Overview

People with sleep deprivation or insomnia try hard to go to sleep and the harder they try, the more difficult it becomes to fall asleep. Insomnia is the most common sleep disorder and its sleeplessness symptoms are a dead giveaway of its diagnosis.

Insomnia is a sleep disorder, the prevalence of which ranges from 10 to 15% among the general population. This condition continues to be underdiagnosed and under-treated.

The presenting complaints are often that of[] difficulties falling asleep in spite of being in bed, waking up often during the night and having trouble going back to sleep, waking up too early in the morning or having an unrefreshing sleep.

If you fall asleep, you may wake up too early and may lie sleepless for hours trying to go back to sleep without success. Insomnia reduces the mental and physical ability of the person.

Insomnia can be acute, which lasts for a short duration or it can be chronic in which case the sleep disorder lasts for a longer duration and which may need medical intervention.

Insomnia is not just a symptom. It is a health condition that needs to be corrected because it can have serious health complications on the body.

There are various reasons that cause you to spend sleepless nights. Some of them are primary and can be corrected immediately. Other causes could be certain health conditions that may need medical intervention.  

Symptoms and signs of insomnia are often enough to diagnose that the person is suffering from this sleep disorder, but specific tests may be required to diagnose an underlying pathology if suspected. Overall, however, insomnia can be cured.

Symptoms and signs

Insomnia symptoms can be night-time and day-time and may include:

  • Difficulty in falling asleep is the main insomnia symptom
  • Depending on sleeping pills or alcohol to fall asleep
  • Feeling tired, irritable, and sleepy during the next day
  • Malaise – feeling unwell
  • Not feeling fresh the next morning when you wake up
  • Waking up several times during the night
  • Lack of concentration, lack of energy, and loss of performance at work during the day
  • Headaches and anxiety
  • Disorientation
  • Dark circles under the eyes
  • Stomach upset problems
  • Impaired motor coordination
  • Motor vehicle accidents caused by mental fatigue due to sleep deprivation
  • Poor socializing

What are the characteristics of chronic insomnia?

Chronic insomnia is a more complex condition than acute insomnia.

Knowing how chronic insomnia presents helps to distinguish it from the acute type. The characteristics of chronic insomnia include:

  • Circumstances: A chronic insomnia diagnosis requires the presence of insomnia without any underlying factors that would interfere with your ability to sleep (such as changes in work schedule, life events, etc.). 
  • Frequency: If you suffer from sleeplessness frequently, at least three times per week for three months, your insomnia is of the chronic type.
  • Duration: Chronic insomnia lasts for at least three months.
  • Explanation: Chronic insomnia doesn’t happen because of medications (including both medical and nonmedical drugs) or other sleep disorders.
  • Daytime inefficiency. There is daytime impairment of cognition and performance that impacts not only the patient and his family but also affects friends and coworkers.
  • More visits to hospital. People with chronic insomnia are more likely to take medical help and may frequently visit hospitals and physicians. 
  • Reduced work efficiency. They have increased absenteeism at work and make more errors
  • Increased risk of accidencts. They are at an increased risk to suffer accidents at work, including accidents on road.   

Diagnosis and tests for insomnia

Insomnia is primarily a subjective clinical diagnosis, and therefore, a patient’s symptoms of sleep problems play the most important role in diagnosis and subsequent management in most cases. 

The sleep specialist, who is an expert in sleep medicine, is one who treats patients with insomnia. He begins by checking the person’s symptoms and thoroughly taking the medical history. He also physically examines the patient.  

The medical history will help to rule out any emotional stress or chronic illness or any medication he is taking that may be disturbing the patient’s sleep. If it is stress-related, the sleep specialist will advise him on certain stress management techniques to sleep well.

The specialist may also ask for certain blood tests to rule out certain medical causes such as an over-active thyroid gland, rheumatoid arthritis, kidney diseases, etc.

More blood tests may help to rule out iron deficiency anemia, and vitamin B12 deficiency (to exclude restless leg syndrome).

If he suspects, he may ask for a reference from a psychiatrist to rule out mental disorders such as depression, bipolar disorder, anxiety, etc.

The sleep specialist may order polysomnography, which is an overnight sleep study, to rule out sleep disorders such as sleep apnea.

 He may also order an electroencephalogram (EEG), electrooculography (EOG), electromyography (EMG), electrocardiography (ECG), pulse oximetry, and airflow to rule out periodic limb movement disorder, sleep apnea, and narcolepsy.