Sleep Medicine: Insomnia and Sleep

Abstract

Insomnia disorder is an economic burden and public health concern affecting up to one-third of the population of the United States. It is mostly seen in older age groups, and often considered a normal aging phenomenon. The diagnosis and treatment of insomnia rely mainly on a thorough sleep history to address the precipitating factors as well as maladaptive behaviors resulting in poor sleep. It is important for clinicians to recognize and manage the symptoms of insomnia to prevent the morbidity associated with it. This review aims to highlight the pathophysiology, associated comorbidities, clinical evaluation and effective management strategies for insomnia disorder.

Figures

Figure 1

Pathophysiology of insomnia (VLPO: ventrolateral preoptic nucleus; TMN: Tuberomammillary nucleus; DR: dorsal raphe; LC: Locus coeruleus; GABA: gamma-aminobutyric acid)

Figure 2

Comorbidities associated with chronic insomnia.

Figure 3

Effect of various pharmacological agents on Total Sleep time (TST), Wakefulness after sleep onset (WASO), Sleep latency (SL), Quality of Sleep (QOS).