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Alternative NamesInsomnia - psychophysiological (learned); Chronic insomnia
Definition Return to top
Primary insomnia is difficulty getting to sleep or staying asleep, or having non-refreshing sleep for at least 1 month without any known physical or mental condition.
See also: Insomnia concerns
Causes Return to top
Insomnia is caused by many different things. The most common causes of insomnia are:
About 25% of elderly people and about 10% of people in general have insomnia.
Secondary insomnia is insomnia caused by a medical condition. Depression is a very common cause of secondary insomnia. Often, insomnia is the symptom for which people with depression seek medical help.
Symptoms Return to top
People who have primary insomnia tend to keep thinking about getting enough sleep. The more they try to sleep, the greater the sense of frustration and distress, and the more difficult sleep becomes.
Exams and Tests Return to top
Your health care provider will do a physical exam and ask you questions about your current medications, drug use, and medical history. Usually, these are the only methods needed to diagnose insomnia.
Polysomnography, an overnight sleep study, can help rule out other types of sleep disorders (such as sleep apnea).
Treatment Return to top
The following tips can help improve sleep. This is called sleep hygiene.
If you follow these recommendations and still have insomnia, your doctor may prescribe medications such as benzodiazepines.
Outlook (Prognosis) Return to top
You should be able to sleep if you practice good sleep hygiene. See a doctor if you have chronic insomnia that does not improve.
It is important to remember that your health is not at risk if you do not get 6 - 8 hours of sleep every day. Different people have different sleep requirements. Some do fine on 4 hours of sleep a night, while others only thrive if they get 10 - 11 hours.
Sleep requirements also change with age. Listen to your body's sleep signals and don't try to sleep more or less than is refreshing for you.
Possible Complications Return to top
Daytime sleepiness is the most common complication, though there is some evidence that lack of sleep can also lower your immune system's ability to fight infections. Sleep deprivation is also a common cause of auto accidents -- if you are driving and feel sleepy, take a break.
When to Contact a Medical Professional Return to top
Call your doctor if chronic insomnia has become a problem.
References Return to top
Goetz CG. Textbook of Clinical Neurology. 2nd ed. St. Louis, Mo: WB Saunders; 2003:1207-1210.
Rakel P, ed. Conn’s Current Therapy 2005. 57th ed. Philadelphia, Pa: WB Saunders; 2005:34-39.Update Date: 2/6/2008 Updated by: Christos Ballas, M.D., Attending Psychiatrist, Hospital of the University of Pennsylvania, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.