archive-url=https://web.archive.org/web/20160811091424/http://www.nhlbi.nih.gov/health/health-topics/topics/inso/diagnosis |archive-date=11 August 2016 }}</ref> Screening may be done with questions like "Do you experience difficulty sleeping?" or "Do you have difficulty falling or staying asleep?"<ref name=Th2007/>

<!-- Treatment -->
Although their efficacy as first line treatments is not unequivocally established,<ref name="Behavioral and psychological treatm">{{cite journal | vauthors = Edinger JD, Arnedt JT, Bertisch SM, Carney CE, Harrington JJ, Lichstein KL, Sateia MJ, Troxel WM, Zhou ES, Kazmi U, Heald JL, Martin JL | title = Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment | journal = Journal of Clinical Sleep Medicine | volume = 17 | issue = 2 | pages = 263–298 | date = February 2021 | pmid = 33164741 | pmc = 7853211 | doi = 10.5664/jcsm.8988 }}</ref> [[sleep hygiene]] and lifestyle changes are typically the first treatment for insomnia.<ref name=NIH2011Tx>{{cite web |title=How Is Insomnia Treated? |url=https://www.nhlbi.nih.gov/health/health-topics/topics/inso/treatment |website=NHLBI |access-date=9 August 2016 |date=13 December 2011 |url-status=dead |archive-url=https://web.archive.org/web/20160728012302/http://www.nhlbi.nih.gov/health/health-topics/topics/inso/treatment |archive-date=28 July 2016 }}</ref><ref name=Wil2008>{{cite journal | vauthors = Wilson JF | title = In the clinic. Insomnia | journal = Annals of Internal Medicine | volume = 148 | issue = 1 | pages = ITC13–1–ITC13–16 | date = January 2008 | pmid = 18166757 | doi = 10.7326/0003-4819-148-1-200801010-01001 | s2cid = 42686046 }}</ref> Sleep hygiene includes a consistent bedtime, a quiet and dark room, exposure to sunlight during the day and regular [[exercise]].<ref name=Wil2008/> [[Cognitive behavioral therapy for insomnia|Cognitive behavioral therapy]] may be added to this.<ref name=AC2016>{{cite journal | vauthors = Qaseem A, Kansagara D, Forciea MA, Cooke M, Denberg TD | title = Management of Chronic Insomnia Disorder in Adults: A Clinical Practice Guideline From the American College of Physicians | journal = Annals of Internal Medicine | volume = 165 | issue = 2 | pages = 125–133 | date = July 2016 | pmid = 27136449 | doi = 10.7326/M15-2175 | doi-access = free }}</ref><ref name=Tra2015>{{cite journal | vauthors = Trauer JM, Qian MY, Doyle JS, Rajaratnam SM, Cunnington D | title = Cognitive Behavioral Therapy for Chronic Insomnia: A Systematic Review and Meta-analysis | journal = Annals of Internal Medicine | volume = 163 | issue = 3 | pages = 191–204 | date = August 2015 | pmid = 26054060 | doi = 10.7326/M14-2841 | s2cid = 21617330 }}</ref> While [[sleeping pill]]s may help, they are sometimes associated with [[injuries]], [[dementia]], and [[addiction]].<ref name=NIH2011Tx/><ref name=AC2016/> These medications are not recommended for more than four or five weeks.<ref name=AC2016/> The effectiveness and safety of [[#Alternative medicine|alternative medicine]] are unclear.<ref name=NIH2011Tx/><ref name=AC2016/>

<!-- Epidemiology and history -->
Between 10% and 30% of adults have insomnia at any given point in time, and up to half of people have insomnia in a given year.<ref name=WHO2009/><ref name=Th2007/><ref name=Tas2015>{{cite book |vauthors=Tasman A, Kay J, Lieberman JA, First MB, Riba M |title=Psychiatry, 2 Volume Set |date=2015 |publisher=John Wiley & Sons |isbn=978-1-118-75336-1 |page=4253 |edition=4 |url=https://books.google.com/books?id=l2KRBgAAQBAJ&pg=PT4253 |access-date=2017-09-01 |archive-date=2023-01-12 |archive-url=https://web.archive.org/web/20230112211935/https://books.google.com/books?id=l2KRBgAAQBAJ&pg=PT4253 |url-status=live }}</ref> About 6% of people have insomnia that is not due to another problem and lasts for more than a month.<ref name=Th2007/> People over the age of 65 are affected more often than younger people.<ref name=Wil2008/> Women are more often affected than men.<ref name=WHO2009/> Descriptions of insomnia occur at least as far back as [[ancient Greece]].<ref>{{cite book | vauthors = Attarian HP |title=Clinical Handbook of Insomnia |date=2003 |publisher=Springer Science & Business Media |isbn=978-1-59259-662-1 |chapter = chapter 1 |chapter-url=https://books.google.com/books?id=Fx-sBAAAQBAJ&pg=PT20 |language=en }}</ref>  
{{TOC limit|3}}