Insomnia Disorder

Question 1

How prevalent?

Answer 1

Most prevalent - 10%

Question 2

Symptoms

Answer 2

• Difficulty falling asleep
• Difficulty staying asleep
• Waking up early in the morning and failing to fall back asleep
• Daytime sleepiness and fatigue
• Cognitive impairment
• Mood changes

Question 3

Duration

Answer 3

• occurring at least 3 nights per week
• Min of 3 months duration
• Acute (<1 month), subacute (1-3 months), or persistent (>3 months)

Question 4

Treatment

Answer 4

• Obtain complete sleep history
• Assess for underlying causes (psychiatric disorders, medical disorders, ethanol/drugs/medications)
• Patient characteristics
• Family history
• Pharm/nonpharm treatment history

Question 5

Causes of Insomnia

Answer 5

• environmental, sleep wake cycle disorders, lifestyle/schedule, irregular activities -> 10%
• Medical (neurologic, pain, UTI, breathing disorders) -> 35%
• Psychiatric (depression/anxiety) -> 50%

Question 6

Causes of Insomnia - Medications

Answer 6

• Acetylcholinesterase inhibitors
• Sympathomimetics
• Clonidine
• Steroids
• Beta Blockers
• Antiparkinson agents
• Nicotine
• Alcohol
  -Drug withdrawal
• Antidepressants
• Stimulants
• thyroid supplements