Insomnia can affect
important aspects of a
patient's life.1 It's helpful
to recognize the relentless
nature of the condition.
Consider asking your patients:
How did you wake up?
Sign up now to receive updates about the impact of insomnia as well as educational resources that may help you identify and support the management of insomnia.
Look forward to updates with insight into your patients’ sleep and wake experiences as well as educational resources to support more effective management of insomnia.
Our records show that you have already signed up with your email.
Something went wrong during the processing of your request.
Please come back later and try again.
More Than a Symptom
Over the past several decades, insomnia has been studied more closely than ever.2-4 With growing acknowledgment that insomnia can be more than a symptom, it became necessary to update the official diagnostic criteria.2,3
Now, there is a distinction between insomnia symptoms and insomnia disorder.3,4
Approximately one-third of adults experience insomnia symptoms.46% to 10% meet the current diagnostic criteria for insomnia disorder.4
Insomnia disorder can now be diagnosed whether it occurs independently or iscomorbid with another medical condition or psychiatric disorder.4
This shift in diagnostic criteria highlights the need for an isolated focus on diagnosing and treating insomnia disorder, regardless of other psychiatric or medical conditions that may be present.3
Epidemiology and Diagnosis
You may already be aware that insomnia symptoms are widely experienced, butinsomnia disorder is underaddressed in the United States.1,5-7 This could be due to differing and varying perceptions of the disorder, its impact, and the role of treatment.8
Insomnia symptoms are more common in8:
Risk factors for insomnia disorder can include: mood and anxiety disorders, type 2 diabetes, cardiovascular disease, and arthritis.9
The major diagnostic criteria for insomnia disorder include4:
Difficulty falling asleep orstaying asleep or waking too early in the morning that leads to dissatisfaction with sleep quantity or quality
Sleep disturbance that leads toimpairment in social, work, educational, behavioral, or other areas of functioning, or that may cause significant distress
Experiencing sleep difficultywhile having adequate opportunity to sleep, at least 3 nights per week for at least 3 months
Next-Day Functional Impact
Inadequate sleep from insomnia can have next-day consequences1:
Because insomnia is a chronic condition, it can have a substantial impact on a person’s quality of life.
Patients with insomnia have reported reduced quality of life in the following areas10,11:
- Physical functioning
- Physical health problems
- Bodily pain
- General health perceptions
- Social functioning
- Emotional health problems
- Mental health problems
The burden of insomnia has been calculated in studies as the number of quality-adjusted life-years insomnia has a significantly higher QALY loss such as depression, arthritis, and other than other medical conditions and psychiatric disorders, health conditions.9(QALYs) lost to insomnia. These studies reported that
~67 billion Insomnia-related presenteeism and annual loss of work performance12,13~32.3 billion Insomnia-related accidents or errors13,14
In the workplace, patients with insomnia have10,15,16:
- Higher risk of accidents
- Higher rates of work absenteeism
- Diminished job performance
For patients already being treated for insomnia, the next-day impact may be due to the residual effects of their insomnia medications. These effects can manifest as17:
- Difficulty concentrating
- Difficulty remembering
of patients taking insomnia
medications reported experiencing
residual next-day effects.17
Medical and Psychiatric Impacts
If left untreated, insomnia may increase the risk of certain conditions, including:
Also, insomnia has been shown to increase the risk of mortality-related events:
- Suicide attempts32
- All-cause mortality33
- Cardiovascular-related mortality22,34
PTSD=posttraumatic stress disorder.
Treating both insomnia and a comorbidity individually may result in better outcomes than treating the comorbidity alone.35,36
The sleep-wake cycle is regulated by sleep promotion and wake promotion pathways. Wake promotion is regulated by orexin, a neuropeptide in the brain that plays a critical role in stabilizing the switch from sleep to wake states.37,38
Orexin physiology in the sleep-wake system37
To enable sleep states,neurons dampen wakefulness via GABA neurotransmitter and inhibit orexin activation of wake-promoting neurons of the brain.37
To enable wake states, increased orexin activates wake-promoting neurons. In turn, sleep-promoting neurons are inhibited.37
When the sleep-wake system functions normally, as shown above, the 2 parts complement each other and result in healthy sleep patterns.37
Insomnia is thought to be the result of one having a chronic state of hyperarousal. Patients who have insomnia may have overactive wake-promoting neurotransmitters that are independent of any psychological, medical, or drug-related stressors.38,39
5-HT=serotonin; ACh=cholinergic; DA=dopamine; GABA=Gamma-amino butyric acid; His=histamine; NA=noradrenaline.