Battling Insomnia: Causes

Allen Blaivas, M.D. Health Pro
  • Judging from the latest shareposts, it's time we get into the nitty-gritty of insomnia, which often leaves people with their feelings of aggravation and frustration.  We will likely spend a few blogs trying to go through this topic in detail, and as always I encourage questions.


    First, I want to say insomnia is a real problem and unfortunately you are not alone.  It is estimated that in a typical physician’s practice, approximately 50 percent of adult patients experience a problem with falling or staying asleep during any year.  Research on sleep problems in the general population documents that between 10 percent and 18 percent of adults consider sleep to be a serious, chronic problem, with women and the elderly reporting more frequent complaints.

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    Frankly, due to time constraints and perhaps a feeling of lacking adequate treatment methods, most physicians do not take the initiative to ask their patients about insomnia, but it can have very significant public and medical health complications. Chronic insomnia can cause impaired performance at work, decreased quality of life, and lead to higher health careusage and costs.  A conservative estimate (in 1994) placed the direct and indirect cost at approximately $100 billion.


    Insomnia is a symptom (not a disease) that arises from many environmental, psychiatric, sleep, and medical disorders.  A diagnosis of insomnia requires that a person’s daytime functioning is affected by their lack of sleep.  A complaint of insomnia can include difficulty falling asleep, staying asleep, early morning awakenings with inability to fall back asleep, or even non-refreshing sleep.  If you sleep only 5-6 hours a night and suffer no symptoms of daytime tiredness, feel well-rested and energetic in the morning, don’t doze off when inactive, but feel like you should be sleeping a more “normal” amount because that is what most people do, don’t fret.  You probably don’t have insomnia, but you maybe one of the lucky ones who are “short sleepers” and require less sleep to make you feel refreshed.


    There are many classification systems for insomnia--one common grouping approaches it by duration of symptoms: transient, short-term, and chronic insomnia.  Transient insomnia lasts for about one week and is usually caused by a significant life event, stress from school, work, or relationship, or jet lag.  After the change passes, sleep (and life) returns to normal.  Short-term insomnia can last from a few weeks to a month or two and is caused by amore far-reaching event, such as a divorce, death of a loved one, and seriouschronic health issues.  Chronic insomnia can last for months toyears and can be very disabling.  It canbe due to a multitude of medical, psychiatric, or sleep problems which I will address in great detail in upcoming blogs.


Published On: May 11, 2007