After completing this module, you should be more aware of:

• Current definitions and classifications of insomnia
• Prevalence and demographics of insomnia among adults
• Common triggers in short-term insomnia and progression to long-term insomnia
• Co-morbidities associated with insomnia
• The relationship between mental health conditions and insomnia
• Neurotransmitter pathways and principles of drug activity in sedation and wakefulness
• Diagnostic tools and processes
• Non-drug management of insomnia
• When and if sleep medication should be considered in insomnia
• Use of OTC products in sleep disturbance
• Use of prescription drugs for insomnia
• Drug developments for insomnia.
   

Put simply, insomnia can be described as regularly having problems sleeping. However, current definitions combine three aspects: sleep, sleeping conditions and daytime consequences.1

The World Health Organization says insomnia disorders are “characterised by the complaint of persistent difficulty with sleep initiation, duration, consolidation, or quality that occurs despite adequate opportunity and circumstances for sleep, and results in some form of daytime impairment”.2

Difficulty falling asleep, waking often, waking early, or not feeling refreshed can occur alone or in combination. However, only if daytime symptoms such as fatigue, disturbed mood or poor concentration are also present should the disturbed sleep be categorised as insomnia disorder.1,3

Short-term insomnia is used to describe symptoms lasting typically a few days or weeks but less than three months. Chronic insomnia is when symptoms occur at least three nights a week for three months or more.3

Chronic insomnia is now regarded as a condition in its own right, but it can be in a dynamic relationship with co-existing medical and/or psychiatric disorders. This means that the older classifications of ‘primary insomnia’ (with no attributable cause) and ‘secondary insomnia’ (arising from a co-morbidity) should be avoided.3