What is Insomnia?
“The word "insomnia' originates from the Latin "in" (no) and "somnus" (sleep). Insomnia is characterized by difficulties going to sleep or going back to sleep when awakened in the night or early morning. Insomnia was described by Johann Heinroth in 1818 as a disorder (Saddichham, 2010). But the concept of insomnia is much older. The first appeared in English dictionaries around 1623. (Insomnia | Search Online Etymology Dictionary, n.d.), and references to sleep disorders go as far back as ancient Egypt (Assad, 2015). The inability to fall asleep when expecting to do so seems to be a human quality and may have been experienced by the earliest humans. Insomnia becomes a chronic disorder when it happens more nights than not, for at least three months despite adequate opportunity to sleep. Currently, many studies investigate the causes, pathophysiology, and treatment of insomnia.
What Do We Know About Insomnia?
Insomnia is a common problem affecting millions of people. About 10% of people worldwide meet the criteria for insomnia disorder and many more experience occasional or acute insomnia symptoms. The 3P model is a popular way to understand the cause of insomnia. Predisposing factors include genetic and early life adversity/trauma that make someone more likely to develop insomnia. Precipitating factors are changes in life that acutely disturb sleep, things such as stress and illness. Perpetuating factors are changes in behavior and thinking patterns in response to acute sleep disturbance that maintain the sleep problem even after the acute stressor has been removed. Common perpetuating factors include spending more time in bed, trying to sleep more, drinking more caffeine, or napping during the day. Cognitive-behavioral therapy for insomnia (CBTI) is the frontline treatment for insomnia disorder. 80% of people who receive CBTI
experience significant improvement in their symptoms. This treatment aims to reduce arousal during sleep onset, increase sleep depth, and help people turn off their minds during sleep.
What are we still looking to answer about Insomnia?
Other unanswered questions include: How can non-drug treatments for insomnia be improved to be more appealing to patients and feasible for society to administer? How are insomnia and mental health related? What are the physiological and experiential hallmarks of insomnia across the sleep-wake cycle? What are the genetic precursors for insomnia?