Explanations for Insomnia
> Some people suffer difficulties in sleeping for a short period of time (a few days of weeks) = tends to be caused by worries, such as exam stress or death in the family, noises at night, jet lag or a temporary medical condition.
Long-term (chronic) insomnia
> Chronic insomnia describes sleep difficulties for more than 4 weeks (DSM definition) - a distinction is then made between secondary & primary insomnia (secondary is much more common).
Primary insomnia -
> Primary insomnia occurs when a person is having sleep problems that aren't directly associated with and other health condition or physical cause (such as drug abuse or medications).
> A person may be feeling stressed/depressed but such psychological states aren't the cause - it may be that they've developed bad sleep habits (going to bed late) & this causes insomnia, but insomnia is the only problem.
> Sometimes insomnia may have had an identifiable cause which has been gotten rid of but the insomnia still persists due to an expectation of sleep difficulty (they've come to expect insomnia which leads to anxiety which keeps them awake).
Secondary insomnia -
> Secondary insomnia is when someone's having sleep problems due to something else - there's a single, underlying medical, psychiatric or environmental cause.
> Secondary insomnia is a symptom of the main disorder (it comes second, after the main disorder) - e.g. insomnia is a characteristic of illness, such as depression (medical condition is first & is the underlying cause of the insomnia).
> Insomnia is typical of people who do shift work or who have circadian rhythm disorders, such as phase delay syndrome, where abnormal biological rhythms cause sleepiness at inappropriate times.
> Older people tend to be more likely to experience insomnia because of discomfort when sleeping due to, for example, rheumatism - they also have more difficulty sleeping due to reduced sleep (SWS) & therefore are more easily awoken.
> Insomnia may be the result of environmental factors, such as too much caffeine or alcohol.
> Other sleep disorders (parasomnias) like apnoea can cause insomnia.
Primary versus secondary insomnia
> It's important to distinguish between primary & secondary insomnia because of the implications for treatment - if insomnia is a symptom of another disorder then it's important to treat the disorder, not the symptom (insomnia).
> It may not be that simple to work out the cause of a person's insomnia - does depression cause insomnia or does insomnia cause depression?
> OHAYON AND ROTH studied almost 15,000 Europeans & found that insomnia more often…