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Primary Insomnia
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Primary Insomnia is only classified as a problem, if over a period of at least one month, a person has difficulty falling asleep or maintaining their sleep. To be diagnosed as primary insomnia, the sleep problem must cause difficulty in the person's social, school, work, or other significant area of life. Most often, people with insomnia complain of problems in falling asleep, or they complain of fitful sleeping or frequent awakening. Some report that the quality of their sleep is poor, that they are restless during sleep. This condition may turn into an aggravating cycle in that the more a person focuses on their sleep problems, they may be less likely to get good quality sleep. Insomnia can also lead to difficulties with a personís concentration, energy level, or mood. The main characteristics of primary insomnia are:

For at least a month the persons main complaint has been trouble going to sleep, staying asleep or feeling unrested.

The insomnia, or resulting daytime fatigue, causes clinically important distress or impairs work, social or personal functioning.

It does not occur solely in the course of Breathing-Related or Circadian Rhythm Sleep Disorder, Narcolepsy or a Parasomnia.

It does not occur solely in the course of another mental disorder (such as a Delirium, Generalized Anxiety Disorder, Major Depressive Disorder).

These symptoms are not directly caused by a general medical condition or substance use, including medications and drugs of abuse.

Associated Features:

Chronic. Illness
Depression
Anxiety
Stress,
High caffeine consumption
Abuse of alcohol
Heavy smoking
Unusual sleep patterns

Differential Diagnosis:

Some disorders have similar or even the same symptoms. The clinician, therefore, in his/her diagnostic attempt, has to differentiate against the following disorders which need to be ruled out to establish a precise diagnosis .Frequently, but not always, insomnia can be caused by:

Anxiety
Depression
Circadian Rhythm Sleep Disorder

Cause:

Insomnia is difficulty in initiating or maintaining sleep, and may be short-term or chronic. Short-term insomnia is most often related to anxiety, for example anticipation of a serious life change, and usually resolves when anxiety lessens. Individuals with chronic insomnia most often report not being able to fall asleep, although individuals may also complain of frequent night-time awakening. Time of onset of primary insomnia is usually young adulthood or middle age.

Treatment:

The treatment is related to the cause, if it can be determined. If there is an obvious physical or psychological cause, these are the main focus of treatment. Control ones environmental and lifestyle is also beneficial, factors such as too much light, noise, caffeine or other stimulants, or erratic hours of wakefulness should be addressed as part of the persons overall treatment plan.

Counseling and Psychotherapy [ See Therapy Section ]:

Behavioral strategies that promote good sleep practices, such as establishing a regular sleep/wake schedule, taking moderate exercise prior to retiring for the night, avoidance of alcohol or stimulating substances, such as caffeine. The establishment of a regular schedule of activities allows the individual to prepare for sleep and may effectively manage the sleep problem.

Pharmacotherapy [ See Psychopharmacology Section ] :

Benzodiazepines and the related compounds, zolpidem and zaleplon, are the safest and most effective hypnotic agents. Ideally, medications are only a short-term solution and other forms of treatment should be tried before resorting to drugs .Barbiturates and related compounds should be used cautiously, if at all, as they are more likely to be associated with addiction and adverse effects without significantly increasing effectiveness.

Other medications that may be used for insomnia include sedating antidepressants such as TCAs or trazodone, as well as antihistamines (eg, diphenhydramine).


DSM Code

307.42 Primary Insomnia

F51.01 Primary Insomnia

Disorder Sheets

Narcolepsy Association UK
Narcolepsy UK
PO Box 13842
Penicuik
EH26 8WX

Tel: +448454500394
Email: Click Here

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Forum: Click Here

Recommended Book

Treatment of Late-Life Insomnia - Click Here to View

 

Primary Insomnia

Misc Information

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