Insomnia: Difference between revisions

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It is thought that insomnia is mediated by:
It is thought that insomnia is mediated by:
*Molecular Mechanism
*Molecular Mechanism
**Hormones causing sleep suppression: Catecholamine, Histamine, Orexin
**Hormones causing wakefulnessn: Catecholamine, Histamine, Orexin
**Hormones promoting: Adenosine, serotonin, GABA, melatonin, Prostaglandin D2
**Hormones promoting sleep: Adenosine, serotonin, GABA, melatonin, Prostaglandin D2
*Hyperarousal model
*Hyperarousal model
**Cognitive
**Cognitive
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*Genetic: ApoE4, PER3, 5HTTLPR, [[Single Nucleotide Polymorphism]], CLOCK gene, HLA DQI*002
*Genetic: ApoE4, PER3, 5HTTLPR, [[Single Nucleotide Polymorphism]], CLOCK gene, HLA DQI*002
* Sleep switch Model (Orexin mediated)
* Sleep switch Model (Orexin mediated)
** Sleep promoting areas:[[Ventrolateral Preoptic Nucleus]]
** Sleep promoting areas:[[Ventrolateral Preoptic]] and [[Median preoptic Nucleus]]
** Wake promoting areas: [[Tuberomammillary nucleus]], [[dorsal raphe]], [[Locus coeruleus]]
** Wake promoting areas: [[Tuberomammillary nucleus]], [[dorsal raphe]], [[Locus coeruleus]]
*Cognitive and Behavioural Model
*Cognitive and Behavioural Model

Revision as of 20:21, 10 February 2021


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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Amber Ehsan Faquih, MD[2] Kiran Singh, M.D. [3], Jyostna Chouturi, M.B.B.S [4]

Synonyms and keywords: Insomnia disorder

Overview

Historical Perspective

Pathophysiology


It is thought that insomnia is mediated by:

Classification

Insomnia has been classified by the International Classification of Sleep Disorders, 2nd Edition into 11 categories[1]:

  • 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

Causes

Differentiating Insomnia from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Other Diagnostic Studies

Treatment

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

Management is guided by available clinical practice guidelines[2].

Case Studies

Case #1

See also

References

  1. "Insomnia: Practice Essentials, Background, Anatomy".
  2. Mysliwiec V, Martin JL, Ulmer CS, Chowdhuri S, Brock MS, Spevak C; et al. (2020). "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". Ann Intern Med. doi:10.7326/M19-3575. PMID 32066145 Check |pmid= value (help).


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