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Insomnia is a sleeping disorder characterised by the inability to fall asleep and/or the inability to remain asleep for a reasonable amount of time. Insomniacs have been known to complain about being unable to close their eyes or "rest their mind" for more than a few minutes at a time. Both organic and non-organic insomnia constitute a sleep disorder.Types of InsomniaThere are two broad categories: * Chronic insomnia - lasting for several weeks, months or even years * Transient insomnia - lasting for a few nights or weeks only, usually connected to a stressful event e.g. an exam, a bereavement.Within these broad categories insomnia usually takes one or more of the following forms: * Difficulty falling asleep - more common among young people * Sleeping lightly and restlessly, waking often, lying awake in the middle of the night - more common in people over 40. In younger people it may be associated with depression. * Waking early and being unable to get back to sleep - this is more common in older people and anyone worrying about something in particular.What Causes Insomnia?Causes of acute insomnia can include: * Significant life stress (job loss or change, death of a loved one, divorce, moving). * Illness. * Emotional or physical discomfort. * Environmental factors like noise, light, or extreme temperatures (hot or cold) that interfere with sleep. * Some medications (for example those used to treat colds, allergies, depression, high blood pressure and asthma) may interfere with sleep. * Interferences in normal sleep schedule (jet lag or switching from a day to night shift, for example).TreatmentNonbenzodiazepine prescription drugs, including the nonbenzodiazepines zolpidem and zopiclone, are more selective for the GABA receptor and may have a cleaner side effect profile than the older benzodiazepines; however, there are controversies over whether these non-benzodiazepine drugs are superior to benzodiazepines. These drugs appear to cause both psychological dependence and physical dependence, and can also cause the same memory and cognitive disturbances as the benzodiazepines along with morning sedation.Some antidepressants such as mirtazapine, trazodone and doxepin have a sedative effect, and are prescribed off label to treat insomnia. The major drawback of these drugs is that they have antihistaminergic, anticholinergic and antiadrenergic properties which can lead to many side effects. Some also alter sleep architecture.
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