Sleep Disorders: Insomnia

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  • Insomnia
    • Defined as problems with falling asleep or staying asleep.
    • Secondary Insomnia
      • Underlying cause and insomnia is a symptom of the main disorder.
      • Insomnia can be a symptom  of depression.
      • Typical of people who do shift work of who have circadian rhythm disorders such as phase delay syndrome.
      • Can be a result of environment factors too such as too much caffeine.
      • Distinguishing between primary and secondary insomnia is important because of the implications of the treatment.
        • If insomnia is a symptom then it is more important to treat the cause rather than the effect. For example if insomnia was caused by depression then it would be best to treat depression as then both depression and insomnia will be treated.
          • However recent research has cast doubt upon whether insomnia is an effect. It may be a cause which shows it may be helpful to treat insomnia too despite it being primary or secondary.
    • Primary Insomnia
      • Insomnia occurs on its own.
      • Developed bad sleep habits - staying up too late or sleeping in a bedroom that is too light.
      • cause may disappear but insomnia remains.
    • Risk factors influencing insomnia
      • Old people and women are more likely to suffer from insomnia.
      • physical problems such as arthritis may disrupt sleep and lead to insomnia - more common in older people.
      • Increased incidence of insomnia in women is due to age-related hormone fluctuations.
      • Sleep Apnoea
        • Person stops breathing when asleep which has disruptive effects on sleep.
        • pauses can vary in length.
      • Personality
        • Insomniacs are more likely to internalise psychological disturbance rather than talking about it
        • Internalisation leads to higher levels of emotional arousal and increased likelihood of feeling anxious which is a risk factor for insomnia.
      • There are risk factors influencing insomnia. Speilman and Glovinsky proposed three different components predisposing, precipitating and perpetuating.
        • Predisposing factors are genetic. for example when you have the gene for a certain disorder so you are more likely to develop it. Bonnet and Arand found insomniacs are more likely to experience hyperarousal making it more difficult to get to sleep. However, predisposing factors alone are unlikely to to explain chronic primary insomnia. The diathesis stress model proposes the vulnerability is not enough to cause a disorder to develop. there needs to some sort of trigger.
          • This shows that there are many factors that can cause insomnia whether they are predisposing, precipitating, or perpetuating.




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