![]() ![]() Joining me in this discussion are my colleagues Dr Karl Doghramji, a professor of psychiatry, neurology, and medicine at Jefferson Medical College of Thomas Jefferson University in Philadelphia Dr Erinn Beagin, an internal medicine practitioner specializing in general practice and preventive care in Princeton, New Jersey Dr Nathaniel Fletcher Watson, the director of the Sleep Medicine Clinic at Harborview at the University of Washington in Seattle, Washington and Dr Vikas Jain, chief executive officer of Dream Sleep Medicine in Frisco, Texas. Thorpy, MD: Hello, and welcome to this Peer Exchange titled “Unmet Needs in Treating Insomnia.” I’m Dr Michael Thorpy, the director of the Sleep-Wake Disorders Center at Monefiore Medical Center and a professor of neurology at Albert Einstein College of Medicine in the Bronx, New York. One of the first steps in improving overall health & well being is to promote thorough sleep evaluations ruling out a sleep disorder.Michael J. Sleep hygiene, cognitive behavioral therapy (CBT) including stress reduction, relaxation, and sleep schedule management and finally medications may be effective treatment options for insomnia. Treatment options for insomnia depend on the underlying cause. Irregular sleep schedules can also cause insomnia. Bed partners who are loud snorers and pets can cause sleep disruption. Finally, caffeine and other stimulants can delay sleep onset and may cause frequent awakenings at night.Įnvironmental Factors: Disruptive factors such as noise, light or extreme temperatures can interfere with sleep. Alcohol and sleep aids are also common causes of insomnia. Medication or Substance Abuse: Insomnia can be an unwanted side effect of many prescription or over-the-counter medications. Often a mental health disorder such as depression or other mood disorders will be diagnosed after a complaint of insomnia. Insomnia is sometimes caused by a mental health disorder. Mental Health Disorders: The relationship between sleep and mental health is complex. Those who experience pain, discomfort, or limited mobility from medical problems may have difficulty falling asleep or staying asleep. Medical Conditions: Many physical illnesses can cause insomnia. Other Sleep Disorders: Some sleep disorders can cause insomnia or make it worse such as sleep apnea or restless legs syndrome. ![]() Stress: This can vary from minor things like work or personal stress to more severe changes such as death, divorce, or job loss. Insomnia is most often associated with something else. Insomnia is also evaluated according to time-sleep onset insomnia vs. Chronic insomnia lasts more than three weeks and nearly 1 in 10 people have chronic insomnia, which often requires treatment. ![]() Acute insomnia lasts for a short time-from a few nights up to three weeks-and goes away on its own without treatment. There are two types of insomnia based on duration. It is more common in older adults, women, people under stress, and people with certain medical and health problems such as depression. Symptoms include difficulty falling asleep, difficulty staying asleep throughout the night, waking up too early in the morning, and poor quality of sleep, or feeling tired in the morning. The causes, symptoms, and severity vary from person to person. Insomnia is the most common sleep complaint and affects as many as 30% of adults.
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