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Dyssomnia

Dyssomnia covers a range of specific sleep disorders, the Inability to Sleep, Insomnia, Sleeplessness, Wakefulness. Chronic and persistent difficulty in either; falling asleep, remaining asleep through the night, or waking up too early. All types of insomnia can lead to daytime drowsiness, poor concentration, and the inability to feel refreshed and rested in the morning.

The Dyssomnias are disorders of sleep or wakefulness they are not Parasomnias. Dysosomias therefore include the following specific disorders:

Insomnia.

Apnea

Insomnia may be divided into three groups: transient insomnias, which last for several days; short-term insomnias, which can last up to three weeks; and chronic insomnias, which continue for more than three weeks.

Associated Features:

Psycho-Physiologic Insomnia.
Idiopathic.
Narcolepsy.
Recurrent Hypersomnia.
Obstructive Apnea Syndrome.
Mixed Apnea Syndrome.
Central Apnea Syndrome.
Alveolar Hypoventilation.
Periodic Leg Movements and Leg-Related Syndrome
.

Differential Diagnosis:

Some disorders have similar symptoms. The clinician, therefore, in his diagnostic attempt has to differentiate against the following disorders which need to be ruled out to establish a precise diagnosis.

Nightmare Disorder
Depression

Cause:

For many people, poor sleep habits are the cause. However, because insomnia is a key symptom of depression, you should be evaluated for depression if you are having sleeping difficulties. Generally transient insomnias may be caused by stress, changes in sleeping patterns, related to shift working and jet lag. Short-term insomnias may be caused by the effects of severe stressful events, serious family or relationship problems and bereavement. Finally the causes of chronic insomnia are more evasive and difficult to identify. Some factors associated with Dyssomnia are therefore:

Jet Lag
Shift Work
Grief
Depression or Major Depression
Anxiety or Stress
Nicotine, Alcohol, Caffeine or other stimulants at bedtime
Natural Aging Process
Excessive Daytime Sleeping
Overactive thyroid (hyperthyroidism)
Medication side-effects
Abruptly Stopping a Medication (such as sleeping pills).

Treatment:

Drug treatment should only be resorted to a as a last option. Practice good sleep hygiene: avoid using alcohol in the evening and to avoid caffeine before bedtime.

Establish a regular bedtime, but don't go to bed if you feel wide awake. Use the bedroom for bedroom activities only. Once in bed, use creative imagery and relaxation techniques to keep your mind off unrestful thoughts. Avoid staying in bed for long periods of time while awake, or going to bed because of boredom. Relax by reading, taking a bath, or listening to soothing music before getting to bed.

Counseling and Psychotherapy [ See Therapy Section ]:

Counseling may be helpful for psychological disorders that lead to insomnia and the practice of relaxation techniques may also be helpful.

Pharmacotherapy [ See Psychopharmacology Section ] :

Antidepressants can often help both the sleeping problem and the depression usually associated with the disorder. As previously indicated medication should be a last resort only.

related books
  Insomnia: Psychological Assessment and Management
UK Support Groups
  Mind

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Fax: 020 8522 1725
Email:
contact@mind.org.uk

Web: http://www.mind.org.uk
  
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Page Updated
19th July 2003