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Insomnia


Facts to Know:

  • About one third of all adults report symptoms of insomnia.
  • Insomnia can exist on its own or in connection with other conditions, including psychiatric conditions (such as anxiety or depression) or physical conditions (such as pain or breathing disorder).
  • Insomnia can be treated effectively with therapy and/or medications.

What is insomnia?

Insomnia is a “sleep disorder” characterized by insufficient sleep quantity or quality.  Insomnia can involve difficulty in falling asleep or in maintaining sleep once it is initiated. The consequences of insomnia can include fatigue, impaired concentration, and depressed or anxious mood.

Symptoms

In general, insomnia is defined subjectively by the sufferer, but specific diagnostic criteria have been suggested:

  • Difficulty in initiating or maintaining sleep, or early-morning awakening with inability to return to sleep.
  • Significant distress or impairment in functioning due to sleep difficulty.
  • Sleep difficulty occurring at least three nights per week and present for at least three months.
  • Sleep difficulty occurring despite adequate opportunity for sleep

Diagnosis

A diagnosis of insomnia is made by a clinician in collaboration with the individual reporting the sleep difficulty.  The diagnosis and understanding of the sleep difficulty can be aided by a “sleep diary” that the individual keeps under the guidance of the clinician.  Polysomnography is a laboratory method that can also aid in the diagnosis and understanding of a sleep problem. Polysomnography entails overnight observation of the individual while various aspects of physiology (such as breathing, movement, and brain activity) are evaluated.

Treatment

At ColumbiaDoctors, we provide an array of treatments for insomnia. Search our providers for a therapist or psychiatrist who may be a good fit for you.

Psychotherapy

Cognitive-behavioral therapy for insomnia (CBT-I) is an effective psychotherapy for insomnia when the insomnia is uncomplicated by other disorders. CBT-I involves changing both behavioral and thinking patterns that can interfere with sleep.  CBT-I can also include various forms of relaxation training.  When insomnia is accompanied by other psychiatric disorders, such as anxiety or depression, psychotherapy can be expanded to address those conditions as well.

Psychopharmacology (Medication Management)

Psychiatric medications can be helpful in alleviating psychiatric disorders that may entail insomnia, allowing insomnia to be brought under better control.  In addition, short-term use of sleep medications can be helpful in providing temporary relief of insomnia.

Medical Referral

For an underlying medical condition (pain, breathing disorder, etc.), referral is available to an appropriate ColumbiaDoctors specialist.

Article written by:

Ethan E. Gorenstein, Ph.D.