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Insomnia — Causes


Insomnia — Causes

When insomnia occurs as an inborn condition it is termed primary insomnia, an example of which is fatal familial insomnia. This is a progressive disorder that begins with a difficulty in initiating sleep and leads to sleep deprivation within a few days time. The onset of this rare familial disease is between the ages of 30 and 60 and the patient progresses to death within 7 to 37 months of its onset.

Insomnia is usually caused by other diseases or conditions and is known as secondary insomnia. Some of these diseases or conditions are:

a. Those that produce pain or discomfort or breathing difficulties like asthma or arthritis

b. Psychiatric disorders usually have an underlying element of insomnia.The severity of insomnia has a close relationship with the clinical course of psychiatric disorders. Depression, anxiety disorders, schizophrenia, personality disorders, and somatoform disorders can affect sleep.

c. Medications that affect the sleep-wake cycle by interfering with nocturnal sleep are beta-adrenergic blockers, thyroid preparations, corticosteroids, monoamine oxidase inhibitors, methyldopa, phenytoin, and some chemotherapeutic agents.

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d. Abuse of substances like alcohol and nicotine can disrupt the normal sleep architecture.

Insomnia may be due to other sleep disorders, some of which are described below:

  • Psychophysiological insomnia:This is a condition in which the person has difficulty falling asleep in his bed or using his bedroom. This insomnia is induced by a stressful situation, which can progress to a chronic entity.

  • Sleep state misperception: Here the person complains of insomnia in spite of having a good night's sleep. Patients with sleep state misperception can sleep entirely normally at night, but wake up feeling as if they have not slept well.
  • Inadequate sleep hygiene:This is a life style disorder that affects sleep. Here the person does not allocate adequate time for sleep. This could be the heavy price we pay for technical advances.
  • Restless legs syndrome: A disorder marked by disagreeable leg sensations just before sleep onset that causes an irresistible urge to move the legs.
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  • Periodic leg movement disorder: A disorder characterized by episodes of highly stereotyped limb movements that occur periodically during sleep, leading to insomnia.
  • Obstructive sleep apnea: A sleep disorder that is associated with repeated episodes of upper airway obstruction during sleep, resulting in snoring and frequent arousals from sleep.
  • Circadian rhythm disorders: In this disorder, there is a mismatch between the timing of sleep and the underlying physiological tendency to sleep, like for example, Jet lag.
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