Insomnia
Sleep pathology in adults

Insomnia is a sleep disorder characterized by difficulty falling asleep, staying asleep, or waking up too early and not being able to go back to sleep.

It is a common condition that can have a significant impact on quality of life and overall health. Insomnia can be acute, when it lasts less than a month, or chronic, when it persists for a prolonged period of time.

• Difficulty initiating sleep
• Difficulty to maintain
• Waking up too early
• Having chronically unrefreshing or poor quality sleep.

It is often related to some diurnal problems:

• Fatigue or daytime discomfort
• Attention, concentration and memory problems
• Dysfunctionn labor underperformance school
• Humoral disturbance irritability
• Daytime sleepiness
• Reduced motivation, energy or initiative
• Error prone, accident prone at work or while driving a car
• Tension, headache or gastrointestinal symptoms in response to loss of sleep
• Sleep-related concerns

Causes of insomnia may include medical, psychological or environmental factors.

According to the AASM, insomnia is divided into the following subtypes:

Maladjustment insomnia: It is temporary and is related to an identifiable stressor that causes sleep problems. It should last at least 3 months and has a good prognosis when the stressor disappears. This sleep disorder may be related to psychological, psychosocial, interpersonal, environmental or physical factors.

Psychophysiological insomnia: A sleep disorder characterized by anxiety and preoccupation with sleep, resulting in multiple awakenings during the night and negative associations with the bed and bedroom. Symptoms include anxiety, sweating, palpitations and muscle tension. Treatment involves addressing the cause of the disorder and using non-pharmacological techniques combined with medications to improve symptoms. It is important to avoid overestimation of symptoms and obsession about insomnia.

Paradoxical insomnia: This refers to an inadequate perception of sleep in which the person complains of not sleeping at all or very little, although his or her level of well-being during the day does not correspond to this complaint. This inadequate perception should last at least one month and naps do not usually appear. Objective methods can show that the person actually sleeps more than he or she subjectively perceives.

Idiopathic insomnia: It is a sleep disorder characterized by the complaint of many years of insomnia without a clear triggering stimulus, occurring since infancy or early childhood. The onset is insidious and the evolution is long.

Insomnia associated with a mental disorder: Insomnia is present for at least one month. You have a diagnosed mental disorder that temporarily coexists with insomnia (it may appear days or weeks later).

Insomnia due to inadequate sleep hygiene: Refers to difficulty sleeping due to inadequate sleep habits, such as not having an irregular sleep schedule, consuming substances that make it difficult to sleep or engaging in activating activities before sleep, and using the bed for non-sleep related activities. Treatment focuses on establishing daily routines that promote healthy sleep, such as going to bed and getting up at the same time every day, avoiding heavy dinners, reducing alcohol intake, not doing intense exercise before bedtime and following a relaxing bedtime routine.

Insomnia due to drug or medication use: It can be caused by different substances, for example illegal drugs, caffeine, alcohol and certain medications. These substances can affect the central nervous system and cause sleep disturbances, such as difficulty falling asleep, nocturnal awakenings and fragmented sleep. It is important to inform your doctor if you are taking any medication that may be aggravating your insomnia problem.

Nonspecific insomnia: Not due to substance use or medical illness.

Physiological (organic) insomnia: Once the disorder is diagnosed and the causes of poor sleep are known, treatment can begin. The treatment is always different depending on the cause.

Diagnosis of insomnia may require a series of examinations and tests, including clinical interviews, sleep questionnaires, and sleep diaries, in which detailed information about sleep patterns and sleep-related behaviors are recorded. In some cases, it may be necessary to perform sleep studies in a sleep laboratory to evaluate brain activity and other physiological factors during sleep.

It is important to rule out other medical or psychiatric conditions that may be causing the insomnia, so additional testing or evaluation by other specialists may be performed if necessary.

Once an accurate diagnosis has been established, an appropriate, personalized and tailored treatment plan can be developed to help the patient improve the quality of their sleep and alleviate the symptoms of insomnia.

There are different treatments for insomnia, ranging from lifestyle changes to pharmacological and non-pharmacological therapies. The type of treatment recommended will depend on the underlying cause of the insomnia, as well as the duration and severity of the problem.