primary insomnia

it is not defined by a specific length of time spent in sleep but upon the lack of sleep relative to an individual’s needs. the person may be asked to maintain a sleep diary. it is not recommended for the routine evaluation of sleeplessness but may be used in special circumstances (for example, to rule out causes of insomnia). sleep state misperception can only be diagnosed in the laboratory because of the need to document that sleep duration and quality are normal when a person describes having poor sleep.

melatonin is a hormone produced by the pineal gland (located in the brain) during the dark hours of the day-night cycle (circadian rhythm). stimulus control therapy: the purpose of this therapy is to re-establish the connection between the bed and sleep by prohibiting the person from engaging in nonsleep activities while in bed. as sleep improves, the person is allowed to gradually increase time in bed by 15 to 30 minutes. then, as you begin to associate going to sleep with your inability to sleep, the problem may become chronic.

this article provides a review of the classification, differential diagnosis, and treatment options available for insomnia. patients with advanced sleep phase disorder, common in elderly persons, become sleepy in the early evening, sleep a normal amount, and then have very early morning awakening. medications used to treat many common disorders, such as decongestants, β-agonists, corticosteroids, β-blockers, diuretics, antidepressants, and h-2 blockers disturb sleep.11 if a medication is thought to be the cause of a sleep disturbance, alternative medications should be considered. treatment of insomnia should be individualized based on the nature and severity of symptoms and should occur after other causes have been considered, diagnosed, and treated. cognitive therapy is as effective as pharmacologic therapy in the elderly.20 many insomniacs develop anxiety about going to sleep and a fear of sleeplessness, which may perpetuate the insomnia.

medications should be used for a short period (2 to 4 weeks) and intermittently, based on the individual patient’s return to an acceptable sleep cycle.21 l-tryptophan, though banned in 1989 because of its association with eosinophilia-myalgia syndrome, has been promoted as a sleep aid. however, elderly patients who complain of early morning awakenings may have their sleep problem worsened by a prebedtime dose. trazodone decreases the insomnia caused by selective serotonin reuptake inhibitors and is a good choice for depressed patients with difficulty sleeping.8 trazodone does not affect sleep latency but does decrease rem sleep and may be associated with significant rebound insomnia.11 priapism is a potentially serious side effect of trazodone and may limit its use in men. tricyclic antidepressants and antihistamines should be used with caution because of their side-effect profiles, especially when used in the elderly or with other medications. newer agents zolpidem and zaleplon are selective benzodiazepine (subtype 1) receptor agonists that have a rapid onset, short half-life, and minimal side effects.

primary insomnia: this means your sleep problems aren’t linked to any other health condition or problem. secondary insomnia: this means you primary insomnia is difficulty initiating sleep (sleep onset insomnia), difficulty maintaining sleep (mid-sleep awakening, early morning awakening) or chronic primary insomnia is sleeplessness or the perception of poor quality sleep that is not caused by medical or psychiatric diseases, conditions,, .

primary insomnia is a decreased ability to fall asleep and/or stay asleep, with resulting daytime effects of sleep deprivation, such as fatigue, dozing off, and irritability. the sleep problems of primary insomnia are not associated with lifestyle habits or a medical or psychiatric cause. insomnia may be divided into extrinsic and intrinsic disorders. extrinsic disorders include problems with sleep hygiene, substance abuse, and primary insomnia is a condition characterized by difficulty sleeping. unlike secondary insomnia, primary insomnia isn’t the result of insomnia may be the primary problem, or it may be associated with other conditions. chronic insomnia is usually a result of stress, life events, .

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