9 In order to diagnose the specific type of insomnia, it is important for clinicians to ask about the history of insomnia, insomnia symptoms, sleep-wake routines and patterns, other sleep-related symptoms, daytime functioning and consequences, and previous treatments.

Insomnia is diagnosed through a detailed clinical history taken from the patient and their bed partner. Other Medical conditions: diabetes, fibromyalgia, hypertension, cardiovascular disease, stroke, chronic pain Psychiatric and cognitive conditions Depression, anxiety, mania, panic attacks, schizophrenia, substance abuse, dementia Sleep disorders: Sleep apnea, restless leg syndrome, periodic limb movement disorder, rapid eye movement disorder, Age-related circadian rhythm change (phase advance) Medications: Theophylline, thyroid hormone, anti-cholinergics, stimulants, oral decongestants, antidepressants, corticosteriods, antihypertensives, opioids, non-steroidal anti-inflammatory drugs It helps with falling asleep however, when the effect wears off, sleep becomes light and disrupted.) alcohol (Note that alcohol is frequently used to self-medicate for sleep problems. Irregular sleep schedules, caffeine use later in the day, alcohol close to bedtime.Ĭaregiving, hospitalizations, new medical problems Moving to a new home or downsizing to a smaller space or a retirement community or related facility 5Įxcessive noise, hot or cold temperatures, light during the sleep period, 5 Recurrent insomnia is episodic and often returns with the occurrence of stressful life events. If the insomnia doesn’t resolve, it evolves into chronic insomnia. Usually when the event that triggers the insomnia is resolved, so too does the insomnia. 5, 8 Life events such as retirement, hospitalizations, and new onset illnesses can precipitate situational insomnia. 5 Situational insomnia is usually acute insomnia which lasts a few days or weeks and is associated with changes in the sleep schedule or the sleep environment. 8 Insomnia can also be situational, persistent, or recurrent. 5– 7 Older adults tend to have more challenges with sleep maintenance compared to younger adults, 3, 4, 8 which results in reductions in total sleep time and sleep efficiency. 5– 7 Late insomnia or early-morning awakenings is waking up early on mornings and being unable to return to sleep. 5– 7 Sleep maintenance or middle insomnia involves multiple and prolonged awakenings during the night. Sleep onset or initial insomnia is manifested by difficulty falling asleep that occurs at the start of the sleep period.

Therapy for insomnia