Insomnia - Knowledge

67: 1779:(CBT-I). Recommendations include reducing caffeine, nicotine, and alcohol consumption, maximizing the regularity and efficiency of sleep episodes, minimizing medication usage and daytime napping, the promotion of regular exercise, and the facilitation of a positive sleep environment. The creation of a positive sleep environment may also be helpful in reducing the symptoms of insomnia. On the other hand, a systematic review by the AASM concluded that clinicians should not prescribe sleep hygiene for insomnia due to the evidence of absence of its efficacy and potential delaying of adequate treatment, recommending instead that effective therapies such as CBT-i should be preferred. 2461: 1747:. Examples of such environmental modifications include using the bed for sleep and sex only, not for activities such as reading or watching television; waking up at the same time every morning, including on weekends; going to bed only when sleepy and when there is a high likelihood that sleep will occur; leaving the bed and beginning an activity in another location if sleep does not occur in a reasonably brief period of time after getting into bed (commonly ~20 min); reducing the subjective effort and energy expended trying to fall asleep; avoiding exposure to bright light during night-time hours, and eliminating daytime naps. 2516: 1563:

sleep and they must result in problems with daytime function. Hyperarousal can be linked to acute insomnia since it activates the body's fight-or-flight response. When we encounter stress or danger, our bodies naturally become more alert, which can interfere with our capacity to both fall asleep and remain asleep. This heightened state of arousal can be useful in the short term during threatening situations, but if it continues over an extended period, it can result in acute insomnia. Acute insomnia is also known as

2276:, are a class of hypnotic medications that are similar to benzodiazepines in their mechanism of action, and indicated for mild to moderate insomnia. Their effectiveness at improving time to sleeping is slight, and they have similar—though potentially less severe—side effect profiles compared to benzodiazepines. Prescribing of nonbenzodiazepines has seen a general increase since their initial release on the US market in 1992, from 2.3% in 1993 among individuals with sleep disorders to 13.7% in 2010. 418: 2355:, are used in the treatment of insomnia. However, while common, use of antipsychotics for this indication is not recommended as the evidence does not demonstrate a benefit, and the risk of adverse effects are significant. A major 2022 systematic review and network meta-analysis of medications for insomnia in adults found that quetiapine did not demonstrate any short-term benefits for insomnia. Some of the more serious adverse effects may also occur at the low doses used, such as 299:. It may result in an increased risk of accidents of all kinds as well as problems focusing and learning. Insomnia can be short term, lasting for days or weeks, or long term, lasting more than a month. The concept of the word insomnia has two possibilities: insomnia disorder (ID) and insomnia symptoms, and many abstracts of randomized controlled trials and systematic reviews often underreport on which of these two possibilities the word insomnia refers to. 1937:

to 6% among those aged 50–59, and reached 7% among those aged 80 and over. More adult women (5%) reported using prescription sleep aids than adult men (3%). Non-Hispanic white adults reported higher use of sleep aids (5%) than non-Hispanic black (3%) and Mexican-American (2%) adults. No difference was shown between non-Hispanic black adults and Mexican-American adults in use of prescription sleep aids.

2128: 2367:, with most of the risk being driven by cardiovascular death. Laboratory data from an unpublished analysis of the same cohort also support the lack of dose-dependency of metabolic side effects, as new use of low-dose quetiapine was associated with a risk of increased fasting triglycerides at one-year follow-up. Concerns regarding side effects are greater in the elderly. 1727:, and maintaining a regular sleep schedule and a wake-up time. Behavioral therapy can assist a patient in developing new sleep behaviors to improve sleep quality and consolidation. Behavioral therapy may include, learning healthy sleep habits to promote sleep relaxation, undergoing light therapy to help with worry-reduction strategies and regulating the circadian clock. 1763:

oneself go to sleep, it relieves the performance anxiety that arises from the need or requirement to fall asleep, which is meant to be a passive act. This technique has been shown to reduce sleep effort and performance anxiety and also lower subjective assessment of sleep-onset latency and overestimation of the sleep deficit (a quality found in many insomniacs).

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deliver treatment, making this effective intervention more accessible and less costly. The Internet has already become a critical source of health-care and medical information. Although the vast majority of health websites provide general information, there is growing research literature on the development and evaluation of Internet interventions.

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a secondary one;" insomnia typically predates psychiatric symptoms. "In fact, it is possible that insomnia represents a significant risk for the development of a subsequent psychiatric disorder." Insomnia occurs in between 60% and 80% of people with depression. This may partly be due to treatment used for depression.

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behaviors that disrupt their sleep, such as irregular sleep schedules, spending excessive time awake in bed, or engaging in stimulating activities close to bedtime, it can lead to conditioned wakefulness contributing to chronic insomnia. People with high levels of stress hormones or shifts in the levels of

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tolerance and withdrawal they can "trick" insomniacs into thinking they are helping with sleep. There is a general awareness that long-term use of benzodiazepines for insomnia in most people is inappropriate and that a gradual withdrawal is usually beneficial due to the adverse effects associated with the

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medications also have a number of side-effects such as day time fatigue, motor vehicle crashes and other accidents, cognitive impairments, and falls and fractures. Elderly people are more sensitive to these side-effects. Some benzodiazepines have demonstrated effectiveness in sleep maintenance in the

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medications for insomnia do not have better sleep than chronic insomniacs not taking medications. In fact, chronic users of hypnotic medications have more regular night-time awakenings than insomniacs not taking hypnotic medications. Many have concluded that these drugs cause an unjustifiable risk to

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A key distinction between CBT-i and ACT lies in the divergent approaches to time spent awake in bed. Proponents of CBT-i advocate minimizing time spent awake in bed, on the basis that this creates cognitive association between being in bed and wakefulness. The ACT approach proposes that avoiding time

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A component of stimulus control therapy is sleep restriction, a technique that aims to match the time spent in bed with actual time spent asleep. This technique involves maintaining a strict sleep-wake schedule, sleeping only at certain times of the day and for specific amounts of time to induce mild

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published a systematic review of 12 studies published from January 2000 to April 2020 that found that adult subjects with higher gaming addiction scores were more likely to have shorter sleep quantity, poorer sleep quality, delayed sleep timing, and greater daytime sleepiness and insomnia scores than

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These online programs are typically behaviorally-based treatments that have been operationalized and transformed for delivery via the Internet. They are usually highly structured; automated or human supported; based on effective face-to-face treatment; personalized to the user; interactive; enhanced

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is a common term for all of the behaviors which relate to the promotion of good sleep. They include habits which provide a good foundation for sleep and help to prevent insomnia. However, sleep hygiene alone may not be adequate to address chronic insomnia. Sleep hygiene recommendations are typically

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Paradoxical intention is a cognitive reframing technique where the insomniac, instead of attempting to fall asleep at night, makes every effort to stay awake (i.e. essentially stops trying to fall asleep). One theory that may explain the effectiveness of this method is that by not voluntarily making

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Medications have been used mainly to reduce symptoms in insomnia of short duration; their role in the management of chronic insomnia remains unclear. Several different types of medications may be used. Many doctors do not recommend relying on prescription sleeping pills for long-term use. It is also

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is the inability to consistently sleep well for a period of less than a month. Insomnia is present when there is difficulty initiating or maintaining sleep or when the sleep that is obtained is non-refreshing or of poor quality. These problems occur despite adequate opportunity and circumstances for

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includes insomnia but does not fully elaborate on the symptoms compared to the DSM-5. Instead of early-morning waking as a symptom, the DSM-IV-TR listed “nonrestorative sleep” as a primary symptom. The duration of the experience was also vague in the DSM-IV-TR. The DSM-IV-TR stated that symptoms had

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In many cases, insomnia is co-morbid with another disease, side-effects from medications, or a psychological problem. Approximately half of all diagnosed insomnia is related to psychiatric disorders. For those who have depression, "insomnia should be regarded as a co-morbid condition, rather than as

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published a systematic review of 31 studies examining associations between screen time and sleep outcomes in children younger than 5 years and found that screen time is associated with poorer sleep outcomes for children under the age of 5, with meta-analysis only confirming poor sleep outcomes among

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Between 10% and 30% of adults have insomnia at any given point in time and up to half of people have insomnia in a given year, making it the most common sleep disorder. About 6% of people have insomnia that is not due to another problem and lasts for more than a month. People over the age of 65 are

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With this technique, it is difficult to distinguish lack of sleep caused by a disorder which is also a cause of premature death, versus a disorder which causes a lack of sleep, and the lack of sleep causing premature death. Most of the increase in mortality from severe insomnia was discounted after

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and, as a result, tend to be tired during most of the day. Another cause of insomnia in children with ADHD is the use of stimulants used to treat their disorder. Children who have ADHD then, as well as the other disorders mentioned, may be given melatonin before bedtime in order to help them sleep.

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side-effects (such as dry mouth) may also be a drawback with these particular drugs. While addiction does not seem to be an issue with this class of drugs, they can induce dependence and rebound effects upon abrupt cessation of use. However, people whose insomnia is caused by restless legs syndrome

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The percentage of adults using a prescription sleep aid increases with age. During 2005–2010, about 4% of U.S. adults aged 20 and over reported that they took prescription sleep aids in the past 30 days. Rates of use were lowest among the youngest age group (those aged 20–39) at about 2%, increased

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have sustained and lasting effects on treating insomnia long after therapy has been discontinued. The addition of hypnotic medications with CBT-I adds no benefit in insomnia. The long lasting benefits of a course of CBT-I shows superiority over pharmacological hypnotic drugs. Even in the short term

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rebound also plays a role as when someone is drinking; alcohol inhibits glutamine, one of the body's natural stimulants. When the person stops drinking, the body tries to make up for lost time by producing more glutamine than it needs. The increase in glutamine levels stimulates the brain while the

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published a systematic review and meta-analysis of 16 studies comprising 8,077 subjects that established a significant association between binge-watching and sleep problems and a stronger association between binge-watching and sleep problems was found during the COVID-19 pandemic than pre-pandemic.

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properties, which contribute to both their therapeutic effects and side effect profiles, while mirtazapine's actions are primarily antihistaminergic and antiserotonergic and trazodone's effects are primarily antiadrenergic and antiserotonergic. Mirtazapine is known to decrease sleep latency (i.e.,

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Stimulus control therapy is a treatment for patients who have conditioned themselves to associate the bed, or sleep in general, with a negative response. As stimulus control therapy involves taking steps to control the sleep environment, it is sometimes referred interchangeably with the concept of

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Non medication based strategies provide long lasting improvements to insomnia and are recommended as a first line and long-term strategy of management. Behavioral sleep medicine (BSM) tries to address insomnia with non-pharmacological treatments. The BSM strategies used to address chronic insomnia

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can be used to keep track of the individual's sleep patterns. The diary should include time to bed, total sleep time, time to sleep onset, number of awakenings, use of medications, time of awakening, and subjective feelings in the morning. The sleep diary can be replaced or validated by the use of

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A qualified sleep specialist should be consulted for the diagnosis of any sleep disorder so the appropriate measures can be taken. Past medical history and a physical examination need to be done to eliminate other conditions that could be the cause of insomnia. After all other conditions are ruled

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Between 10% and 30% of adults have insomnia at any given point in time and up to half of people have insomnia in a given year. About 6% of people have insomnia that is not due to another problem and lasts for more than a month. People over the age of 65 are affected more often than younger people.

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upon discontinuation, and long-term worsening of sleep, especially after consistent usage over long periods of time. Benzodiazepines, while inducing unconsciousness, actually worsen sleep as – like alcohol – they promote light sleep while decreasing time spent in deep sleep. A further problem is,

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have been found, but the results have been inconsistent, and the implications of altered levels of such a ubiquitous neurotransmitter are unknown. Studies on whether insomnia is driven by circadian control over sleep or a wake dependent process have shown inconsistent results, but some literature

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published a systematic review of 49 studies investigating associations between electronic media use and various sleep outcomes among children and adolescents 15 years of age or younger that found a strong association with sleep duration and stronger evidence for an association with sleep duration

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often sleep for a normal amount of time. The problem is that, despite sleeping for multiple hours each night and typically not experiencing significant daytime sleepiness or other symptoms of sleep loss, they do not feel like they have slept very much, if at all. Because their perception of their

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A survey of 1.1 million residents in the United States found that those that reported sleeping about 7 hours per night had the lowest rates of mortality, whereas those that slept for fewer than 6 hours or more than 8 hours had higher mortality rates. Severe insomnia – sleeping less than 3.5

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lasts for longer than a month. It can be caused by another disorder, or it can be a primary disorder. Common causes of chronic insomnia include persistent stress, trauma, work schedules, poor sleep habits, medications, and other mental health disorders. When an individual consistently engages in

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has demonstrated effectiveness in the treatment of insomnia with improvements in duration as well as quality of sleep. Self-help therapy (defined as a psychological therapy that can be worked through on one's own) may improve sleep quality for adults with insomnia to a small or moderate degree.

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can emerge. Although there is little evidence for benefit of benzodiazepines in insomnia compared to other treatments and evidence of major harm, prescriptions have continued to increase. This is likely due to their addictive nature, both due to misuse and because – through their rapid action,

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Despite the therapeutic effectiveness and proven success of CBT, treatment availability is significantly limited by a lack of trained clinicians, poor geographical distribution of knowledgeable professionals, and expense. One way to potentially overcome these barriers is to use the Internet to

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have been found suggesting increased activity of the HPA axis and arousal; second, increased global cerebral glucose utilization during wakefulness and NREM sleep in people with insomnia; and lastly, increased full body metabolism and heart rate in those with insomnia. All these findings taken

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published a systematic review of 42 studies that found digital media use to be associated with shorter sleep duration and poorer sleep quality and bedtime or nighttime use with poor sleep outcomes, but only found associations for general screen use, mobile phone use, computer and internet use,

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While insomnia can be caused by a number of conditions, it can also occur without any identifiable cause. This is known as Primary Insomnia. Primary Insomnia may also have an initial identifiable cause, but continues after the cause is no longer present. For example, a bout of insomnia may be

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and lack evidence of long-term effectiveness. It is preferred that hypnotics be prescribed for only a few days at the lowest effective dose and avoided altogether wherever possible, especially in the elderly. Between 1993 and 2010, the prescribing of benzodiazepines to individuals with sleep

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published a systematic review of 12 studies investigating associations between exposure to video games, sleep outcomes, and post-sleep cognitive abilities that found the data present in the studies indicated associations between a reduction in sleep duration, increased sleep onset latency,

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The lowest mortality was seen in individuals who slept between six and a half and seven and a half hours per night. Even sleeping only 4.5 hours per night is associated with very little increase in mortality. Thus, mild to moderate insomnia for most people is associated with increased

2363:. Such concerns of risks at low doses are supported by Danish observational studies that showed an association of use of low-dose quetiapine (excluding prescriptions filled for tablet strengths >50 mg) with an increased risk of major cardiovascular events as compared to use of 1838:

CBT is the well-accepted form of therapy for insomnia since it has no known adverse effects, whereas taking medications to alleviate insomnia symptoms have been shown to have adverse side effects. Nevertheless, the downside of CBT is that it may take a lot of time and motivation.

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published a meta-analysis of 29 studies comprising 20,041 subjects that found a weak-to-moderate association between mobile phone addiction and sleep disorder and that adolescents with mobile phone addiction were at higher risk of developing sleep disorder. In August 2022, the

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important to identify and treat other medical conditions that may be contributing to insomnia, such as depression, breathing problems, and chronic pain. As of 2022, many people with insomnia were reported as not receiving overall sufficient sleep or treatment for insomnia.

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published a systematic review of 36 cross-sectional studies and 6 longitudinal studies that found that 24 of the cross-sectional studies and 5 of the longitudinal studies established significant associations between more frequent social media use and poor sleep outcomes.

1960:. Diphenhydramine and doxylamine are widely used in nonprescription sleep aids. They are the most effective over-the-counter sedatives currently available, at least in much of Europe, Canada, Australia, and the United States, and are more sedating than some prescription 796:

triggered by a stressful work or life event. However the condition may continue after the stressful event has been resolved. In such cases, the insomnia is usually perpetuated by the anxiety or fear caused by the sleeplessness itself, rather than any external factors.

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have emerged as alternative approaches to treating insomnia. ACT rejects the idea that behavioral changes can help insomniacs achieve better sleep, since they require "sleep efforts" - actions which create more "struggle" and arouse the nervous system, leading to

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published a systematic review and meta-analysis of 34 studies comprising 51,901 subjects that established significant associations between problematic gaming and sleep duration, poor sleep quality, daytime sleepiness, and other sleep problems. In September 2021,

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published a meta-analysis of 23 longitudinal studies comprising 116,431 adolescent subjects that found that adolescent screen time with computers, smartphones, social media, and television are positively associated with negative impacts on sleep health later in

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It is common for patients who have difficulty falling asleep to also have nocturnal awakenings with difficulty returning to sleep. Two-thirds of these patients wake up in the middle of the night, with more than half having trouble falling back to sleep after a

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Around half of post-menopausal women experience sleep disturbances, and generally sleep disturbance is about twice as common in women as men; this appears to be due in part, but not completely, to changes in hormone levels, especially in and post-menopause.

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Wilson SJ, Nutt DJ, Alford C, Argyropoulos SV, Baldwin DS, Bateson AN, et al. (November 2010). "British Association for Psychopharmacology consensus statement on evidence-based treatment of insomnia, parasomnias and circadian rhythm disorders".

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published a systematic review and meta-analysis of 14 studies that found positive associations between problematic smartphone use and poor sleep quality and between higher levels of problematic smartphone use and elevated risk of poor sleep quality.

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published a systematic review and meta-analysis of 16 studies of smartphone addiction and sleep among medical students found that 57% of subjects had poor sleep and 39% of subjects had smartphone addiction with a correlation index of 0.3, while

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out a comprehensive sleep history should be taken. The sleep history should include sleep habits, medications (prescription and non-prescription), alcohol consumption, nicotine and caffeine intake, co-morbid illnesses, and sleep environment. A

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Two main models exists as to the mechanism of insomnia, cognitive and physiological. The cognitive model suggests rumination and hyperarousal contribute to preventing a person from falling asleep and might lead to an episode of insomnia.

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is generally the first line treatment once this has been done. It has been found to be effective for chronic insomnia. The beneficial effects, in contrast to those produced by medications, may last well beyond the stopping of therapy.

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in the treatment and management of insomnia. In this therapy, patients are taught improved sleep habits and relieved of counter-productive assumptions about sleep. Common misconceptions and expectations that can be modified include:

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Early morning awakening is an awakening occurring earlier (more than 30 minutes) than desired with an inability to go back to sleep, and before total sleep time reaches 6.5 hours. Early morning awakening is often a characteristic of

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drinker is trying to sleep, keeping them from reaching the deepest levels of sleep. Stopping chronic alcohol use can also lead to severe insomnia with vivid dreams. During withdrawal, REM sleep is typically exaggerated as part of a

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published a systematic review of 23 studies that found that excessive use of digital screens by adolescents was associated with poor sleep quality, nighttime awakenings, long sleep latency, and daytime sleepiness. In December 2022,

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published a systematic review and meta-analysis of 40 studies with 33,650 post-secondary student subjects that found a weak-to-moderate positive association between mobile phone addiction and poor sleep quality. In April 2021,

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published a systematic review and meta-analysis of 19 studies comprising 253,904 adolescent subjects that found that excessive technology use had a strong and consistent association with reduced sleep duration and prolonged

2001:, can have an immediate sedative effect, and are prescribed to treat insomnia. Trazodone was at the beginning of the 2020s the biggest prescribed drug for sleep in the United States despite not being indicated for sleep. 10669:

Suraev AS, Marshall NS, Vandrey R, McCartney D, Benson MJ, McGregor IS, et al. (October 2020). "Cannabinoid therapies in the management of sleep disorders: A systematic review of preclinical and clinical studies".

10055:"Comparative effects of 18 antipsychotics on metabolic function in patients with schizophrenia, predictors of metabolic dysregulation, and association with psychopathology: a systematic review and network meta-analysis" 1509:

The insomnia is not better explained by and does not occur exclusively during the course of another sleep-wake disorder (e.g., narcolepsy, a breathing-related sleep disorder, a circadian rhythm sleep-wake disorder, a

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Authier N, Boucher A, Lamaison D, Llorca PM, Descotes J, Eschalier A (2009). "Second meeting of the French CEIP (Centres d'Evaluation et d'Information sur la Pharmacodépendance). Part II: benzodiazepine withdrawal".

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Difficulty maintaining sleep, characterized by frequent awakenings or problems returning to sleep after awakenings. (In children, this may manifest as difficulty returning to sleep without caregiver intervention.)

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Winokur A, DeMartinis NA, McNally DP, Gary EM, Cormier JL, Gary KA (October 2003). "Comparative effects of mirtazapine and fluoxetine on sleep physiology measures in patients with major depression and insomnia".

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sleep deprivation. Complete treatment usually lasts up to 3 weeks and involves making oneself sleep for only a minimum amount of time that they are actually capable of on average, and then, if capable (i.e. when

11092: 11073: 11042: 2027:, a melatonergic antidepressant with claimed sleep-improving qualities that does not cause daytime drowsiness, is approved for the treatment of depression though not sleep conditions in the European Union and 720:

published a systematic review and meta-analysis of 26 studies that found a weak but statistically significant association with increased smartphone and tablet computer use and poorer sleep in early childhood.

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Bertschy G, Ragama-Pardos E, Muscionico M, Aït-Ameur A, Roth L, Osiek C, et al. (January 2005). "Trazodone addition for insomnia in venlafaxine-treated, depressed inpatients: a semi-naturalistic study".

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Mallawaarachchi SR, Anglim J, Hooley M, Horwood S (2022). "Associations of smartphone and tablet use in early childhood with psychosocial, cognitive and sleep factors: a systematic review and meta-analysis".

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diseases can benefit from the use of melatonin. This is because they often have trouble sleeping due to their disorders. For example, children with ADHD tend to have trouble falling asleep because of their

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It has been hypothesized that epigenetics might also influence insomnia through a controlling process of both sleep regulation and brain-stress response having an impact as well on the brain plasticity.

1106:. They also have an elevated metabolic rate, which does not occur in people who do not have insomnia but whose sleep is intentionally disrupted during a sleep study. Studies of brain metabolism using 707:

between the ages of 6 and 15 years than for 5 years of age or younger, while evidence for associations between electronic media use with other sleep outcomes was more inconclusive. In December 2021,

8601: 1434:. Usually, the test is not needed to make a diagnosis, and insomnia especially for working people can often be treated by changing a job schedule to make time for sufficient sleep and by improving 10356: 2689:. Horne writes "everybody sleeps and needs to do so", and generally this appears true. However, he also relates from contemporary accounts the case of Paul Kern, who was shot in 1915 fighting in 1875:

Research has shown that "ACT has a significant effect on primary and comorbid insomnia and sleep quality, and ... can be used as an appropriate treatment method to control and improve insomnia".

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and/or sleep maintenance. They are oriented towards blocking signals in the brain that stimulate wakefulness, therefore claiming to address insomnia without creating dependence. There are three

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Common forms of CBT-I treatments include stimulus control therapy, sleep restriction, sleep hygiene, improved sleeping environments, relaxation training, paradoxical intention, and biofeedback.

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hours in women and 4.5 hours in men – is associated with a 15% increase in mortality, while getting 8.5 or more hours of sleep per night was associated with a 15% higher mortality rate.

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published a systematic review of 9 studies that found a weak-to-moderate association between sleep quantity and quality and problematic smartphone use among adolescents. In October 2020, the

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may be done to look for underlying sleep disorders. Screening may be done with two questions: "do you experience difficulty sleeping?" and "do you have difficulty falling or staying asleep?"

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Bhagavan C, Kung S, Doppen M, John M, Vakalalabure I, Oldfield K, et al. (December 2020). "Cannabinoids in the Treatment of Insomnia Disorder: A Systematic Review and Meta-Analysis".

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published a systematic review and meta-analysis of 17 studies comprising 36,485 subjects that found that smartphone overuse was closely associated with self-reported poor sleep quality,

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and lifestyle changes are typically the first treatment for insomnia. Sleep hygiene includes a consistent bedtime, a quiet and dark room, exposure to sunlight during the day and regular

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Numerous studies have reported positive outcomes of combining cognitive behavioral therapy for insomnia treatment with treatments such as stimulus control and the relaxation therapies.

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Krystal AD (August 2009). "A compendium of placebo-controlled trials of the risks/benefits of pharmacological treatments for insomnia: the empirical basis for U.S. clinical practice".

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published a systematic review and meta-analysis of 80 studies that found that greater screen time was associated with shorter sleep duration among toddlers and preschoolers, while the

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indicate that people with insomnia have higher metabolic rates by night and by day. The question remains whether these changes are the causes or consequences of long-term insomnia.

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are used in the treatment of insomnia. The evidence for melatonin in treating insomnia is generally poor. There is low-quality evidence that it may speed the onset of sleep by 6

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Some patients may need to do an overnight sleep study to determine if insomnia is present. Such a study will commonly involve assessment tools including a polysomnogram and the

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Jiaxin Y, Xi F, Xiaoli L, Yamin L (2020). "Association of problematic smartphone use with poor sleep quality, depression, and anxiety: A systematic review and meta-analysis".

3376:"Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment" 1832:

when compared to short-term hypnotic medication such as zolpidem, CBT-I still shows significant superiority. Thus CBT-I is recommended as a first line treatment for insomnia.

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The sleep disturbance causes clinically significant distress or impairment in social, occupational, educational, academic, behavioral, or other important areas of functioning.

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Pagano M, Bacaro V, Crocetti E (2023). ""Using digital media or sleeping … that is the question". A meta-analysis on digital media use and unhealthy sleep in adolescence".

9996:"Comparative effects of pharmacological interventions for the acute and long-term management of insomnia disorder in adults: a systematic review and network meta-analysis" 1981:

are effective for treating sleep problems whether or not they are associated with depression. While all antidepressants help regulate sleep, some antidepressants, such as

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Jiang XL, Zheng XY, Yang J, Ye CP, Chen YY, Zhang ZG, et al. (December 2015). "A systematic review of studies on the prevalence of insomnia in university students".

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Zhang J, Zhang X, Zhang K, Lu X, Yuan G, Yang H, et al. (2022). "An updated of meta-analysis on the relationship between mobile phone addiction and sleep disorder".

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that found that the increased screen time during the lockdowns negatively impacted sleep duration, sleep quality, sleep onset latency, and wake time. In March 2023, the

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Morin CM, Bélanger L, Bastien C, Vallières A (January 2005). "Long-term outcome after discontinuation of benzodiazepines for insomnia: a survival analysis of relapse".

4161:"Correlations between mobile phone addiction and anxiety, depression, impulsivity, and poor sleep quality among college students: A systematic review and meta-analysis" 3932:

Alimoradi Z, Lin CY, Broström A, Bülow PH, Bajalan Z, Griffiths MD, et al. (2019). "Internet addiction and sleep problems: A systematic review and meta-analysis".

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Among lifestyle practices, going to sleep and waking up at the same time each day can create a steady pattern which may help to prevent insomnia. Avoidance of vigorous

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Brautsch LA, Lund L, Andersen MM, Jennum PJ, Folker AP, Andersen S (2023). "Digital media use and sleep in late adolescence and young adulthood: A systematic review".

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Trauer JM, Qian MY, Doyle JS, Rajaratnam SM, Cunnington D (August 2015). "Cognitive Behavioral Therapy for Chronic Insomnia: A Systematic Review and Meta-analysis".

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subunit is associated with sedation, motor impairment, respiratory depression, amnesia, ataxia, and reinforcing behavior (drug-seeking behavior). Modulation of the α

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published a systematic review and meta-analysis of 16 studies that established a correlation coefficient of 0.56 between nomophobia and insomnia. In September 2023,

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and severe insomnia is associated only with a very small effect on mortality. It is unclear why sleeping longer than 7.5 hours is associated with excess mortality.

1276:, opioids may be appropriate in carefully selected patients with pain-associated insomnia. However, dependence on opioids can lead to long-term sleep disturbances. 9810: 5895: 2075:

While the use of melatonin in the short-term has been proven to be generally safe and it is shown to not be a dependent medication, side effects can still occur.

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Riemann D, Perlis ML (June 2009). "The treatments of chronic insomnia: a review of benzodiazepine receptor agonists and psychological and behavioral therapies".

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subunit is associated with anxiolytic activity and disinhibition. For this reason, certain benzodiazepines may be better suited to treat insomnia than others.

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gene in both males and females. This study showed that the genetic architecture of insomnia strongly overlaps with psychiatric disorders and metabolic traits.

900:: an injury or condition that causes pain can preclude an individual from finding a comfortable position in which to fall asleep, and can also cause awakening. 7295: 7088:"Clinical Practice Guideline for the Pharmacologic Treatment of Chronic Insomnia in Adults: An American Academy of Sleep Medicine Clinical Practice Guideline" 8658:

Schittecatte M, Dumont F, Machowski R, Cornil C, Lavergne F, Wilmotte J (2002). "Effects of mirtazapine on sleep polygraphic variables in major depression".

8382: 888:, which can cause sleep onset insomnia due to the discomforting sensations felt and the need to move the legs or other body parts to relieve these sensations 2021:

the time it takes to fall asleep), promoting sleep efficiency and increasing the total amount of sleeping time in people with both depression and insomnia.

10153:"Use of low-dose quetiapine increases the risk of major adverse cardiovascular events: results from a nationwide active comparator-controlled cohort study" 8593: 2233:

subunit compared to alprazolam and diazepam, making them superior sedative-hypnotics – alprazolam and diazepam, in turn, have higher activity at the α

7595:

Ellis J, Hampson SE, Cropley M (May 2002). "Sleep hygiene or compensatory sleep practices: An examination of behaviours affecting sleep in older adults".

6920: 6697: 1406:. It is measured using eight different parameters related to sleep, finally represented as an overall scale which assesses an individual's sleep pattern. 1369:

suggests a deregulation of the circadian rhythm based on core temperature. Increased beta activity and decreased delta wave activity has been observed on

10332: 5045: 7531: 8184:

Ritterband LM, Gonder-Frederick LA, Cox DJ, Clifton AD, West RW, Borowitz SM (2003). "Internet interventions: In review, in use, and into the future".

291:. They may have difficulty falling asleep, or staying asleep for as long as desired. Insomnia is typically followed by daytime sleepiness, low energy, 9692: 3285:"The Association Between Insomnia and Sleep Duration in Adults With Attention-Deficit Hyperactivity Disorder: Results From a General Population Study" 14336: 11934: 4855: 3731: 1526:

to be present for a month, whereas in the DSM-5 it stated symptoms had to be present for three months and occur at least 3 nights a week (Gillette).

1129:

that influence the risk of insomnia, and showed that insomnia is highly polygenic. In particular, a strong positive association was observed for the

7224: 4073:

Mac Cárthaigh S, Griffin C, Perry J (2020). "The relationship between sleep and problematic smartphone use among adolescents: A systematic review".

3500: 1868:

to be avoided) but rather as a longer-term activity to help calm the nervous system and create the internal conditions from which sleep can emerge.

12744: 9595:"Effectiveness of non-benzodiazepine hypnotics in treatment of adult insomnia: meta-analysis of data submitted to the Food and Drug Administration" 5250:

Ouellet MC, Beaulieu-Bonneau S, Morin CM (2006). "Insomnia in patients with traumatic brain injury: frequency, characteristics, and risk factors".

5157: 2386:

have sleep-promoting effects but are not commonly used for treatment of insomnia. Gabapentin is not effective in helping alcohol related insomnia.

6376: 10501:

Kim J, Lee SL, Kang I, Song YA, Ma J, Hong YS, et al. (May 2018). "Natural Products from Single Plants as Sleep Aids: A Systematic Review".

5023: 4709:"Systematic Review and Meta-Analysis of the Correlation Coefficients between Nomophobia and Anxiety, Smartphone Addiction, and Insomnia Symptoms" 4209: 2863: 2799: 1860:. The ACT approach posits that acceptance of the negative feelings associated with insomnia can, in time, create the right conditions for sleep. 1450: 10713:

Gates PJ, Albertella L, Copeland J (December 2014). "The effects of cannabinoid administration on sleep: a systematic review of human studies".

10201: 8523: 6986: 5917: 1361:

all contributing to insomnia. However, it is unknown if the hyperarousal is a result of, or cause of insomnia. Altered levels of the inhibitory

1156:

Alcohol is often used as a form of self-treatment of insomnia to induce sleep. However, alcohol use to induce sleep can be a cause of insomnia.

13551: 8996: 8972: 8744: 2772: 12956: 9157: 4110:"The Relationships between Screen Use and Health Indicators among Infants, Toddlers, and Preschoolers: A Meta-Analysis and Systematic Review" 2072:

Usage of melatonin as a treatment for insomnia in adults has increased from 0.4% between 1999 and 2000 to nearly 2.1% between 2017 and 2018.

1945:

As an alternative to taking prescription drugs, some evidence shows that an average person seeking short-term help may find relief by taking

6339: 5534: 5207:

Bendz LM, Scates AC (January 2010). "Melatonin treatment for insomnia in pediatric patients with attention-deficit/hyperactivity disorder".

4625:"Dose-response analysis of smartphone usage and self-reported sleep quality: a systematic review and meta-analysis of observational studies" 14782: 14329: 13568: 9861:

Maglione M, Maher AR, Hu J, Wang Z, Shanman R, Shekelle PG, et al. (Sep 2011). "Off-Label Use of Atypical Antipsychotics: An Update".

5450: 5343: 3705: 1585:

are more likely than others to have chronic insomnia. Its effects can vary according to its causes. They might include muscular weariness,

3138: 12405: 11002: 10961: 8460: 5599:"Genome-wide association analysis of insomnia complaints identifies risk genes and genetic overlap with psychiatric and metabolic traits" 4917: 4576:"Unprecedented times and uncertain connections: A systematic review examining sleep problems and screentime during the COVID-19 pandemic" 527: 6727: 12395: 11545: 9712:

Thompson W, Quay TA, Rojas-Fernandez C, Farrell B, Bjerre LM (June 2016). "Atypical antipsychotics for insomnia: a systematic review".

8840: 8424: 8386: 6800: 6245:

Soldatos CR, Dikeos DG, Paparrigopoulos TJ (June 2000). "Athens Insomnia Scale: validation of an instrument based on ICD-10 criteria".

3538: 2735: 2636:

affected more often than younger people. Females are more often affected than males. Insomnia is 40% more common in women than in men.

7843: 1541:

lasts for less than a week. It can be caused by another disorder, by changes in the sleep environment, by the timing of sleep, severe

479:

can be misdiagnosed as insomnia, as sleep onset is delayed to much later than normal while awakening spills over into daylight hours.

8943: 8099: 4953: 1788: 1776: 1687:

medication for insomnia and they may have longer lasting effects. Hypnotic medication is only recommended for short-term use because

378: 256: 9825: 14557: 8776: 2106: 1755:

improves), slowly increasing this amount (~15 min) by going to bed earlier as the body attempts to reset its internal sleep clock.

347: 5817:

Poyares D, Guilleminault C, Ohayon MM, Tufik S (1 June 2004). "Chronic benzodiazepine usage and withdrawal in insomnia patients".

1617:

a few hours before going to sleep is recommended, while exercise earlier in the day may be beneficial. Other practices to improve

1479:

Predominant complaint of dissatisfaction with sleep quantity or quality, associated with one (or more) of the following symptoms:

608: 5358: 4020:"Associations of screen time, sedentary time and physical activity with sleep in under 5s: A systematic review and meta-analysis" 3600:

Kertesz RS, Cote KA (2011). "Event-related potentials during the transition to sleep for individuals with sleep-onset insomnia".

8263: 6514:"Sleep disorders and depression: brief review of the literature, case report, and nonpharmacologic interventions for depression" 3885:"Exposure to video games: effects on sleep and on post-sleep cognitive abilities. A sistematic review of experimental evidences" 1651:

Making the bedroom suitable for sleep by keeping it dark, cool, and free of devices, such as clocks, cell phones, or televisions

653:

published a systematic review and meta-analysis of 23 studies comprising 35,684 subjects that found a statistically significant

9878:

Nasrallah HA (January 2008). "Atypical antipsychotic-induced metabolic side effects: insights from receptor-binding profiles".

9511: 6616: 6210:

Lord C, Sekerovic Z, Carrier J (October 2014). "Sleep regulation and sex hormones exposure in men and women across adulthood".

3578: 10380:"Gabapentin and pregabalin in bipolar disorder, anxiety states, and insomnia: Systematic review, meta-analysis, and rationale" 9020:

Lyseng-Williamson KA (November 2012). "Melatonin prolonged release: in the treatment of insomnia in patients aged ≥55 years".

8920:

Brasure M, MacDonald R, Fuchs E, Olson CM, Carlyle M, Diem S, et al. (December 2015). "Management of Insomnia Disorder".

8142: 6355:

Actigraphy is indicated as a method to characterize circadian patterns or sleep disturbances in individuals with insomnia, ...

1913:. In some places medications are prescribed in over 95% of cases. They, however, are a second line treatment. In 2019, the US 14687: 14287: 11927: 10996: 10955: 10444: 9541: 9505: 8817: 8390: 8165: 7416: 5723: 5191: 4911: 3685: 3660: 3484: 3132: 3017: 2840: 2640: 2615:. After controlling for sleep duration and insomnia, use of sleeping pills was also found to be associated with an increased 1397: 8219:

Cheng SK, Dizon J (2012). "Computerised cognitive behavioural therapy for insomnia: a systematic review and meta-analysis".

2229:

receptor compared to other benzodiazepines (for example, triazolam and temazepam have significantly higher activity at the α

1483:

Difficulty initiating sleep. (In children, this may manifest as difficulty initiating sleep without caregiver intervention.)

8371: 6885: 6833:

Abad VC, Guilleminault C (September 2018). "Insomnia in Elderly Patients: Recommendations for Pharmacological Management".

5682: 9063:

Lemoine P, Zisapel N (April 2012). "Prolonged-release formulation of melatonin (Circadin) for the treatment of insomnia".

8305:"Management of Chronic Insomnia Disorder in Adults: A Clinical Practice Guideline From the American College of Physicians" 2906:"Management of Chronic Insomnia Disorder in Adults: A Clinical Practice Guideline From the American College of Physicians" 14352: 11507: 8345:"FDA adds Boxed Warning for risk of serious injuries caused by sleepwalking with certain prescription insomnia medicines" 7796: 7641: 1284:

Insomnia affects people of all age groups but people in the following groups have a higher chance of acquiring insomnia:

9826:

American Association of Clinical Endocrinologists, North American Association for the Study of Obesity (February 2004).

1426:

to screen for sleep disorders. This test may be indicated for patients with symptoms in addition to insomnia, including

13544: 9792: 9497:

Handbook of Integrative Clinical Psychology, Psychiatry, and Behavioral Medicine: Perspectives, Practices, and Research

5887: 4760:"The relationship between smartphone addiction and sleep among medical students: A systematic review and meta-analysis" 3069: 2197: 1864:

practice is a key feature of this approach, although mindfulness is not practised to induce sleep (this in itself is a

1823:

medications are equally effective in the short-term treatment of insomnia, but their effects wear off over time due to

999:, can cause an inability to sleep at some times of the day and excessive sleepiness at other times of the day. Chronic 751: 716: 14714: 14599: 14545: 12661: 8420: 3534: 1848: 745:

published a systematic review of 18 studies investigating associations between sleep problems and screen time during

38: 10853: 10583:

Wheatley D (July 2005). "Medicinal plants for insomnia: a review of their pharmacology, efficacy and tolerability".

9642:

Jacobson LH, Hoyer D, de Lecea L (January 2022). "Hypocretins (orexins): The ultimate translational neuropeptides".

14677: 14304: 11920: 11385: 11380: 11352: 9806: 9788: 7307: 2221:. Some theorize that certain benzodiazepines (hypnotic benzodiazepines) have significantly higher activity at the α 2207: 2046:

found the safety of taking antidepressants for insomnia to be uncertain with no evidence supporting long term use.

808: 302:

Insomnia can occur independently or as a result of another problem. Conditions that can result in insomnia include

7715:"Cognitive behavior therapy and pharmacotherapy for insomnia: a randomized controlled trial and direct comparison" 14446: 11540: 11497: 11471: 11230: 1000: 982: 891: 10236:

Conn DK, Madan R (2006). "Use of sleep-promoting medications in nursing home residents: risks versus benefits".

7059:"NIH State-of-the-Science Conference Statement on manifestations and management of chronic insomnia in adults". 14461: 6912: 6693: 3234:"Unclear Insomnia Concept in Randomized Controlled Trials and Systematic Reviews: A Meta-Epidemiological Study" 2392:, while once used, are no longer recommended for insomnia due to the risk of addiction and other side effects. 1348:

The physiological model is based upon three major findings in people with insomnia; firstly, increased urinary

958: 768: 726: 66: 8701:

Le Strat Y, Gorwood P (September 2008). "Agomelatine, an innovative pharmacological response to unmet needs".

5646:

Palagini L, Biber K, Riemann D (June 2014). "The genetics of insomnia – evidence for epigenetic mechanisms?".

5049: 1793:

There is some evidence that cognitive behavioral therapy for insomnia (CBT-I) is superior in the long-term to

1666:

It is recommended to rule out medical and psychological causes before deciding on the treatment for insomnia.

13537: 11812: 11620: 11482: 2693:

and then "never slept again" until his death in 1955. Kern appears to be a completely isolated, unique case.

2519: 1122: 966: 11059: 1168:

and REM sleep fragmentation. Frequent moving between sleep stages occurs with; awakenings due to headaches,

14702: 14540: 14400: 11492: 11420: 11265: 9685: 8009:

Salari N, Khazaie H, Hosseinian-Far A, Khaledi-Paveh B, Ghasemi H, Mohammadi M, et al. (August 2020).

7999:

Meadows, G. (2015) The sleep book: How to sleep well every night. London, UK: Orion Publishing Group, p.2-7

5943:

Lichstein KL, Taylor DJ, McCrae CS, Ruiter ME (November 2010). "Insomnia: epidemiology and risk factors.".

5852:

Asaad TA, Ghanem MH, Samee AM, El-Habiby MM (2011). "Sleep Profile in Patients with Chronic Opioid Abuse".

5597:

Hammerschlag AR, Stringer S, de Leeuw CA, Sniekers S, Taskesen E, Watanabe K, et al. (November 2017).

3508: 1914: 1815:

Performance anxiety after trying for so long to have a good night's sleep by controlling the sleep process.

1667: 1603: 1454: 1265: 1107: 954: 593: 484: 476: 441: 230: 10463:

Leach MJ, Page AT (December 2015). "Herbal medicine for insomnia: A systematic review and meta-analysis".

4863: 3727: 397:. These medications are not recommended for more than four or five weeks. The effectiveness and safety of 14373: 13432: 13082: 11625: 7216: 6942:

Wortelboer U, Cohrs S, Rodenbeck A, Rüther E (2002). "Tolerability of hypnosedatives in older patients".

3374:

Edinger JD, Arnedt JT, Bertisch SM, Carney CE, Harrington JJ, Lichstein KL, et al. (February 2021).

2237:

subunit compared to triazolam and temazepam, making them superior anxiolytic agents). Modulation of the α

2095: 1549:. Its consequences – sleepiness and impaired psychomotor performance – are similar to those of 1442: 1103: 942: 781: 581: 14189: 9994:

De Crescenzo F, D'Alò GL, Ostinelli EG, Ciabattini M, Di Franco V, Watanabe N, et al. (July 2022).

5153: 3289:

Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine

14388: 14263: 14025: 13987: 13967: 13187: 13001: 11487: 7014: 2871: 2807: 2460: 2429: 2425: 2284: 2054: 2031:. After trials in the United States, its development for use there was discontinued in October 2011 by 1692: 589: 4311:"Electronic media use and sleep in children and adolescents in western countries: a systematic review" 657:

for sleep problems and reduced sleep duration for subjects with internet addiction. In February 2020,

14572: 13803: 12838: 11703: 11512: 11460: 11435: 8425:"Evaluating Newer Sleeping Pills Used to Treat: Insomnia. Comparing Effectiveness, Safety, and Price" 2069:

minutes. Ramelteon does not appear to speed the onset of sleep or the amount of sleep a person gets.

1542: 869: 556: 555:

Some cases of insomnia are not really insomnia in the traditional sense, because people experiencing

550: 492: 31: 17: 9970:. Comparative Effectiveness Reviews, No. 43. Rockville: Agency for Healthcare Research and Quality. 9192:"The efficacy and safety of drug treatments for chronic insomnia in adults: a meta-analysis of RCTs" 8011:"The effect of acceptance and commitment therapy on insomnia and sleep quality: A systematic review" 5971:

Billings ME, Cohen RT, Baldwin CM, Johnson DA, Palen BN, Parthasarathy S, et al. (March 2021).

5921: 5019: 4210:"Interplay between social media use, sleep quality, and mental health in youth: A systematic review" 2764: 1888:

by graphics, animations, audio, and possibly video; and tailored to provide follow-up and feedback.

1098:

have suggested that people who have sleep disruption have elevated night-time levels of circulating

14777: 14729: 14719: 14466: 14245: 13949: 13164: 12978: 11260: 11123: 7467:

Lande RG, Gragnani C (December 2010). "Nonpharmacologic approaches to the management of insomnia".

5474:"Interactions between sleep, stress, and metabolism: From physiological to pathological conditions" 2152: 1261: 1157: 630: 173: 9165: 3852:"Sleep problems in excessive technology use among adolescent: a systemic review and meta-analysis" 3539:"Evaluating New Sleeping Pills Used to Treat: Insomnia Comparing Effectiveness, Safety, and Price" 14550: 14510: 14488: 14292: 11800: 11581: 11390: 10053:

Pillinger T, McCutcheon RA, Vano L, Mizuno Y, Arumuham A, Hindley G, et al. (January 2020).

8841:"Servier and Novartis sign licensing agreement for agomelatine, a novel treatment for depression" 6298: 5522: 3341: 1063: 928:, emotional or mental tension, work problems, financial stress, birth of a child, and bereavement 496: 168: 10436: 7756:"Behavioral and pharmacological therapies for late-life insomnia: a randomized controlled trial" 7552:

Kierlin L (November 2008). "Sleeping without a pill: nonpharmacologic treatments for insomnia".

5442: 3701: 3283:

Wynchank D, Ten Have M, Bijlenga D, Penninx BW, Beekman AT, Lamers F, et al. (2018-03-15).

1752: 14707: 14662: 14587: 14456: 14378: 14033: 13297: 13236: 13050: 12010: 11896: 11445: 11280: 10539:

Meolie AL, Rosen C, Kristo D, Kohrman M, Gooneratne N, Aguillard RN, et al. (April 2005).

10378:

Hong JS, Atkinson LZ, Al-Juffali N, Awad A, Geddes JR, Tunbridge EM, et al. (March 2022).

10285:"Drugs for Insomnia beyond Benzodiazepines: Pharmacology, Clinical Applications, and Discovery" 9190:

Buscemi N, Vandermeer B, Friesen C, Bialy L, Tubman M, Ospina M, et al. (September 2007).

4533:

da Silva SS, da Silveira MA, de Almeida HC, do Nascimento MC, Dos Santos MA, Heimer MV (2022).

4024: 3652: 3122: 2340: 2058: 1019: 885: 766:

internet, and social media and not for television, game console, and tablet use. In July 2023,

499:, compulsive worrying about the future, feeling overstimulated, and overanalyzing past events. 405:

Women are more often affected than men. Descriptions of insomnia occur at least as far back as

225: 11174: 11055: 10986: 10945: 10541:"Oral nonprescription treatment for insomnia: an evaluation of products with limited evidence" 8468: 7432:

van Straten A, Cuijpers P (February 2009). "Self-help therapy for insomnia: a meta-analysis".

7406: 5713: 4901: 2685:

have published stories about people who supposedly never sleep, such as that of Thái Ngọc and

14751: 14682: 14667: 14630: 13218: 13032: 11718: 11450: 11067: 11063: 11051: 8524:"Restless Legs Syndrome Fact Sheet | National Institute of Neurological Disorders and Stroke" 7664:"Comparative effectiveness of cognitive behavioral therapy for insomnia: a systematic review" 6719: 4535:"Use of digital screens by adolescents and association on sleep quality: a systematic review" 3472: 2830: 2723: 2299:, all of which are FDA-approved for treatment of insomnia characterized by difficulties with 1716: 1403: 1151: 323: 234: 204: 8844: 5523:"New Research on Insomnia: Sleep Disorders May Precede or Exacerbate Psychiatric Conditions" 3968: 2967: 1929:, due to concerns about serious injuries resulting from abnormal sleep behaviors, including 14620: 14615: 14505: 14441: 14426: 14410: 14405: 13367: 12885: 11872: 10339:(Plain English summary). National Institute for Health and Care Research. 17 October 2022. 10333:"Review finds little evidence to support gabapentinoid use in bipolar disorder or insomnia" 10104:"Dose-dependent effects of antipsychotics on efficacy and adverse effects in schizophrenia" 8866:

Everitt H, Baldwin DS, Stuart B, Lipinska G, Mayers A, Malizia AL, et al. (May 2018).

7823: 6985:

van Straten A, van der Zweerde T, Kleiboer A, Cuijpers P, Morin CM, Lancee J (April 2018).

6371: 4771: 1756: 1724: 1723:. Some examples are keeping a journal, restricting the time spent awake in bed, practicing 1720: 1688: 1370: 1052: 674: 601: 597: 303: 242: 184: 8107: 4949: 3232:

Banno M, Tsujimoto Y, Kohmura K, Dohi E, Taito S, Someko H, et al. (September 2022).

8: 14672: 14500: 14197: 14151: 13720: 12853: 12848: 12415: 11972: 11867: 11857: 11323: 11223: 11096: 2193: 1453:, 81 major sleep disorder diagnostic categories. Patients with some disorders, including 1077:

Increased exposure to the blue light from artificial sources, such as phones or computers

1072: 950: 938: 921: 659: 621: 561: 362:. Diagnosis is based on sleep habits and an examination to look for underlying causes. A 10782: 10749: 9923:

Coe HV, Hong IS (May 2012). "Safety of low doses of quetiapine when used for insomnia".

4794: 4775: 4759: 4735: 4708: 4700: 2169:

disorders has decreased from 24% to 11% in the US, coinciding with the first release of

2035:, who had bought the rights to market it there from the European pharmaceutical company 894:(PLMD), which occurs during sleep and can cause arousals of which the sleeper is unaware 471:

insomnia is difficulty falling asleep at the beginning of the night, often a symptom of

14635: 14368: 14081: 13284: 12714: 12630: 11995: 11877: 11630: 11530: 11395: 11117: 11113: 11105: 11101: 10695: 10651: 10608: 10429: 10404: 10379: 10348: 10314: 10261: 10177: 10152: 10133: 10079: 10054: 10035: 9948: 9903: 9770: 9667: 9619: 9594: 9593:

Huedo-Medina TB, Kirsch I, Middlemass J, Klonizakis M, Siriwardena AN (December 2012).

9403: 9379:"Sedative hypnotics in older people with insomnia: meta-analysis of risks and benefits" 9378: 9354: 9329: 9307: 9264: 9216: 9191: 9134: 9107: 9088: 9045: 8892: 8867: 8726: 8683: 8500: 8483: 8244: 8201: 8060:

Edinger JD, Means MK (July 2005). "Cognitive-behavioral therapy for primary insomnia".

8037: 8010: 7974: 7949: 7925: 7900: 7690: 7663: 7612: 7577: 7565: 7523: 7496:"The effects of light therapy on sleep problems: A systematic review and meta-analysis" 7382: 7357: 7276: 7112: 7087: 7027: 6967: 6858: 6776: 6749: 6670: 6643: 6540: 6513: 6491: 6437: 6412: 6326: 6192: 6144: 6119: 6095: 6070: 6046: 6021: 5997: 5972: 5952: 5869: 5764: 5752: 5623: 5598: 5574: 5549: 5498: 5473: 5414: 5389: 5311: 5294: 5275: 5232: 5130: 5105: 4649: 4624: 4600: 4575: 4510: 4483: 4464: 4388: 4361: 4337: 4310: 4286: 4259: 4240: 4185: 4160: 4136: 4109: 4090: 4050: 4019: 4000: 3957: 3909: 3884: 3827: 3802: 3778: 3645: 3625: 3453: 3400: 3375: 3317: 3260: 3233: 3093: 3064: 2979: 1218: 746: 151: 76: 14321: 11109: 10070: 10012: 9995: 7334: 6594: 6581:

Roth T, Roehrs T (2003). "Insomnia: epidemiology, characteristics, and consequences".

6258: 4975:

Taylor DJ, Mallory LJ, Lichstein KL, Durrence HH, Riedel BW, Bush AJ (February 2007).

2515: 1513:

The insomnia is not attributable to the physiological effects of a substance (e.g., a

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subjects with lower gaming addiction scores and non-gamer subjects. In January 2022,

702: 449: 430: 296: 212: 161: 135: 10612: 10265: 9311: 9268: 9092: 8730: 8687: 8594:"Idorsia petitions DEA to de-schedule its insomnia drug—plus Merck and Eisai rivals" 8248: 7950:"Improving sleep with mindfulness and acceptance: a metacognitive model of insomnia" 7581: 7280: 6971: 6862: 6620: 6495: 6299:"Clinical guideline for the evaluation and management of chronic insomnia in adults" 6196: 6120:"Insomnia: Prevalence, Impact, Pathogenesis, Differential Diagnosis, and Evaluation" 5873: 5279: 3782: 3629: 3574: 3457: 2983: 2662: 14582: 14567: 14535: 13924: 12818: 12428: 11882: 11822: 11185: 10918: 10891: 10825: 10777: 10769: 10765: 10761: 10722: 10679: 10635: 10592: 10552: 10510: 10472: 10399: 10391: 10340: 10318: 10296: 10245: 10207: 10172: 10164: 10115: 10074: 10066: 10017: 10007: 9952: 9932: 9887: 9839: 9760: 9721: 9651: 9614: 9606: 9567: 9466: 9398: 9390: 9349: 9341: 9291: 9248: 9211: 9203: 9129: 9119: 9072: 9049: 9029: 8887: 8883: 8879: 8710: 8667: 8632: 8563: 8495: 8416: 8316: 8228: 8193: 8134: 8122: 8069: 8032: 8022: 7969: 7961: 7920: 7912: 7873: 7767: 7726: 7685: 7675: 7604: 7561: 7527: 7507: 7441: 7377: 7373: 7369: 7330: 7258: 7188: 7144: 7107: 7099: 7031: 7009: 7001: 6951: 6842: 6771: 6761: 6665: 6655: 6590: 6535: 6525: 6475: 6432: 6424: 6321: 6313: 6254: 6219: 6176: 6139: 6131: 6090: 6082: 6041: 6033: 5992: 5984: 5948: 5861: 5826: 5791: 5768: 5748: 5655: 5618: 5610: 5569: 5561: 5493: 5485: 5409: 5401: 5306: 5259: 5216: 5125: 5117: 4988: 4834: 4826: 4789: 4779: 4730: 4720: 4681: 4644: 4636: 4595: 4587: 4546: 4505: 4495: 4448: 4421: 4383: 4373: 4332: 4322: 4281: 4271: 4224: 4180: 4172: 4131: 4121: 4082: 4045: 4037: 3988: 3984: 3941: 3904: 3896: 3863: 3822: 3814: 3762: 3609: 3530: 3437: 3395: 3387: 3353: 3312: 3296: 3255: 3245: 3204: 3088: 3078: 2963: 2917: 2492: 2017: 1946: 1708: 1557: 1546: 1362: 1042: 988: 946: 516: 472: 369:

Although their efficacy as first line treatments is not unequivocally established,

92: 9828:"Consensus development conference on antipsychotic drugs and obesity and diabetes" 8205: 6987:"Cognitive and behavioral therapies in the treatment of insomnia: A meta-analysis" 6750:"Acute and Chronic Insomnia: What Has Time and/or Hyperarousal Got to Do with It?" 6644:"Acute and Chronic Insomnia: What Has Time and/or Hyperarousal Got to Do with It?" 5739:

Ashton H (May 2005). "The diagnosis and management of benzodiazepine dependence".

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in both men and women as they age may account in part for increased prevalence of

14577: 14471: 14451: 14383: 14095: 13889: 13865: 13843: 13818: 13784: 13451: 13403: 13317: 13139: 13104: 12903: 12781: 12699: 12694: 12672: 12554: 12063: 11753: 11680: 11658: 11605: 11365: 11270: 11128: 10280: 9801: 9797: 9495: 9076: 8415: 7731: 7714: 6385: 6381: 6223: 6180: 5973:"Disparities in Sleep Health and Potential Intervention Models: A Focused Review" 5865: 4784: 4591: 4425: 3613: 3529: 3159: 2496: 2476: 2320: 2202: 2140: 2102: 2043: 2009: 1965: 1953: 1906: 1872:

in bed may increase the pressure to sleep and arouse the nervous system further.

1735: 1731: 1423: 1222: 1095: 1083: 1028: 1015: 934: 846: 709: 634: 520: 315: 196: 11951: 9966:

Maglione M, Maher AR, Hu J, Wang Z, Shanman R, Shekelle PG, et al. (2011).

9725: 9394: 5988: 5690: 5489: 3357: 14697: 14657: 14647: 14298: 14208: 14075: 13884: 13768: 13583: 13223: 13151: 13037: 12948: 12898: 12842: 12813: 12802: 12786: 12682: 12163: 12108: 12005: 11990: 11960: 11827: 11698: 11640: 11343: 11243: 11216: 11139: 10922: 10726: 10683: 10639: 10476: 10395: 10344: 9571: 8567: 8197: 8027: 7965: 7916: 7877: 7511: 7445: 7148: 7005: 6748:

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6135: 5795: 5659: 4725: 4685: 4475: 4327: 4228: 4041: 3945: 3900: 2672: 2652: 2616: 2472: 2413: 2405: 2312: 2214: 2189: 2177: 2156: 2148: 2136: 2013: 1978: 1949: 1824: 1794: 1696: 1635: 1590: 1446: 1385: 1353: 1314: 1308: 1198: 1186: 642: 577: 560:

sleep is incomplete, they incorrectly believe it takes them an abnormally long

406: 343: 284: 260: 144: 11086: 10830: 10813: 10120: 10103: 9330:"Trends in prescribing of sedative-hypnotic medications in the USA: 1993–2010" 9239:

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5548:

Lind MJ, Aggen SH, Kirkpatrick RM, Kendler KS, Amstadter AB (September 2015).

5121: 4830: 4551: 4534: 4452: 4378: 4276: 3868: 3851: 541:, excessive night-time urination, can also result in a poor quality of sleep. 14766: 14652: 14642: 14249: 14217: 14123: 14059: 13953: 13914: 13853: 13838: 13828: 13789: 13750: 13746: 13724: 13633: 13623: 13476: 13466: 13456: 13425: 13345: 13210: 13169: 13024: 12983: 12918: 12823: 12776: 12771: 12749: 12709: 12587: 12572: 12324: 12319: 12309: 12226: 12211: 12206: 12201: 12103: 12093: 12088: 12078: 12058: 12000: 11912: 11805: 11653: 11610: 11560: 11555: 11328: 10596: 9844: 9827: 9774: 8714: 7901:"Adherence to cognitive behavioral therapy for insomnia: a systematic review" 6766: 6660: 6617:"Insomnia – sleeplessness, chronic insomnia, acute insomnia, mental ..." 6479: 6037: 5336:"The epidemiological survey of exercise-induced insomnia in chinese athletes" 4993: 4976: 4086: 3308: 2682: 2449: 2417: 2375: 2165: 2115: 1982: 1852: 1771: 1744: 1704: 1618: 1586: 1514: 1435: 1357:

together suggest a deregulation of the arousal system, cognitive system, and

1048: 962: 880: 646: 508: 495:. Anxiety symptoms may well lead to insomnia. Some of these symptoms include 382: 370: 311: 252: 192: 11208: 11082: 9295: 7772: 7755: 7680: 4176: 4152: 3284: 3250: 1430:, obesity, a thick neck diameter, or high-risk fullness of the flesh in the 435:

Waking during the night, being unable to return to sleep and waking up early

417: 14746: 14739: 14734: 14478: 14273: 14257: 14086: 13995: 13977: 13961: 13939: 13934: 13899: 13832: 13822: 13799: 13754: 13648: 13518: 13420: 13415: 13325: 13228: 13179: 13114: 13042: 12993: 12938: 12933: 12739: 12656: 12625: 12620: 12615: 12605: 12600: 12562: 12458: 12448: 12380: 12294: 12236: 12221: 12123: 12083: 12073: 12053: 12048: 12038: 12028: 11773: 11550: 11535: 10930: 10839: 10812:

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Matthews EE, Arnedt JT, McCarthy MS, Cuddihy LJ, Aloia MS (December 2013).

7885: 7839: 7781: 7740: 7699: 7573: 7519: 7480: 7453: 7391: 7342: 7272: 7202: 7156: 7121: 7072: 7023: 6963: 6854: 6785: 6679: 6602: 6549: 6487: 6446: 6335: 6266: 6231: 6188: 6153: 6104: 6055: 6006: 5838: 5803: 5760: 5667: 5632: 5583: 5507: 5423: 5320: 5271: 5228: 5139: 5087: 5074:

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Janssen X, Martin A, Hughes AR, Hill CM, Kotronoulas G, Hesketh KR (2020).

3996: 3953: 3918: 3836: 3774: 3621: 3449: 3409: 3326: 3269: 3218: 3209: 3190: 3102: 2975: 2931: 2465: 2445: 2356: 2324: 2296: 2110: 1998: 1930: 1900: 1857: 1118: 1071:: exercise-induced insomnia is common in athletes in the form of prolonged 1011: 907: 850: 445: 355: 307: 292: 188: 10895: 10514: 10301: 10284: 9891: 9749:"Off-label use of atypical antipsychotic agents for treatment of insomnia" 9439: 9260: 9124: 8106:. Washington, DC: Pew Internet & American Life Project. Archived from 7193: 7176: 6984: 6086: 4532: 14692: 14267: 14184: 14165: 14118: 14091: 14071: 14043: 14015: 14005: 14000: 13971: 13929: 13919: 13904: 13874: 13857: 13813: 13778: 13742: 13738: 13695: 13658: 13638: 13608: 13603: 13593: 13503: 13447: 13442: 13398: 13372: 13330: 13307: 13292: 13251: 13197: 13065: 13011: 12961: 12928: 12913: 12873: 12734: 12729: 12724: 12595: 12577: 12567: 12496: 12476: 12438: 12314: 12251: 12246: 12191: 12176: 12148: 12113: 12098: 12033: 12020: 11985: 11832: 11708: 11648: 11600: 11595: 11586: 11425: 11375: 11370: 11252: 11169: 10022: 8636: 7086:

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2690: 2612: 2504: 2500: 2437: 2433: 2401: 2389: 2360: 2352: 2316: 2300: 2292: 2273: 2098:

may improve quality of sleep in older people with minimal side effects.

2024: 1990: 1918: 1861: 1646: 1427: 1411: 1381: 1237: 1221:: decreasing sleep time, delaying time to REM sleep, and decreasing deep 1177: 1173: 842: 804: 573: 512: 468: 363: 359: 238: 218: 11034: 10882:

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for a week or more, using a non-invasive device that measures movement.

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5565: 5405: 4640: 3083: 2421: 2383: 2379: 2348: 2344: 2308: 2288: 1957: 1891:

There is good evidence for the use of computer based CBT for insomnia.

1431: 1416: 1206: 1202: 1038: 992: 822: 654: 585: 331: 140: 10168: 10151:

Højlund M, Andersen K, Ernst MT, Correll CU, Hallas J (October 2022).

9936: 9610: 9592: 8671: 8232: 7103: 5220: 3391: 3369: 3367: 3300: 2287:

are a more recently introduced class of sleep medications and include

429:

Difficulty falling asleep, including difficulty finding a comfortable

14240: 14221: 14169: 14146: 14113: 14038: 13909: 13774: 13710: 13678: 13673: 13653: 13613: 13508: 13302: 13192: 13159: 13094: 13006: 12971: 12923: 12766: 12719: 12526: 12511: 12501: 12491: 12400: 12362: 12352: 12344: 12329: 12286: 12276: 12271: 12241: 12196: 12133: 12068: 11901: 11852: 11847: 11713: 11675: 11412: 11318: 11308: 11293: 11180: 11145: 10206:(Thesis). Syddansk Universitet. Det Sundhedsvidenskabelige Fakultet. 9345: 8402: 8321: 8304: 7494:

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estimates of insomnia vary between 38% in males to 59% in females. A

1007: 911: 858: 818: 394: 327: 319: 200: 8303:

Qaseem A, Kansagara D, Forciea MA, Cooke M, Denberg TD (July 2016).

8183: 5614: 5596: 2904:

Qaseem A, Kansagara D, Forciea MA, Cooke M, Denberg TD (July 2016).

1964:. Antihistamine effectiveness for sleep may decrease over time, and 14235: 14229: 14173: 14135: 14107: 13705: 13700: 13668: 13618: 13560: 13492: 13483: 13377: 13129: 12858: 12828: 12754: 12689: 12544: 12521: 12516: 12481: 12334: 12266: 12128: 12043: 11947: 11943: 11768: 11743: 11663: 11455: 9865:. Rockville (MD): Agency for Healthcare Research and Quality (US). 8924:. Rockville (MD): Agency for Healthcare Research and Quality (US). 8372:"Prescription sleep aid use among adults: United States, 2005-2010" 7493: 4623:

Chu Y, Oh Y, Gwon M, Hwang S, Jeong H, Kim HW, et al. (2023).

4033: 3364: 2488: 2441: 2265: 2261: 2184: 2160: 2032: 1961: 1926: 1922: 1910: 1820: 1684: 1639: 1614: 1582: 1506:

The sleep difficulty occurs despite adequate opportunity for sleep.

1358: 1349: 1304: 1273: 1257: 1245: 1214: 1169: 1099: 1034: 974: 865: 834: 830: 774: 538: 531: 390: 386: 374: 339: 335: 288: 157: 11150: 9711: 7713:

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Daraj LR, AlGhareeb M, Almutawa YM, Trabelsi K, Jahrami H (2023).

4410: 3340:

Cortesi F, Giannotti F, Ivanenko A, Johnson K (July–August 2010).

2201:

with regular use of short-acting sleep aids for insomnia, daytime

1602:

Prevention and treatment of insomnia may require a combination of

14724: 14253: 13957: 13760: 13732: 13437: 13174: 12988: 12863: 12759: 12666: 12385: 12118: 11795: 11790: 11785: 11780: 11763: 11668: 11502: 11402: 11360: 11313: 8657: 6913:"Insomnia (Acute & Chronic): Symptoms, Causes, and Treatment" 4545:(10). Sérgio Arouca National School of Public Health: e00300721. 4488: