Insomnia which is resulted from problems with sleep initiation and maintenance is considered as one of the most prevalent health issue and a widely encountered challenge in clinical practice. Due to many potential causes for insomnia, unfamiliarity with non-pharmacological treatments, and existing concerns about the challenges faced with pharmacological approaches, many health care professionals seem reluctant to efficiently address insomnia in their practice. Physicians should expand their awareness on the advances in treating insomnia due to its potential effects on function and general health.
Although the pathophysiological aspects of insomnia are described in the literature, many contributing mechanisms for this disorder have remained unraveled. The question of ânature or nurtureâ has also existed for insomnia. Both sleep-wake related mechanisms and stressresponse- related gene-environment interactions are shown to play a role in our brain plasticity. There are some recent theories on the epigenetic mechanisms involved in insomnia and gene-environment interactions which regulate this disorder.
The ICSD differentiates insomnia either as primary or secondary. Primary insomnia includes idiopathic insomnia, psychophysiological insomnia and paradoxical insomnia. Secondary insomnia includes insomnia secondary to psychosocial stressors, psychiatric disorders, medical disorders, various sleep disorders, drug and substance abuse and prescription medications. Misuse of some medications which are thought to help sleep may profoundly lead to poor sleep and unfavorable neuro-cognitive consequences.
Last date updated on June, 2014