So, how is insomnia different from old fashioned sleeplessness? The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) defines insomnia as the difficulty initiating and maintaining sleep, “characterized by frequent awakenings or problems returning to sleep after awakenings.”

 

Insomnia has an ongoing impact on both nights and days, with a difficulty of falling asleep and maintaining sleep, as well as experiencing clinically significant distress in multiple areas of life. 

 

Insomnia is characterized by persistent dissatisfaction with sleep quantity or quality, by specific complaints of difficulty falling asleep, by frequent nighttime awakenings, and by difficulty returning to sleep. It’s also often associated with awakenings earlier in the morning than desired.

In addition, insomnia may be characterized by significant distress or impairment in daytime functioning, as indicated by symptoms such as fatigue, daytime sleepiness, impairment in cognitive performance, and mood disturbances. Untreated insomnia is associated with significant consequences and comorbidities, including psychological, physical, and occupational impairment as well as a significant economic burden.

It is important to rule out other sleep disorders, especially sleep apnea, which can be the single-most treatable cause of poor sleep and insomnia, as these can coexist.

Sleep apnea affects sleep quality because the episodes of stopping breathing at night can lead to awakenings. This results in awakenings and creates an inability to go back to sleep. Other sleep disorders, like periodic limb movements at night, can also result in frequent awakenings at night.

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