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'''For patient information click [[Insomnia (patient information)|here]]'''
'''For patient information click [[Insomnia (patient information)|here]]'''
{{Insomnia}}
{{Insomnia}}
{{CMG}}; {{AF}} {{KS}}, {{JC}}
{{CMG}}; {{AE}} {{Adnan Ezici}} , {{AF}} , {{KS}} , {{JC}} , {{NS}}


{{SK}} Insomnia disorder
{{SK}} Insomnia disorder
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==[[Insomnia pathophysiology|Pathophysiology]]==
==[[Insomnia pathophysiology|Pathophysiology]]==
<br />
 
It is thought that insomnia is mediated by:
*Molecular Mechanism
**Hormones causing wakefulnessn: Catecholamine, Histamine, Orexin
**Hormones promoting sleep: Adenosine, serotonin, GABA, melatonin, Prostaglandin D2
*Hyperarousal model
**Cognitive
**Physiologic
**Cortical
*Genetic: [[ApoE4]], [[PER3]], [[5HTTLPR]], [[Single Nucleotide Polymorphism]], CLOCK gene, HLA DQI*002
* Sleep switch Model (Orexin mediated)
** Sleep promoting areas:[[Ventrolateral Preoptic]] and [[Median preoptic Nucleus]]
** Wake promoting areas: [[Tuberomammillary nucleus]], [[dorsal raphe]], [[Locus coeruleus]]
*Cognitive and Behavioural Model
**Precipitating factors
**Predisposing factors
**Perpetuating factors


==[[Insomnia classification|Classification]]==
==[[Insomnia classification|Classification]]==
[[Insomnia]] has been classified by the International Classification of Sleep Disorders, 2nd Edition into 11 categories<ref name="urlInsomnia: Practice Essentials, Background, Anatomy">{{cite web |url=https://emedicine.medscape.com/article/1187829-overview#a5 |title=Insomnia: Practice Essentials, Background, Anatomy |format= |work= |accessdate=}}</ref>:
*Psychophysiologic insomnia (primary insomnia)
*Adjustment insomnia (acute insomnia)
*Paradoxical insomnia
*Behavioral insomnia of childhood
*Primary sleep disorders causing insomnia
*Idiopathic insomnia
*Inadequate sleep hygiene
*Insomnia due to mental disorder
*Insomnia due to drug or substance abuse
*Insomnia due to a medical condition
*Insomnia not due to a substance or known physiologic condition, unspecified
Insomnia has also been classified by the International Classification of Sleep Disorder, 3rd Edition into<ref name="urlSleep Medicine: Insomnia and Sleep">{{cite web |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6390785/ |title=Sleep Medicine: Insomnia and Sleep |format= |work= |accessdate=}}</ref>:
*Chronic Insomnia Disorder
*Short-term Insomnia Disorder
*Other Insomnia Disorder


==[[Insomnia causes|Causes]]==
==[[Insomnia causes|Causes]]==
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==[[Insomnia risk factors|Risk Factors]]==
==[[Insomnia risk factors|Risk Factors]]==
==[[Insomnia screening|Screening]]==


==[[Insomnia natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
==[[Insomnia natural history, complications and prognosis|Natural History, Complications and Prognosis]]==


==Diagnosis==
==Diagnosis==
[[Insomnia history and symptoms|History and Symptoms]] | [[Insomnia physical examination|Physical Examination]] | [[Insomnia laboratory findings|Laboratory Findings]] | [[Insomnia other diagnostic studies|Other Diagnostic Studies]]
[[Insomnia diagnostic criteria|Diagnostic Study of Choice]] | [[Insomnia history and symptoms|History and Symptoms]] | [[Insomnia physical examination|Physical Examination]] | [[Insomnia laboratory findings|Laboratory Findings]] | [[Insomnia electrocardiogram|Electrocardiogram]] | [[Insomnia x ray|X-ray]] | [[Insomnia echocardiography and ultrasound|Echocardiography and Ultrasound]] | [[Insomnia CT scan|CT scan]] | [[Insomnia  MRI|MRI]] | [[Insomnia other imaging findings|Other Imaging Findings]] | [[Insomnia other diagnostic studies|Other Diagnostic Studies]]


==Treatment==
==Treatment==
[[Insomnia medical therapy|Medical Therapy]] | [[Insomnia non-pharmacological therapy|Non-pharmacological therapy]] | [[Insomnia primary prevention|Primary Prevention]] | [[Insomnia secondary prevention|Secondary Prevention]] | [[Insomnia cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Insomnia future or investigational therapies|Future or Investigational Therapies]]
[[Insomnia medical therapy|Medical Therapy]] | [[Insomnia non-pharmacological therapy|Non-pharmacological therapy]] | [[Insomnia surgery|Surgery]] | [[Insomnia primary prevention|Primary Prevention]] | [[Insomnia secondary prevention|Secondary Prevention]] | [[Insomnia cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Insomnia future or investigational therapies|Future or Investigational Therapies]]
 
Management is guided by available [[clinical practice guideline]]s<ref name="pmid32066145">{{cite journal| author=Mysliwiec V, Martin JL, Ulmer CS, Chowdhuri S, Brock MS, Spevak C | display-authors=etal| title=The Management of Chronic Insomnia Disorder and Obstructive Sleep Apnea: Synopsis of the 2019 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guidelines. | journal=Ann Intern Med | year= 2020 | volume=  | issue=  | pages=  | pmid=32066145 | doi=10.7326/M19-3575 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32066145  }} </ref>.


==Case Studies==
==Case Studies==

Latest revision as of 04:03, 5 August 2021


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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Adnan Ezici, M.D[2] , Amber Ehsan Faquih, MD[3] , Kiran Singh, M.D. [4] , Jyostna Chouturi, M.B.B.S [5] , Sanjana Nethagani, M.B.B.S.[6]

Synonyms and keywords: Insomnia disorder

Overview

Historical Perspective

Pathophysiology

Classification

Causes

Differentiating Insomnia from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice | History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | X-ray | Echocardiography and Ultrasound | CT scan | MRI | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Non-pharmacological therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

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References


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