Sleep is a natural, important process that is a necessity piece of a person's overall functionality. In essence, sleep allows the body to refresh and rejuvenate, as several key processes connected to the growth and repair of the immune, nervous, skeletal, and muscular systems occur at their most heightened level during the act of slumber. Yet while most people have no issue falling asleep due an internal adherence to their own circadian rhythm, there are some that cannot complete this task on a routine basis due to a condition known as insomnia.

Insomnia at a Glance

The basic definition of insomnia is that it is a sleep disorder marked by an inability to fall asleep or to stay asleep as long as a person would desire. However, the actual condition itself is much more complex.

The category of insomnia is segmented into two separate groups. The first group, primary insomnia, is a sleep disorder that is not linked to any separate condition. The second group, secondary insomnia or comorbid insomnia, is a sleep disorder brought about by the presence of another sleep, medical, or psychiatric disorder. Examples of comorbid insomnia can be found through the condition's links to significant hormonal shifts, excessive anxiety, rheumatoid arthritis, and clinical depression, amongst other conditions.

As far as recognizing the condition itself, the latest edition of the Diagnostic and Statistical Manual of Mental Disorders lists certain criteria that defines the distinguishing marks of the actual condition itself. Some of these metrics include a difficulty in initiating sleep, trouble maintaining sleep once it has been achieved, and early-morning awakening paired with an inability to return to sleep. These metrics are augmented by certain measurements related to length and time, such as whether such difficulties occur at least three times a week or if they happen despite the person having the adequate opportunity to sleep. Furthermore, the criteria used by the DSM states that this issue is only marked as such if the condition is not better explained by a different sleep-wake disorder, such as narcolepsy or sleep apnea.

Types of Insomnia

In addition to being grouped into primary or comorbid categories, the condition of insomnia can be further broken down into three separate types:

  1. Transient insomnia - This type of insomnia is measured by its fleeting nature, as conditions that fall into this designation lasts for less than a week. There are several root causes to this type of insomnia, such as changes in a person's sleep environment or severe depression.
  2. Acute insomnia - Also known as short term insomnia or stress related insomnia, this type of insomnia is measured by an inability to sleep well consistently for less than a month. This type can occur even when the conditions for sleep are adequate enough to promote sleep.
  3. Chronic insomnia - This type of insomnia a measured by the condition lasting longer than a month. It can either be a primary or a comorbid disorder. It has been determined that people that have high levels of stress hormones or experience shifts in their cytokine levels are the most likely candidates to have this kind of condition.

Insomnia Symptoms

Although insomnia can sometimes be considered a symptom of another condition, the condition itself is marked by several symptoms in its own right.

The most prominent symptom of insomnia, naturally, is an inability to fall asleep. This would include a person finding it difficult to find a comfortable sleeping position. Another symptom is an inability to return to sleep after waking up during the night. Other symptoms of insomnia are primarily tied to the after-effects of not getting a good night sleep. These would include not feeling refreshed after a period of sleep or a heightened level of irritability, anxiety, or daytime sleepiness. It would also contain periods of early morning awakening, which pairs an awakening that occurs more than 30 minutes than desired with an inability to go back to sleep, resulting in a sleep session that is less than 6.5 hours.

Occasionally, a condition in which a delayed period of sleep can occur is designated as being insomnia. However, this is an incorrect designation, as this particular condition is actually defined by a second condition known as delayed sleep phase disorder.

Comorbid Insomnia and Outside Influences

In certain cases, comorbid insomnia can be brought about by a person's interactions with certain foreign ingestions. The most common of this type of interaction is caffeine, whose properties as a stimulant can make it difficult for a person to fall asleep. Other items that can be associated with this kind of ingestion-based interaction include the use of psychoactive drugs up to and including certain prescribed medications. The condition can also be brought about through the removal of certain materials that have been ingested for any duration of time, such as withdrawal from anti-anxiety drugs or pain-relievers.

Another condition that has been linked to the cause of insomnia has to do with certain issues regarding the body as it is trying to rest. One of these conditions is restless legs syndrome; a condition that is marked by the onset of discomforting sensations that are felt and a need to move or shift extremities as a means to achieve relief. Another one of these conditions is periodic limb movement disorder; a condition that is marked by the causation of limb movements that occur without the sleeper's knowledge. This condition should not be confused with restless legs syndrome, as this particular condition is one that is solely marked by involuntary movements.

A third condition that has been determined to cause insomnia is the disturbance of the circadian rhythm; the biological process that essentially governs periods of wakefulness and sleepiness. These conditions, such as shift work or jet lag, can produce an inability to sleep at times that the circadian rhythm would deem as optimal, as well as excessive sleepiness during other times throughout the day.

Other Insomnia-Related Metrics

It has been determined that insomnia is a condition that affects all age groups and both genders. However, it has also been determined that the condition affects certain groups at a more prevalent rate. These groups include people over 60, people with a history of mental health disorders including depression, those that have a heightened level of emotional stress, and people that are in conditions that force a disruption to the circadian rhythm, such as working late night shifts or traveling through different time zones.

Additionally, it has also been suggested through study that certain steroid hormones can play a key factor in the promotion of insomnia. The hormone that is most prominently linked to this particular condition is cortisol, which is also the hormone that causes wakefulness.

Treatment of Insomnia

As a rule, instances of transient insomnia or acute insomnia are not something that needs to be treated. The reason for this is because both insomnia types are considered to be temporary and will terminate on their own within a specified interval.

Chronic insomnia, on the other hand, is a condition that can be treated. However, there are a few steps involved in the overarching treatment process.

The first step involves the proper diagnosis and subsequent treatment of any underlying conditions that may be causing a symptomatic instance of insomnia. Once all of these conditions have been ruled out, there are several avenues that can be explored. Some of these treatments are non-pharmacological in their nature, and these particular treatments are typically recommended as a first line defense and a long term management strategy. The strategies that are most often deployed include a focus on sleep hygiene, stimulus control, relaxation therapy, and certain emphases on developing new sleep behaviors such as keeping a regular daily sleep schedule and restricting the amount of time a person stays awake in bed. An additional emphasis has been placed in deploying preventative measures as a means to control insomnia, such as avoiding caffeinated drinks during the 8 hours before the designated sleeping time.

Another treatment for insomnia is built around prescribed medications as well as non-prescription sleeping tablets. Studies show that the percentage of adults that turn to prescription sleep aids increases with age. It has also been noted that some people that are suffering from the transient or acute types of insomnia may seek short-term relief in the form of over-the-counter antihistamines, which have been known to cause drowsiness as a side effect. Alternative medicines such as the herbs chamomile and lavender have also been used by people seeking relief from the condition.

Ultimately, it is important that the person that is suffering from the chronic form of insomnia seek out some sort of treatment as a means to combat the condition. The body's need for sleep is an essential component of overall bodily functionality, and finding out ways to promote and protect that particular process could very well represent the fine line that separates a person that is capable of performing at an optimal level and a person that is incapable of high performance.