this: the sleeping disorder

Insomnia is a symptom of a sleeping disorder characterized by persistent difficulty falling asleep or staying asleep despite the opportunity. Insomnia is a symptom, not a stand-alone diagnosis or a disease. By definition, insomnia is "difficulty initiating or maintaining sleep, or both" and it may be due to inadequate quality or quantity of sleep. It is typically followed by functional impairment while awake. Both organic and non-organic insomnia constitute a sleep disorder.

According to the U.S. Department of Health and Human Services in year 2007, approximately 64 million Americans regularly suffer from insomnia each year. Insomnia is 1.4 times more common in women than in men.

Types of insomnia

Although there are several different degrees of insomnia, three types of insomnia have been clearly identified: transient, acute, and chronic.

1. Transient insomnia lasts from days to weeks. It can be caused by another disorder, by changes in the sleep environment, by the timing of sleep, severe depression, or by stress. Its consequences - sleepiness and impaired psychomotor performance - are similar to those of sleep deprivation.
2. Acute insomnia is the inability to consistently sleep well for a period of between three weeks to six months.
3. Chronic insomnia lasts for years at a time. It can be caused by another disorder, or it can be a primary disorder. Its effects can vary according to its causes. They might include sleepiness, muscular fatigue, hallucinations, and/or mental fatigue; but people with chronic insomnia often show increased alertness. Some people that live with this disorder see things as though they were happening in slow motion, whereas moving objects seem to blend together. Can cause double vision.

Patterns of insomnia

The pattern of insomnia often is related to the etiology. Insomnia affects 8 in 10 people.

1. Onset insomnia - difficulty falling asleep at the beginning of the night, often associated with anxiety disorders.
2. Middle-of-the-Night Insomnia - Insomnia characterized by difficulty returning to sleep after awakening in the middle of the night or waking too early in the morning. Also referred to as nocturnal awakenings. Encompasses middle and terminal insomnia.
3. Middle insomnia - waking during the middle of the night, difficulty maintaining sleep. Often associated with pain disorders or medical illness.
4. Terminal (or late) insomnia - early morning waking. Characteristic of clinical depression.

Causes

Insomnia can be caused by:

• Psychoactive drugs or stimulants, including certain medications, herbs, caffeine, cocaine, ephedrine, amphetamines, methylphenidate, MDMA, methamphetamine and modafinil
• Fluoroquinolone antibiotic drugs, see Fluoroquinolone toxicity, associated with more severe and chronic types of insomnia
• Hormone shifts such as those that precede menstruation and those during menopause
• Life problems like fear, stress, anxiety, emotional or mental tension, work problems, financial stress, unsatisfactory sex life
• Mental disorders such as bipolar disorder, clinical depression, general anxiety disorder, post traumatic stress disorder, schizophrenia, or obsessive compulsive disorder.
• Disturbances of the circadian rhythm, such as shift work and jet lag, can cause an inability to sleep at some times of the day and excessive sleepiness at other times of the day. Jet lag is seen in people who travel through multiple time zones, as the time relative to the rising and setting of the sun no longer coincides with the body's internal concept of it. The insomnia experienced by shift workers is also a circadian rhythm sleep disorder.
• Estrogen is considered to play a significant role in women's mental health (including insomnia). A conceptual model of how estrogen affects mood was suggested by Douma et al 2005 based on their extensive literature review relating activity of endogenous, bio-identical and synthetic estrogen with mood and well-being. They concluded the sudden estrogen withdrawal, fluctuating estrogen, and periods of sustained estrogen low levels correlated with significant mood lowering. Clinical recovery from depression postpartum, perimenopause, and postmenopause was shown to be effective after levels of estrogen were stabilized and/or restored.
• Certain neurological disorders, brain lesions, or a history of traumatic brain injury
• Medical conditions such as hyperthyroidism
• Abuse of over-the counter or prescription sleep aids can produce rebound insomnia
• Poor sleep hygiene, e.g., noise
• Parasomnia, which includes a number of disruptive sleep events including nightmares, sleepwalking, violent behavior while sleeping, and REM behavior disorder, in which a person moves his/her physical body in response to events within his/her dreams
• A rare genetic condition can cause a prion-based, permanent and eventually fatal form of insomnia called fatal familial insomnia
• Parasites can cause intestinal disturbances while sleeping.