|
|
(151 intermediate revisions by 9 users not shown) |
Line 1: |
Line 1: |
| __NOTOC__ | | __NOTOC__ |
| | |
| '''For patient information click [[Insomnia (patient information)|here]]''' | | '''For patient information click [[Insomnia (patient information)|here]]''' |
| | | {{Insomnia}} |
| {{Infobox_Disease | | | {{CMG}}; {{AE}} {{Adnan Ezici}} , {{AF}} , {{KS}} , {{JC}} , {{NS}} |
| Name = {{PAGENAME}} |
| |
| Image = |
| |
| Caption = |
| |
| DiseasesDB = 26877 |
| |
| ICD10 = {{ICD10|F|51|0|f|50}}, {{ICD10|G|47|0|g|40}} |
| |
| ICD9 = {{ICD9|307.42}}, {{ICD9|307.41}}, {{ICD9|780.51}}, {{ICD9|780.52}} |
| |
| ICDO = |
| |
| OMIM = |
| |
| MedlinePlus = 000805 |
| |
| MeshID = D007319 |
| |
| }}
| |
| {{SI}}
| |
| {{CMG}}; {{AE}} {{KS}} | |
|
| |
|
| {{SK}} Insomnia disorder | | {{SK}} Insomnia disorder |
|
| |
|
| ==Overview== | | ==[[Insomnia overview|Overview]]== |
| '''Insomnia''' is a [[sleep disorder]] characterized by an inability to [[sleep]] and/or inability to remain asleep for a reasonable period. Insomniacs typically complain of being unable to close their eyes or "rest their mind" for more than a few minutes at a time. Both organic and nonorganic insomnia constitute a [[sleep disorder]].<ref>http://www3.who.int/icd/currentversion/fr-icd.htm?gf50.htm+f510 </ref><ref>http://www3.who.int/icd/currentversion/fr-icd.htm?gg40.htm+g47 </ref>
| |
|
| |
|
| ==Classification==
| |
| ===Types of insomnia===
| |
| Three types of insomnia exist: transient, acute, and chronic
| |
| #'''Transient insomnia''' lasts from one night to a few weeks. Most people occasionally suffer from transient insomnia due to such causes as [[jet lag]] or short-term anxiety. If this form of insomnia continues to occur from time to time, the insomnia is classified as intermittent.
| |
| #'''[[Acute (medical)|Acute]] insomnia''' is the inability to consistently sleep well for a period of between three weeks to six months.
| |
| #'''[[chronic (medicine)|Chronic]] insomnia''' is regarded as the most serious; persists almost nightly for at least a month.
| |
|
| |
|
| ===Patterns of Insomnia=== | | ==[[Insomnia historical perspective|Historical Perspective]]== |
| The pattern of insomnia often is related to the etiology.[http://www.emedicine.com/MED/topic609.htm]
| |
| # Initial insomnia - difficulty falling asleep at the beginning of the night, often associated with [[anxiety disorder]]s.
| |
| # Middle insomnia - waking during the middle of the night, difficulty maintaining sleep. Often associated with pain syndromes or medical illness.
| |
| # Terminal (or late) insomnia - early morning waking. Characteristic of [[Clinical depression]].
| |
|
| |
|
| ==Causes==
| |
| ==Overview==
| |
|
| |
|
| | ==[[Insomnia pathophysiology|Pathophysiology]]== |
|
| |
|
| ===Life Threatening Causes===
| |
|
| |
|
| ===Common Causes=== | | ==[[Insomnia classification|Classification]]== |
| The common causes of insomnia include
| |
| * [[Stress (medicine)|Stress]]
| |
| * [[Anxiety disorder]]
| |
| * [[Depression]]
| |
| * medications
| |
| * [[Caffeine]]
| |
| * [[Alcoholism]]
| |
| * [[Sleep disorder]]
| |
| * eating habits and
| |
| * certain medical conditions such as [[Restless legs syndrome|Restless leg syndrome]].
| |
|
| |
|
| | ==[[Insomnia causes|Causes]]== |
|
| |
|
| | ==[[Insomnia differential diagnosis|Differentiating Insomnia from other Diseases]]== |
|
| |
|
| ===Causes by Organ System=== | | ==[[Insomnia epidemiology and demographics|Epidemiology and Demographics]]== |
| {|style="width:80%; height:100px" border="1"
| |
| |style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" |'''Cardiovascular'''
| |
| |style="height:100px"; style="width:75%" border="1" bgcolor="Beige" |[[chronic stable angina|Angina]], [[buerger's disease]], [[congestive cardiac failure]], [[hypertension]], [[ischemic heart disease]], [[coronary heart disease|ischemic heart disease]], [[Nocturnal angina pectoris|nocturnal angina]], [[sleep apnea]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Chemical/Poisoning'''
| |
| |bgcolor="Beige"|[[acrodynia]], [[Aldehyde dehydrogenase|Aldehyde syndrome]], [antimony]], [[asbestosis]], [[benzoate ]], [[Cathinone|cathinone poisoning]], [[celery]], [[contact dermatitis|chemical-related eczema]], [[cumin]], [[erythrosine]], [[ethylbenzene]], [[gasoline]], [[Natural gasoline|gasoline]], [[contact dermatitis|irritant contact eczema]], [[lead]], [[mercury poisoning]], [[monocrotophos]], [[monosodium glutamate|Msg]], [[parsley]], [[quinoline yellow ss|quinoline yellow]], [[RDX|rdx]], [[silo unloader syndrome]], [[sulfite]], [[sunset yellow]], [[tartrazine]], [[tetryl]], [[toluene]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Dental'''
| |
| |bgcolor="Beige"| [[Dental caries]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Dermatologic'''
| |
| |bgcolor="Beige"| [[Contact dermatitis|Irritant contact eczema]], [[eczema]], [[atopic dermatitis|erythrodermic eczema]], [[Dermatomyositis|Eyelid eczema]]
| |
| [[Atopic dermatitis|Erythrodermic eczema]][[Contact dermatitis|Chemical-related eczema]], [[Contact dermatitis|Environmental allergen related eczema]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Drug Side Effect'''
| |
| |bgcolor="Beige"|[[4-Aminopyridine]],[[Abecarnil]], [[Alcohol withdrawal|Alcohol withdrawal syndrome]],[[Alemtuzumab]],[[Amantadine]],[[Zolpidem|Ambien withdrawal]],[[3,4-Diaminopyridine|Amifampridine]], [[Aminophylline]],[[Amobarbital sodium]], [[Amoxicillin]],[[Antidepressants]], [[Stimulant|Central nervous system stimulants]], [[Amphetamine|chronic amphetamine use]], [[Benzodiazepine withdrawal syndrome|Ativan withdrawal]],[[Benzphetamine]],[[Beta blockers|Beta antagonists]],[[Bronchodilators]],[[Bupropion]],[[Butorphanol]],[[Caffeine]], [[Burnout syndrome]], [[clonazepam]], [[clonidine]], [[dalfampridine]], [[dapsone]], [[Meperidine|demerol withdrawal]], [[desmopressin]], [[dexamfetamine]], [[Meperidine (patient information)|dxedrine withdrawal]], [[diazepam]], [[dilaudid withdrawal]], [[dimebon]], [[ramelteon]], [[rotigotine]], [[selegiline]], [[isoproterenol (aerosol)]], [[lisdexamfetamine]], [[desmopressin]],[[Morphine|hydrocodone withdrawal]], [[Mepenzolate|lacosamidemepenzolate]], [[lamotrigine]], [[lorazepam]], [[lysergic acid diethylamide]], Marie-seé syndrome, [[meropenem]], [[methcathinone]], [[Methylenedioxymethamphetamine]], [[Methylphenidate]], [[middle ear infection]], [[milnacipran hydrochloride]], [[modafinil]], [[morphine withdrawal]],[[niacin]], [[oxycodone|oxycontin withdrawal]], [[pain killer addiction]], [[pergolide]], [[Depressant|Central nervous system depressants]], [[Stimulant|Central nervous system stimulants]], [[Clonazepam]], [[Clonidine]], [[Cocaine withdrawal (patient information)|Cocaine withdrawal]] , [[Dalfampridine]], [[Dapsone]], [[Meperidine|Demerol withdrawal]], [[Ecstasy withdrawal]],[[Efavirenz]], [[Escitalopram]],
| |
| [[Flibanserin]][[Eribulin]],
| |
| [[Felbamate]]
| |
| [[Desmopressin]]
| |
| [[Dextroamphetamine|Dexamfetamine]] ,[[Meperidine (patient information)|Dexedrine withdrawal]]
| |
| [[Diazepam]]
| |
| [[Hydromorphone|Dilaudid withdrawal]]
| |
| [[Dimebon]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Ear Nose Throat'''
| |
| |bgcolor="Beige"| [[Acute sinusitis ]], [[Earache]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Endocrine'''
| |
| |bgcolor="Beige"|[[Andropause]], [[Cushing's syndrome|cushing's diseases]], [[diabetes]], [[grief]], [[hyperthyroidism]],[[melatonin]], [[menopause]], [[menstruation]], [[Pituitary adenoma|Pituitary tumors]], [[Premenstrual syndrome]], [[Effects of alcohol on the body|Alcohol-induced pseudo-cushing syndrome]], [[Hashimoto's thyroiditis|Autoimmune thyroid diseases]], [[Hypocalcemia|Calcium deficiency]], [[Cushing's syndrome|Cushing's diseases]],
| |
| [[Diabetes mellitus|Diabetes]]|-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Environmental'''
| |
| |bgcolor="Beige"| [[ stressors]],[[Acute mountain sickness]], [[Epstein barr virus related fibromyalgias]],[[Eyelid eczema ]],[[High altitude]],[[Hot bedroom]],[[Inadequate sleep hygiene]],[[Injury]],[[Leg cramps]],[[Mountain sicknesss]],[[Noise]],[[Pickwickian syndrome]],[[Poorly ventilated bedroom]],[[Posaconazole]],[[Prostatitis]],[[Shift work]],[[Shortness of breath - when it occurs at night]],[[Contact dermatitis|Environmental allergen related eczema]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Gastroenterologic'''
| |
| |bgcolor="Beige"| [[Cirrhosis of liver]],[[Colic]],[[Congenital hepatic porphyria]],[[Duodenal ulcers]],[[Generalized anxiety disorder - trouble staying asleep]],[[Glucocorticoids]],[[Indigestion]],[[Inflammatory bowel disease (ibd)]],[[Percocet withdrawal]],[[Renal failure]], [[Cirrhosis|Cirrhosis of liver]],
| |
| [[Food allergies]][[Congenital hepatic porphyria]],[[Helicobacter pylori infection|Duodenal ulcers]],
| |
| [[Gastroesophageal reflux disease]]|-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Genetic'''
| |
| |bgcolor="Beige"| [[Acute intermittent porphyria]],[[Alzheimer disease, early-onset, with cerebral amyloid angiopathy ]],[[Angelman-like syndrome, x-linked ]],[[Congenital hepatic porphyria]],[[Down's syndrome associated alzheimer's disease ]],[[Familial forms of alzheimer's disease ]],[[Huntington's disease]],[[Inborn amino acid metabolism disorder]],[[Neuromuscular disorders including painful peripheral neuropathies]],[[Phentermine]],[[Physical discomfort - any disease that causes any discomfort may interfere with sleep:]],[[Pineal teratoma]],[[Prion fatal familial insomnia]],[[Propranolol]],[[Down syndrome|Down's syndrome associated alzheimer's disease]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Hematologic'''
| |
| |bgcolor="Beige"|[[Aplastic anemia]], [[Iron deficiency anemia|iron-deficiency anemia]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Iatrogenic'''
| |
| |bgcolor="Beige"| [[Calcium deficiency]],
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Infectious Disease'''
| |
| |bgcolor="Beige"| [[Acquired immunodeficiency syndromes (aids)]],[[Ascariasis ]],[[Creutzfeldt-jakob disease]], [[Ecstasy abuse]], [[Eribulin]],[[Lyme disease]],[[Helicobacter pylori infection|Duodenal ulcers]],[[African trypanosomiasis|East African trypanosomiasis]],
| |
| [[Chronic fatigue syndrome (patient information)|Epstein barr virus related fibromyalgias]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Musculoskeletal/Orthopedic'''
| |
| |bgcolor="Beige"|[[Arthritis]],[[Restless legs syndrome - difficulty staying asleep]],[[fibromyalgia]], [[Chronic fatigue syndrome (patient information)|Epstein barr virus related fibromyalgias]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Neurologic'''
| |
| |bgcolor="Beige"|[[Acute mountain sickness]],[[Acute pain]],[[Alzheimer disease]], [[Concussion|Brain concussion]],[[Brain damage|Brain injury]], [[Central sleep apnea]],[[Circadian rhythm sleep disorder]],[[Cluster headache]],[[Cognitive styles]],[[Crack addiction]],[[Creutzfeldt-jakob disease]],[[Crystal meth addiction]],[[Dementia]],[[Diaphragmatic paralysis]],[[Down's syndrome associated alzheimer's disease ]],[[East african trypanosomiasis at night]],[[Heart congestion]],[[Huntington's disease]],[[Increased arousal]],[[Jet lag]],[[Kleine-levin-critchley syndrome]],[[Lead]],[[Lisdexamfetamine]],[[Mental retardation, microcephaly, epilepsy and ataxia syndrome ]],[[Nocturnal frontal lobe epilepsy type 1]],[[Nocturnal myoclonus]],[[Opioid withdrawal]],[[Panic attack]],[[Pea ]],[[Phentermine]],[[Pierre robin's sequence]],[[Restless legs syndrome - difficulty staying asleep]],[[Rett's syndromes]],[[Rice ]],[[Rolandic epilepsy]],[[Seizures]],[[Restless leg syndrome (rls)]], [[Stroke|Cerebral hemispheric and brainstem strokes]], [[Chronic fatigue syndrome]], [[Cluster headache]]
| |
| [[Circadian rhythm sleep disorder]], [[Chronic pain]], [[Delayed sleep phase syndrome|Delayed sleep-wake phase disorder]], [[Dementia]]
| |
| [[Creutzfeldt-Jakob disease|Creutzfeldt-jakob disease]], [[Fatal familial insomnia]]
| |
| [Dyssomnia]][[Diaphragmatic paralysis]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Nutritional/Metabolic'''
| |
| |bgcolor="Beige"|[[Acute intermittent porphyria]], [[Anise|Aniseed]], [[Achiote|annatto ]],[[Amaranth]], [[ antioxidants ]],[[butylated hydroxyanisole|BHA]], [[butylated hydroxytoluene|BHT]],[[Capsicum|Bell pepper]],[[ carageenan gum ]],[[Benzoate]], [[ carmine ]],[[ erythrosine ]],[[ guar gum ]],[[ gum acacia ]],[[ gum tragacanth ]],[[ lecithin ]],[[ monocrotophos]], [[Hypocalcemia|Calcium deficiency]],[[Carrageenan|Carageenan gum]], [[Celery]], [[Carmine]][[Abalone ]],[[Acute intermittent porphyria]],[[Alcohol withdrawal syndrome]],[[Alcohol-induced pseudo-cushing syndrome]],[[Allergic tension-fatigue syndrome]],[[Almond ]],[[Aniseed ]],[[Apple ]],[[Apricot ]],[[Avocado ]], [[Banana ]],[[Barley ]],[[Bean ]],[[Beef]],[[Beer ]],[[Bell pepper ]],[[Brain tumors]],[[Bronchodilators]],[[Butorphanol]],[[Cashew ]],[[Chamomile tea ]],[[Cherry ]],[[Chestnut ]],[[Chick pea ]],[[Chicken meat]],[[Cinnamon ]],[[Codfish ]],[[Congenital hepatic porphyria]],[[Crayfish ]], [[Cumin ]],[[Diabetes]],[[Duck meat]],[[Fibromyalgia]],[[Food allergies ing]],[[Glut-1 deficiency syndrome]],[[Gluten allergy ]],[[Graves disease]],[[Hops ]],[[Kidney bean ]],[[Kiwi fruit ]],[[Lentil ]],[[Lettuce ]],[[Lima bean ]],[[Linden tea ]],[[Lychee ]],[[Mackerel ]], [[Mango ]], [[Meat]], [[Melon ]], [[Milk ]], [[Mustard leaf ]], [[Night eating syndrome]], [[Olive ]], [[Other movement disorders]], [[Parasomnias]], [[Parkinson's disease]],[[Peach ]], [[Peanuts ]], [[Pear ]], [[Pecan ]], [[Peptic ulcer disease]], [[Peramivir]], [[Pinealoma]], [[Plantain ]], [[Pomegranates ]], [[Poor bed]], [[Poor sleep habits]], [[Postconcussive syndrome]], [[Pregabalin]], [[Quorn ]], [[Rape trauma syndromes]], [[Scallop ]], [[Seafood allergy ]], [[Sesame ]], [[Shellfish ]], [[Chestnut]], [[Cinnamon]], [[Fennel]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Obstetric/Gynecologic'''
| |
| |bgcolor="Beige"|
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Oncologic'''
| |
| |bgcolor="Beige"|[[Brain tumor]],
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Ophthalmologic'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Overdose/Toxicity'''
| |
| |bgcolor="Beige"| [[ saffron ]],[[Acrodynia]],[[Amphetamine intoxication]],[[Barbiturate abuse]],[[Benzodiazepine abuse]],[[Hypervitaminosis A|Chronic vitamin A toxicity]],[[Ecstasy withdrawal ]],[[Excessive caffeine]],[[Exemestane]],[[Folic acid toxicity]],[[Glucose transport defect, blood-brain barrier]],[[Heroin dependence]],[[Lsd addiction]], [[Folic acid toxicity]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Psychiatric'''
| |
| |bgcolor="Beige"|[[Psychogenic dwarfism|Abuse dwarfism syndrome]], [[Advanced sleep phase syndrome|Advanced sleep-wake phase disorder]],[[Alcoholism]],[[Amphetamine detailed information|Amphetamine abuse]], [[Pain|Acute pain]], [[Anxiety disorder]],[[Barbiturate|Barbiturate abuse]], [[Benzodiazepine|Benzodiazepine abuse]],[[Bipolar disorder|Bipolar affective disorder]],[[Burnout syndrome]], [[chronic sleep restriction]],[[grief ]],[[quinoline yellow ]],[[Advanced sleep-wake phase disorder]],[[Alzheimer disease]],[[Anger]],[[Anxiety disorders]], [[Chronic depression]],[[Chronic fatigue syndrome]], [[Circadian rhythm sleep disorder]],[[Clinical depression]],[[Crack cocaine|Crack addiction]], [[Cocaine withdrawal (patient information)|Crack withdrawal]], [[Crystal Meth Anonymous|Crystal meth addiction]][[Cognitive styles]],[[Combat stress reaction]],[[Daytime napping - can cause or prolong the problem.]],[[Delayed sleep-wake phase disorder]],[[Depression]],[[Discontinuation syndrome]],[[Disturbing feelings]],[[Disturbing thoughts]],[[Double depression]],[[Dyssomnia - difficulty staying asleep]],[[Dysthymia - waking too early]],[[Ecstasy withdrawal ]],[[Eczema ]],[[Extreme temperatures]],[[Fatal familial insomnia, a rare prion disease]],[[Fears]],[[Felbamate]],[[Ginseng overuse]],[[Guarana overuse]],[[Heroin dependence]],[[Huntington's disease]],[[Idiopathic insomnia]],[[Inadequate sleep hygiene]],[[Inborn amino acid metabolism disorder]],[[Increased arousal]],[[Irregular sleep-wake rhythm disorder ]],[[Jet lag]],[[Kleine-levin-critchley syndrome]],[[Major depressive disorder related fibromyalgias]],[[Major life events (e.g., illness, separation)]],[[Mania]],[[Mental stimulation before bedtime]],[[Mood disorder]],[[Narcolepsy with cataplexy]],[[Narcolepsy without cataplexy]],[[Narcolepsy]],[[Night urination - may effectively cause insomnia due to the practical need to urinate:]],[[Nightmares]],[[Nocturnal panic disorder]],[[Not enough exercise]],[[Olivopontocerebellar atrophy ]],[[Opioid addiction]],[[Oxazepam]],[[Paprika ]],[[Parsley ]],[[Phenol sulfotransferase deficiency]],[[Phentermine]],[[Physical discomfort - any disease that causes any discomfort may interfere with sleep:]],[[Pierre robin's sequence]],[[Pine nut ]],[[Potato ]],[[Pramipexole]][[Primary insomnia]],[[Problem sleepiness ]],[[Prostatitis]],[[Pumpkin ]],[[Pyridoxine deficiency]],[[Reflux esophagitis]],[[Renon-delille syndrome]],[[Rice ]],[[Secondary fibromyalgias]],[[Severe chronic pain ]],[[Cocaine abuse]],[[Crack addiction]], [[Crystal meth addiction]],[[chemical addiction]], [[cocaine withdrawal]], [[codeine withdrawal]], [[Cocaine withdrawal (patient information)|crack withdrawal]], [[exhilaration or excitement]],[[oxycontin addiction]],[[periodic limb movements in sleep]], perry syndrome, [[pick's disease]], [[postpartum depression]], [[pregnancy]], [[alcoholism]], [[premenstrual dysphoric disorders]], [[Amphetamine|Chronic amphetamine use]], [[sleep deprivation|Chronic sleep restriction]], [[Chronic stress]],
| |
| [[Chronic fatigue syndrome]], [[Circadian rhythm sleep disorder]], [[Cluster headache]], [[Cocaine|Cocaine abuse]],
| |
| [[Sleep disorder|Disrupted sleep schedules]], [[Methylenedioxymethamphetamine detailed information|Ecstasy abuse]], [[Fatal familial insomnia]]
| |
| [[Shift work sleep disorder|Endogenous insomnia]][[Bipolar disorder|Disturbing thoughts]], [[Anxiety disorder|Fear of not sleeping]]
| |
| [[Dysthymia|Double depression]][[Narcolepsy|Daytime napping]],[[Delayed sleep phase syndrome|Delayed sleep-wake phase disorder]], [[Dementia]], [[Dyssomnia]],
| |
| [[Withdrawal|Discontinuation syndrome]][[Depression]], [[Excited state|Exhilaration or excitement]]
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Pulmonary'''
| |
| |bgcolor="Beige"| [[Acute mountain sickness]],[[Asthma]],[[Brazil nut ]],[[Sleep apnea|Breathing-related sleep disorder]],[[Chronic obstructive pulmonary disease]],[[Lung disorder]],[[Nocturnal asthma ]],[[Shortness of breath]],[[Asthma|Bronchial asthma including nocturnal asthma]],[[Diaphragmatic paralysis]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Renal/Electrolyte'''
| |
| |bgcolor="Beige"| [[Chronic renal failure|Chronic renal disease]],[[Kidney disease]],[[Resistance to thyroid stimulating hormone]],[[Hypocalcemia|Calcium deficiency]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Rheumatology/Immunology/Allergy'''
| |
| |bgcolor="Beige"| [[Aplastic anemia]],[[Asthma]],[[Hashimoto's thyroiditis|Autoimmune thyroid diseases]],[[Epstein barr virus related fibromyalgias]],[[Goose meat]],[[Inflammatory bowel disease (ibd)]],[[Major depressive disorder related fibromyalgias]],[[Prion fatal familial insomnia]],[[Restless leg syndrome (rls)]],[[Right parietal lobe syndrome related alzheimer's disease ]], [[Asthma|Bronchial asthma including nocturnal asthma]], [[Buerger's disease]], [[Chronic fatigue syndrome]], [[Sleep hygiene|Chronic insomnia disorder]], [[Fibromyalgia|fibromyalgias]], [[Food allergies]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Sexual'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Trauma'''
| |
| |bgcolor="Beige"| [[Bladder distention ]],[[Brain concussion]],[[Brain injury]],[[Diaphragmatic paralysis]],[[Mild traumatic brain injury]],[[Post-traumatic stress]],|-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Urologic'''
| |
| |bgcolor="Beige"| [[Bipolar affective disorder]],[[Cystitis]],[[Enlarged prostate]],[[Environment change]],[[Benign prostatic hyperplasia]], [[Megacystis|Bladder distention]], [[Urinary retention|Enlarged bladder]], [[Benign prostatic hyperplasia|Enlarged prostate]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Miscellaneous'''
| |
| |bgcolor="Beige"| [[ idiopathic insomnia]],[[Ageing]],[[Chronic daily stress]],[[Chronic pain]],[[Chronic stress]],[[Dementia]],[[Diaphragmatic paralysis]],[[Illness]],[[Normal aging]],[[Oat ]],[[Obstructive sleep apnea]],[[Pork]],[[Restless leg syndrome (rls)]],[[Severe chronic pain ]],[[Sex at bedtime - some people become stimulated after sex.]],|-
| |
| |}
| |
|
| |
|
| ===Causes in Alphabetical Order=== | | ==[[Insomnia risk factors|Risk Factors]]== |
| {{columns-list|3|
| |
| *[[4-Aminopyridine]]
| |
| *[[Abecarnil]]
| |
| *[[Psychogenic dwarfism|Abuse dwarfism syndrome]]
| |
| *[[Immunodeficiency|Acquired immunodeficiency syndromes]]
| |
| *[[Acrodynia]]
| |
| *[[Acute intermittent porphyria]]
| |
| *[[Altitude sickness|Acute mountain sickness]]
| |
| *[[Pain|Acute pain]]
| |
| *[[Sinusitis|Acute sinusitis]]
| |
| *[[Advanced sleep phase syndrome|Advanced sleep-wake phase disorder]]
| |
| *[[Ageing]]
| |
| *[[Alcohol withdrawal|Alcohol withdrawal syndrome]]
| |
| *[[Effects of alcohol on the body|Alcohol-induced pseudo-cushing syndrome]]
| |
| *[[Alcoholism]]
| |
| *[[Aldehyde dehydrogenase|Aldehyde syndrome]]
| |
| *[[Alemtuzumab]]
| |
| *[[Chronic fatigue syndrome|Allergic tension-fatigue syndrome]]
| |
| *[[Alzheimer disease]]
| |
| *[[Amantadine]]
| |
| *[[Amaranth]]
| |
| *[[Zolpidem|Ambien withdrawal]]
| |
| *[[3,4-Diaminopyridine|Amifampridine]]
| |
| *[[Aminophylline]]
| |
| *[[Amobarbital sodium]]
| |
| *[[Amoxicillin]]
| |
| *[[Amphetamine detailed information|Amphetamine abuse]]
| |
| *[[Amphetamine|Amphetamine intoxication]]
| |
| *[[Andropause]]
| |
| *[[Anemia]]
| |
| *[[Anger]]
| |
| *[[Chronic stable angina|Angina]]
| |
| *[[Anise|Aniseed]]
| |
| *[[Achiote|Annatto]]
| |
| *[[Antidepressants]]
| |
| *[[Antimony]]
| |
| *[[Antioxidants]]
| |
| *[[Anxiety disorder]]
| |
| *[[Aplastic anemia]]
| |
| *[[Armodafinil]]
| |
| *[[Arthritis]]
| |
| *[[Asbestosis]]
| |
| *[[Ascariasis ]]
| |
| *[[Aspirin]]
| |
| *[[Asthma]]
| |
| *[[Benzodiazepine withdrawal syndrome|Ativan withdrawal]]
| |
| *[[Hashimoto's thyroiditis|Autoimmune thyroid diseases]]
| |
| *[[Barbiturate|Barbiturate abuse]]
| |
| *[[Capsicum|Bell pepper]]
| |
| *[[Benign prostatic hyperplasia]]
| |
| *[[Benzoate]]
| |
| *[[Benzodiazepine|Benzodiazepine abuse]]
| |
| *[[Benzphetamine]]
| |
| *[[Beta blockers|Beta antagonists]]
| |
| *[[butylated hydroxyanisole|BHA]]
| |
| *[[butylated hydroxytoluene|BHT]]
| |
| *[[Bipolar disorder|Bipolar affective disorder]]
| |
| *[[Megacystis|Bladder distention]]
| |
| *[[Concussion|Brain concussion]]
| |
| *[[Brain damage|Brain injury]]
| |
| *[[Brain tumor]]
| |
| *[[Sleep apnea|Breathing-related sleep disorder]]
| |
| *[[Asthma|Bronchial asthma including nocturnal asthma]]
| |
| *[[Bronchodilators]]
| |
| *[[Buerger's disease]]
| |
| *[[Bupropion]]
| |
| *[[Burnout syndrome]]
| |
| *[[Butorphanol]]
| |
| *[[Hypocalcemia|Calcium deficiency]]
| |
| *[[Cancer]]
| |
| *[[Carrageenan|Carageenan gum]]
| |
| *[[Carmine]]
| |
| *[[Cathinone|Cathinone poisoning]]
| |
| *[[Celery]]
| |
| *[[Depressant|Central nervous system depressants]]
| |
| *[[Stimulant|Central nervous system stimulants]]
| |
| *[[Sleep apnea|Central sleep apnea]]
| |
| *[[Stroke|Cerebral hemispheric and brainstem strokes]]
| |
| *[[Contact dermatitis|Chemical-related eczema]]
| |
| *[[Chestnut]]
| |
| *[[Congestive heart failure|Chf]]
| |
| *[[Amphetamine|Chronic amphetamine use]]
| |
| *[[Chronic fatigue syndrome]]
| |
| *[[Sleep hygiene|Chronic insomnia disorder]]
| |
| *[[Chronic obstructive pulmonary disease]]
| |
| *[[Chronic pain]]
| |
| *[[Chronic renal failure|Chronic renal disease]]
| |
| *[[sleep deprivation|Chronic sleep restriction]]
| |
| *[[Chronic stress]]
| |
| *[[Hypervitaminosis A|Chronic vitamin A toxicity]]
| |
| *[[Cinnamon]]
| |
| *[[Circadian rhythm sleep disorder]]
| |
| *[[Cirrhosis|Cirrhosis of liver]]
| |
| *[[Clonazepam]]
| |
| *[[Clonidine]]
| |
| *[[Cluster headache]]
| |
| *[[Cocaine|Cocaine abuse]]
| |
| *[[Cocaine withdrawal (patient information)|Cocaine withdrawal]]
| |
| *[[Colic]]
| |
| *[[Combat stress reaction]]
| |
| *[[Congenital hepatic porphyria]]
| |
| *[[Congestive heart failure|Congestive cardiac failure]]
| |
| *[[Crack cocaine|Crack addiction]]
| |
| *[[Cocaine withdrawal (patient information)|Crack withdrawal]]
| |
| *[[Creutzfeldt-Jakob disease|Creutzfeldt-jakob disease]]
| |
| *[[Crystal Meth Anonymous|Crystal meth addiction]]
| |
| *[[Cumin]]
| |
| *[[Cushing's syndrome|Cushing's diseases]]
| |
| *[[Cystitis]]
| |
| *[[Dalfampridine]]
| |
| *[[Dapsone]]
| |
| *[[Narcolepsy|Daytime napping]]
| |
| *[[Delayed sleep phase syndrome|Delayed sleep-wake phase disorder]]
| |
| *[[Dementia]]
| |
| *[[Meperidine|Demerol withdrawal]]
| |
| *[[Dental caries|Dental problem]]
| |
| *[[Depression]]
| |
| *[[Desmopressin]]
| |
| *[[Dextroamphetamine|Dexamfetamine]]
| |
| *[[Meperidine (patient information)|Dexedrine withdrawal]]
| |
| *[[Diabetes mellitus|Diabetes]]
| |
| *[[Diaphragmatic paralysis]]
| |
| *[[Diazepam]]
| |
| *[[Dyssomnia]]
| |
| *[[Hydromorphone|Dilaudid withdrawal]]
| |
| *[[Dimebon]]
| |
| *[[Withdrawal|Discontinuation syndrome]]
| |
| *[[Sleep disorder|Disrupted sleep schedules]]
| |
| *[[Bipolar disorder|Disturbing thoughts]]
| |
| *[[Dysthymia|Double depression]]
| |
| *[[Down syndrome|Down's syndrome associated alzheimer's disease]]
| |
| *[[Helicobacter pylori infection|Duodenal ulcers]]
| |
| *[[Dyssomnia]]
| |
| *[[Otalgia|Earache]]
| |
| *[[African trypanosomiasis|East African trypanosomiasis]]
| |
| *[[Methylenedioxymethamphetamine detailed information|Ecstasy abuse]]
| |
| *[[Ecstasy withdrawal]]
| |
| *[[Eczema]]
| |
| *[[Efavirenz]]
| |
| *[[Shift work sleep disorder|Endogenous insomnia]]
| |
| *[[Urinary retention|Enlarged bladder]]
| |
| *[[Benign prostatic hyperplasia|Enlarged prostate]]
| |
| *[[Contact dermatitis|Environmental allergen related eczema]]
| |
| *[[Chronic fatigue syndrome (patient information)|Epstein barr virus related fibromyalgias]]
| |
| *[[Eribulin]]
| |
| *[[Atopic dermatitis|Erythrodermic eczema]]
| |
| *[[Erythrosine]]
| |
| *[[Escitalopram]]
| |
| *[[Ethylbenzene]]
| |
| *[[Caffeine|Excessive caffeine]]
| |
| *[[Excited state|Exhilaration or excitement]]
| |
| *[[Dermatomyositis|Eyelid eczema]]
| |
| *[[Fatal familial insomnia]]
| |
| *[[Anxiety disorder|Fear of not sleeping]]
| |
| *[[Felbamate]]
| |
| *[[Fennel]]
| |
| *[[Fibromyalgia|fibromyalgias]]
| |
| *[[Flibanserin]]
| |
| *[[Folic acid toxicity]]
| |
| *[[Food allergies]]
| |
| *[[Natural gasoline|Gasoline]]
| |
| *[[Gastroesophageal reflux disease]]
| |
| *[[Generalized anxiety disorder]]
| |
| *[[Ginseng|Ginseng overuse]]
| |
| *[[Visceroptosis|Glenard syndrome]]
| |
| *[[Glucocorticoids]]
| |
| *[[Blood-brain barrier|Glucose transport defect, blood-brain barrier]]
| |
| *[[De Vivo disease|Glut-1 deficiency syndrome]]
| |
| *[[Wheat allergy|Gluten allergy]]
| |
| *[[Graves disease]]
| |
| *[[Grief]]
| |
| *[[Guar gum]]
| |
| *[[Guarana|Guarana overuse]]
| |
| *[[Acacia senegal|Gum acacia]]
| |
| *[[Tragacanth|Gum tragacanth]]
| |
| *[[Headache|Headache syndromes]]
| |
| *[[Congestive heart failure|Heart congestion]]
| |
| *[[Heartburn]]
| |
| *[[Heroin|Heroin dependence]]
| |
| *[[Seasonal affective disorder|Holiday depression]]
| |
| *[[Hops]]
| |
| *[[Hunger]]
| |
| *[[Huntington's disease]]
| |
| *[[Morphine|Hydrocodone withdrawal]]
| |
| *[[Hypertension]]
| |
| *[[Hyperthyroidism]]
| |
| *[[Illness]]
| |
| *[[Sleep hygiene|Inadequate sleep hygiene]]
| |
| *[[Maple syrup urine disease|Inborn amino acid metabolism disorder]]
| |
| *[[Hypervigilance|Increased arousal]]
| |
| *[[Indigestion]]
| |
| *[[Inflammatory bowel disease]]
| |
| *[[Injury]]
| |
| *[[Iron deficiency anemia]]
| |
| *[[Circadian rhythm sleep disorder|Irregular sleep-wake rhythm disorder]]
| |
| *[[Contact dermatitis|Irritant contact eczema]]
| |
| *[[Coronary heart disease|Ischemic heart disease]]
| |
| *[[Isoproterenol (aerosol)]]
| |
| *[[Jet lag]]
| |
| *[[Nephrology|Kidney disease]]
| |
| *[[Mepenzolate|Lacosamidemepenzolate]]
| |
| *[[Lamotrigine]]
| |
| *[[Lead]]
| |
| *[[Lecithin]]
| |
| *[[Cramp|Leg cramps]]
| |
| *[[Lentil]]
| |
| *[[Lettuce]]
| |
| *[[Light]]
| |
| *[[Lisdexamfetamine]]
| |
| *[[Lorazepam]]
| |
| *[[Lysergic Acid Diethylamide|Lsd addiction]]
| |
| *[[Lyme disease]]
| |
| *[[Lysergic Acid Diethylamide|Lysergic acid diethylamide]]
| |
| *[[Mania]]
| |
| *[[Melatonin]]
| |
| *[[Menopause]]
| |
| *[[Menstruation]]
| |
| *[[Mercury poisoning]]
| |
| *[[Meropenem]]
| |
| *[[Methcathinone]]
| |
| *[[Methylenedioxymethamphetamine]]
| |
| *[[Methylphenidate]]
| |
| *[[Otitis media|Middle ear infection]]
| |
| *[[Concussion|Mild traumatic brain injury]]
| |
| *[[Milk]]
| |
| *[[Milnacipran hydrochloride]]
| |
| *[[Modafinil]]
| |
| *[[Monocrotophos]]
| |
| *[[Mood disorder]]
| |
| *[[Morphine Oral (patient information)|Morphine withdrawal]]
| |
| *[[movement disorders]]
| |
| *[[Monosodium glutamate|Msg]]
| |
| *[[Mussel]]
| |
| *[[Mycosis fungoides|Mycosis fungoides, familial]]
| |
| *[[Narcolepsy]]
| |
| *[[Narcotic|Narcotic addiction]]
| |
| *[[Neuralgia|Neuromuscular disorders including painful peripheral neuropathies]]
| |
| *[[Niacin]]
| |
| *[[Night eating syndrome]]
| |
| *[[Nightmare|Nightmares]]
| |
| *[[Nocturia]]
| |
| *[[Nocturnal angina pectoris|Nocturnal angina]]
| |
| *[[Nocturnal asthma]]
| |
| *[[Autosomal dominant nocturnal frontal lobe epilepsy|Nocturnal frontal lobe epilepsy type 1]]
| |
| *[[Nocturnal myoclonus]]
| |
| *[[Panic disorder|Nocturnal panic disorder]]
| |
| *[[Noise]]
| |
| *[[Sedentary lifestyle|Not enough exercise]]
| |
| *[[Sleep apnea|Obstructive sleep apnea]]
| |
| *[[Olivopontocerebellar atrophy]]
| |
| *[[Opioid abuse and dependence|Opioid addiction]]
| |
| *[[Opioid withdrawal]]
| |
| *[[Overeating]]
| |
| *[[Oxaprozin]]
| |
| *[[Oxazepam]]
| |
| *[[Oxycodone|Oxycontin addiction]]
| |
| *[[Oxycodone|Oxycontin withdrawal]]
| |
| *[[Pain]]
| |
| *[[Analgesic|Pain killer addiction]]
| |
| *[[Panic attack]]
| |
| *[[Parasomnia|Parasomnias]]
| |
| *[[Parkinson's disease]]
| |
| *[[Parsley]]
| |
| *[[Peptic ulcer|Peptic ulcer disease]]
| |
| *[[Peramivir]]
| |
| *[[Oxycodone|Percocet withdrawal]]
| |
| *[[Pergolide]]
| |
| *[[Nocturnal myoclonus|Periodic limb movements in sleep]]
| |
| *Perry syndrome
| |
| *Phenol sulfotransferase deficiency
| |
| *[[Phentermine]]
| |
| *[[Pick's disease]]
| |
| *[[Obesity hypoventilation syndrome|Pickwickian syndrome]]
| |
| *[[Pierre Robin syndrome|Pierre robin's sequence]]
| |
| *[[Pineal teratoma]]
| |
| *[[Pinealoma]]
| |
| *[[Pituitary adenoma|Pituitary tumors]]
| |
| *[[Posaconazole]]
| |
| *[[Post traumatic stress disorder|Post-traumatic stress]]
| |
| *[[Post-concussion syndrome|Postconcussive syndrome]]
| |
| *[[Postnatal depression|Postpartum depression]]
| |
| *[[Pramipexole]]
| |
| *[[Pregabalin]]
| |
| *[[Pregnancy]]
| |
| *[[Premenstrual dysphoric disorder|Premenstrual dysphoric disorders]]
| |
| *[[Premenstrual syndrome]]
| |
| *[[Depression|Primary affective disorder]]
| |
| *[[Primary insomnia]]
| |
| *[[Fatal familial insomnia|Prion fatal familial insomnia]]
| |
| *[[Propranolol]]
| |
| *[[Prostatitis]]
| |
| *[[Itch|pruritus]]
| |
| *[[Psychiatric disorders]]
| |
| *[[Pyridoxine deficiency]]
| |
| *[[Pyrimethamine]]
| |
| *[[Quinoline Yellow SS|Quinoline yellow]]
| |
| *[[Quorn]]
| |
| *[[Ramelteon]]
| |
| *[[Rape trauma syndrome|Rape trauma syndromes]]
| |
| *[[RDX]]
| |
| *[[Esophagitis|Reflux esophagitis]]
| |
| *[[Rapid eye movement behavior disorder|Rem-behavior disorder]]
| |
| *[[Renal insufficiency|Renal failure]]
| |
| *[[Thyroid hormone resistance|Resistance to thyroid stimulating hormone]]
| |
| *[[Respiratory muscle paralysis]]
| |
| *[[Restless legs syndrome|Restless leg syndrome]]
| |
| *[[Rett syndrome|Rett's syndromes]]
| |
| *[[Rheumatoid arthritis|Rheumatoid arthritis related fibromyalgias]]
| |
| *[[Gerstmann syndrome|Right parietal lobe syndrome]]
| |
| *[[Methylphenidate|Ritalin withdrawal]]
| |
| *[[Epilepsy classification|Rolandic epilepsy]]
| |
| *[[Rotigotine]]
| |
| *[[Schizophrenia]]
| |
| *[[Food allergy|Seafood allergy]]
| |
| *[[Sedative|Sedative dependence]]
| |
| *[[Seizure|Seizures]]
| |
| *[[Selegiline]]
| |
| *[[Sesame]]
| |
| *[[Chronic pain|Severe chronic pain]]
| |
| *[[Shift work]]
| |
| *[[Dyspnea|Shortness of breath]]
| |
| *[[Sibutramine]]
| |
| *[[Silo unloader syndrome]]
| |
| *[[Sinusitis|Sinusitis]]
| |
| *[[Sleep disorder|Situational/acute insomnia]]
| |
| *[[Systemic lupus erythematosus|Sle related fibromyalgias]]
| |
| *[[Sleep apnea]]
| |
| *[[Sleep disorder]]
| |
| *[[Sleep paralysis]]
| |
| *[[Sleep and breathing|Sleep-disordered breathing]]
| |
| *[[Sedative|Sleeping pill addiction]]
| |
| *[[Smoking|Smoking especially at bedtime]]
| |
| *[[Sleepwalking|Somnambulism]]
| |
| *[[Sopite syndrome]]
| |
| *Steroid withdrawal syndrome
| |
| *[[Stress (medicine)|Stress]]
| |
| *[[Eczema|Stress-related eczema]]
| |
| *[[Substance abuse]]
| |
| *[[Sulfite]]
| |
| *[[Sunset yellow]]
| |
| *[[Suvorexant]]
| |
| *[[Tartrazine]]
| |
| *[[Tasimelteon]]
| |
| *[[Bruxism|Teeth grinding]]
| |
| *[[Temazepam]]
| |
| *[[Eczema|Temperature-related eczema]]
| |
| *[[Tension myositis syndrome|Tension myositis related fibromyalgias]]
| |
| *[[Terbutaline]]
| |
| *[[Tetryl]]
| |
| *[[Beriberi|Thiamine deficiency]]
| |
| *[[Thyme]]
| |
| *[[Tolcapone]]
| |
| *[[Toluene]]
| |
| *[[Sedative|Tranquilizer addiction]]
| |
| *[[Sedative|Tranquilizer withdrawal]]
| |
| *[[Traumatic brain injury|Traumatic brain injury causing post-traumatic insomnia]]
| |
| *[[Ribavirin|Tribavirin]]
| |
| *[[Trigeminal neuralgia]]
| |
| *[[Pain|Ulcer pain]]
| |
| *[[Chronic renal failure pathophysiology|Uremia]]
| |
| *[[Urinary tract infection]]
| |
| *[[Varenicline]]
| |
| *[[Variegate porphyria]]
| |
| *[[Lortab|Vicodin withdrawal]]
| |
| *[[Vilazodone]]
| |
| *[[Thiamine|Vitamin B1 toxicity]]
| |
| *[[Vitamin B12 deficiency]]
| |
| *[[Wernicke-korsakoff syndrome]]
| |
| *[[African trypanosomiasis|West African trypanosomiasis]]
| |
| *[[Wheat]]
| |
| *[[Whiplash|Whiplashs]]
| |
| *[[Wiskott-Aldrich syndrome]]
| |
| *[[Zolpidem|Withdrawal of sleeping pills]]
| |
| *[[Intestinal parasite|Worms]]
| |
| *X-linked Angelman-like syndrome
| |
| *[[Alprazolam|Xanax withdrawal]]
| |
| *[[Xanthan gum]]
| |
| *[[Zonisamide]]
| |
| *[[Zucchini]]
| |
| }}
| |
|
| |
|
| | ==[[Insomnia screening|Screening]]== |
|
| |
|
|
| | ==[[Insomnia natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
| Insomnia can be caused by:
| |
| * [[Psychoactive drug|Psychoactive drugs]] or [[Stimulant|stimulants]], including certain [[medication]], [[herbs]], [[Caffeine|caffeine]], [[Cocaine|cocaine]], [[Ephedrine|ephedrine]], [[Amphetamine|amphetamines]], [[Methylphenidate|methylphenidate]], [[MDMA]], [[Methamphetamine|methamphetamine]] and [[Modafinil|modafinil]]
| |
| * [[Hormone]] shifts such as those that preceed [[menstruation]] and those during [[menopause]]
| |
| * Psychological problems like [[fear]], [[stress (psychology)|stress]], [[anxiety]], emotional or mental tension, work problems, financial stress, unsatisfactory sex life
| |
| * [[Mental disorder|Mental Disorders]] such as [[Clinical depression|clinical depression]], [[bipolar disorder]], [[General anxiety disorder|general anxiety disorder]], [[Sleep disorder|sleep disorders]]
| |
| * [[Circadian rhythm sleep disorder|Disturbances of the circadian rhythm]] such as shift work and [[Jet lag|jet lag]]
| |
| * Certain [[Neurology|neurological disorders]], [[Brain|brain]] [[Lesion|lesions]], or a [[Medical history|history]] of [[Traumatic brain injury]]
| |
| * [[Disease|Medical conditions]] such as [[Hyperthyroidism]] and [[Wilson's Syndrome]]
| |
| *[[Drugs]]: [[Acamprosate calcium]], [[acetaminophen]], [[Asenapine maleate]] [[Atovaquone]], [[caspofungin acetate]], [[Dolutegravir]], [[Elvitegravir]], [[Leuprolide]], [[levofloxacin]], [[Megestrol]], [[Oxandrolone]], [[Nandrolone]], [[Pertuzumab]], [[Pirfenidone]], [[Rasagiline]], [[Romiplostim]], [[Secobarbital sodium]], [[Sulfasalazine]], [[Trifluoperazine]], [[Varenicline]].
| |
| | |
| Insomnia also sometimes occurs for no apparent reason.<ref>http://www.paralumun.com/sleeplessness.htm</ref>
| |
| An overactive mind or physical pain may also be causes. Finding the underlying cause of insomnia is usually necessary to cure it. Insomnia can be common after the loss of a loved one, even months or a year after the death, if they are not grieving correctly (pretending they are over it when they are not).
| |
| | |
| === Acute ===
| |
| * Environment changes
| |
| * Extremes of temperature
| |
| * Illness
| |
| * Injury
| |
| * Light
| |
| * Noise
| |
| * Poor bed
| |
| * Situational stress
| |
| | |
| === Chronic ===
| |
| * [[Angina]]
| |
| * [[Anxiety]]
| |
| * [[Arthritis|Arthritis pain]]
| |
| * [[Asthma]]
| |
| * [[Benign prostatic hyperplasia]]
| |
| * [[Bipolar Disorder]]
| |
| * [[Caffeine]]
| |
| * [[Cancer]] pain
| |
| * [[Chronic Fatigue Syndrome]]
| |
| * [[Chronic Obstructive Pulmonary Disease]] (COPD)
| |
| * [[Chronic Renal Disease]]
| |
| * [[Headache|Cluster headaches]]
| |
| * [[Congestive Heart Failure]]
| |
| * [[Dementia]]
| |
| * [[Depression]]
| |
| * [[Diabetes Mellitus]]
| |
| * [[Drugs]]- [[Armodafinil]], [[Clomifene]], [[Diflunisal]], [[Eculizumab]], [[Efavirenz]], [[Fluvoxamine]], [[Levofloxacin]], [[Naltrexone]], [[Ofloxacin]], [[Oxymetazoline]], [[Paroxetine]], [[Phentermine]], [[Ribavirin]], [[Rifaximin]], [[Romiplostim]], [[Sulindac]], [[Tacrolimus]], [[Temozolomide]], [[Thalidomide]], [[Topiramate]], [[Varenicline]]
| |
| * [[Fibromyalgia]]
| |
| * [[Gastroesophageal Reflux Disease]] (GERD)
| |
| * [[Hyperthyroidism]]
| |
| * [[Inflammatory Bowel Disease]] (IBD)
| |
| * [[Mania]]
| |
| * [[Menopause]]
| |
| * Nocturnal [[panic disorder]]
| |
| * Other [[movement disorder]]s
| |
| * Pain
| |
| * [[Parkinson's Disease]]
| |
| * [[Peptic Ulcer Disease]]
| |
| * Poor sleep hygiene
| |
| * [[Posttraumatic Stress Disorder]]
| |
| * [[Pregnancy]]
| |
| * [[Pruritis]]
| |
| * [[Psychosis]]
| |
| * [[Reflux esophagitis]]
| |
| * [[Schizophrenia]]
| |
| * [[Seizures]]
| |
| * [[Sleep Apnea]]
| |
| * [[Uremia]]
| |
| * [[Urinary Tract Infection]] (UTI)
| |
| | |
| === Other ===
| |
| * Circadian rhythm disorders
| |
| * Idiopathic insomnia
| |
| *Drugs
| |
| **[[Alemtuzumab]]
| |
| **[[Amoxicillin]]
| |
| **[[Amobarbital sodium]]
| |
| **[[Benzphetamine]]
| |
| **[[Butorphanol]]
| |
| **[[Dalfampridine]]
| |
| **[[Desmopressin]]
| |
| **[[Dapsone]]
| |
| **[[Eribulin]]
| |
| **[[Exemestane]]
| |
| **[[Felbamate]]
| |
| **[[Isoproterenol (aerosol)]]
| |
| **[[Lacosamide]][[Mepenzolate]]
| |
| **[[Milnacipran hydrochloride]]
| |
| **[[Vilazodone]]
| |
| **[[Meropenem]]
| |
| **[[Niacin]]
| |
| **[[Oxaprozin]]
| |
| **[[Pergolide]]
| |
| **[[Ramelteon]]
| |
| **[[Rotigotine]]
| |
| **[[Terbutaline]]
| |
| * [[Narcolepsy]]
| |
| * [[Obstructive sleep apnea]]
| |
| * [[Periodic limb movement disorder]]
| |
| * Prion fatal familial insomnia
| |
| * Psychophysiologic insomnia
| |
| * REM-behavior disorder
| |
| * [[Restless leg syndrome]] (RLS)
| |
| * Sleep state misperception
| |
| | |
| ==Differential Diagnosis==
| |
| *Breathing-related sleep disorders
| |
| *Delayed sleep phase and shift work types of circadian rhythm sleep-wake disorder
| |
| *[[Narcolepsy]]
| |
| *Normal sleep variations
| |
| *Parasomnias
| |
| *[[Restless legs syndrome]]
| |
| *Situational/acute insomnia
| |
| *Substance/medication-induced [[sleep disorder]], insomnia type<ref name=DSMV>{{cite book | title = Diagnostic and statistical manual of mental disorders : DSM-5 | publisher = American Psychiatric Association | location = Washington, D.C | year = 2013 | isbn = 0890425558 }}</ref>
| |
| | |
| ==Epidemiology and Demographics==
| |
| ===Prevalence===
| |
| The prevalence of insomnia disorder is 10,000-20,000 per 100,000 (10%-20%) in the primary care setting.<ref name=DSMV>{{cite book | title = Diagnostic and statistical manual of mental disorders : DSM-5 | publisher = American Psychiatric Association | location = Washington, D.C | year = 2013 | isbn = 0890425558 }}</ref>
| |
| | |
| According to the U.S. [[Department of Health and Human Services]] in year 2007, approximately 64 million Americans suffer from insomnia each year.<ref name="titleBrain Basics: Understanding Sleep: National Institute of Neurological Disorders and Stroke (NINDS)">{{cite web |url=http://www.ninds.nih.gov/disorders/brain_basics/understanding_sleep.htm |title=Brain Basics: Understanding Sleep: National Institute of Neurological Disorders and Stroke (NINDS) |accessdate=2007-12-16 |format= |work=}}</ref> Insomnia tends to increase with age and affects about 40 percent of women and 30 percent of men.<ref name="titleInsomnia">{{cite web |url=http://www.womenshealth.gov/faq/insomnia.htm |title=Insomnia |accessdate=2007-12-16 |format= |work=}}</ref> The average American gets 7 hours of sleep, instead of the 8 to 10 hours recommended by doctors. Children however are recommended more than 8 hours.
| |
| | |
| ==Risk Factors==
| |
| *Advancing age
| |
| *Anxiety or worry-prone personality
| |
| *Chronic daily stress
| |
| *Cognitive styles
| |
| *Familial disposition
| |
| *Fear of not sleeping
| |
| *Female gender
| |
| *High altitude
| |
| *Increased arousal
| |
| *Irregular sleep scheduling
| |
| :*Excessive caffeine use
| |
| :* Irregular sleep schedules
| |
| *Light
| |
| *Major life events (e.g., illness, separation)
| |
| *Noise
| |
| *Poor sleep habits
| |
| *Poor sleep hygiene practices
| |
| *Tendency to repress emotions
| |
| *Uncomfortably high or low temperature<ref name=DSMV>{{cite book | title = Diagnostic and statistical manual of mental disorders : DSM-5 | publisher = American Psychiatric Association | location = Washington, D.C | year = 2013 | isbn = 0890425558 }}</ref>
| |
|
| |
|
| ==Diagnosis== | | ==Diagnosis== |
| Patients with [[delayed sleep phase syndrome]] are often mis-diagnosed with insomnia. If the patient has trouble getting to sleep, but has normal sleep architecture once asleep, a [[circadian rhythm]] disorder is a more likely cause.
| | [[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]] |
| | |
| ===Diagnostic Criteria===
| |
| | |
| ====DSM-V Diagnostic Criteria for Insomnia Disorder<ref name=DSMV>{{cite book | title = Diagnostic and statistical manual of mental disorders : DSM-5 | publisher = American Psychiatric Association | location = Washington, D.C | year = 2013 | isbn = 0890425558 }}</ref>====
| |
| {{cquote|
| |
| | |
| *A.A predominant complaint of dissatisfaction with sleep quantity or quality, associated with one (or more) of the following symptoms:
| |
| :*1.Difficulty initiating sleep.(In children, this may manifest as difficulty initiating sleep without caregiver intervention.)
| |
| :*2.Difficulty maintaining sleep, characterized by frequent awakenings or problems returning to sleep after awakenings. (In children, this may manifest as difficulty returning to sleep without caregiver intervention.):
| |
| :*3. Early-morning awakening with inability to return to sleep.
| |
|
| |
| '''''AND'''''
| |
| | |
| *B.The sleep disturbance causes clinically significant distress or impairment in social, occupational,educational, academic, behavioral, or other important areas of functioning.
| |
| | |
| '''''AND'''''
| |
| | |
| *C.The sleep difficulty occurs at least 3 nights per week.
| |
| | |
| '''''AND'''''
| |
| | |
| *D.The sleep difficulty is present for at least 3 months.
| |
| | |
| '''''AND'''''
| |
| | |
| *E.The sleep difficulty occurs despite adequate opportunity for sleep.
| |
| | |
| '''''AND'''''
| |
| | |
| *F.The insomnia is not better explained by and does not occur exclusively during the course of another sleep-wake disorder (e.g., [[narcolepsy]], a breathing-related sleep disorder, a circadian rhythm sleep-wake disorder, a parasomnia).
| |
| | |
| '''''AND'''''
| |
| | |
| *G.The insomnia is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication).
| |
| | |
| '''''AND'''''
| |
| | |
| *H. Coexisting mental disorders and medical conditions do not adequately explain the predominant complaint of insomnia.
| |
| | |
| Specify if:
| |
| | |
| *With non-sleep disorder mental comorbidity, including substance use disorders
| |
| | |
| *With other medical comorbidity
| |
| | |
| *With other sleep disorder
| |
| | |
| Specify if:
| |
| | |
| *Episodic:Symptoms last at least 1 month but less than 3 months.
| |
| | |
| *Persistent: Symptoms last 3 months or longer.
| |
| | |
| *Recurrent: Two (or more) episodes within the space of 1 year.
| |
| | |
| <SMALL>''Note:Acute and short-term insomnia (i.e., symptoms lasting less than 3 months but otherwise meeting all criteria with regard to frequency, intensity, distress, and/or impairment)should be coded as an other specified insomnia disorder.''</SMALL>
| |
| }}
| |
| | |
| ===Insomnia versus poor sleep quality===
| |
| Poor sleep quality can occur as a result of sleep apnea or [[major depression]]. Poor sleep quality is caused by the individual not reaching stage 4 or delta sleep which has restorative properties. There are, however, people who are unable to achieve stage 4 sleep due to brain damage who still lead perfectly normal lives.
| |
| | |
| *'''[[Sleep apnea]]''' is a condition that occurs when a sleeping person's breathing is interrupted, thus interrupting the normal sleep cycle. With the obstructive form of the condition, some part of the sleeper's respiratory tract loses muscle tone and partially collapses. People with obstructive sleep apnea often do not remember awakening or having difficulty breathing, but they complain of excessive sleepiness during the day. Central sleep apnea interrupts the normal breathing stimulus of the [[central nervous system]], and the individual must actually wake up to resume breathing. This form of apnea is often related to a cerebral vascular condition, congestive heart failure, and premature aging.
| |
| | |
| Major depression leads to alterations in the function of the hypothalamus and pituitary causing excessive release of cortisol which can lead to poor sleep quality.
| |
| | |
| Nocturnal polyuria or excessive nighttime urination can be very disturbing to sleep.<ref>{{cite book | coauthors = Adler and Thorpy | title = Sleep issues in Parkinson’s disease | url = http://www.neurology.org/cgi/content/full/64/12_suppl_3/S12 | accessyear = 2007 | accessmonth = June | year = 2005 | publisher = Neurology | language = English | pages = 64; S12-20 }}</ref> Nocturnal polyuria can be nephrogenic (related to kidney disease) or it may be due to prostate enlargement or hormonal influences. Deficiencies in vasopressin, which is either caused by a pituitary problem or by insensitivity of the kidney to the effects of vasopressin, can lead to nocturnal polyuria. Excessive thirst or the use of diuretics can also cause these symptoms.
| |
|
| |
|
| ==Treatment== | | ==Treatment== |
| In many cases, insomnia is caused by another disease or psychological problem. In this case, medical or psychological help may be useful.
| | [[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]] |
|
| |
|
| ===Medications=== | | ==Case Studies== |
| Many insomniacs rely on [[sleeping tablet]]s and other [[sedative]]s to get rest. All sedative drugs have the potential of causing psychological dependence where the individual cannot psychologically accept that they can sleep without drugs. Certain classes of sedatives such as [[benzodiazepine]]s and newer [[nonbenzodiazepine]] drugs can also cause physical dependence which manifests in withdrawal symptoms if the drug is not carefully titrated down.
| | [[Insomnia case study one|Case #1]] |
|
| |
|
| In comparing the options, a [[systematic review]] found that [[benzodiazepine]]s and [[nonbenzodiazepine]]s have similar efficacy which was [[statistical_significance | insignificantly]] more than for [[antidepressant]]s.<ref name="pmid17619935">Buscemi N, Vandermeer B, Friesen C, Bialy L, Tubman M, Ospina M, Klassen TP, Witmans M. The efficacy and safety of drug treatments for chronic insomnia in adults: a meta-analysis of RCTs. J Gen Intern Med. 2007 Sep;22(9):1335-50. Epub 2007 Jul 10. PMID 17619935</ref> Benzodiazepines had an [[statistical_significance | insignificant]] tendency for more [[adverse drug reaction]]s.<ref name="pmid17619935"/>
| | ==See also== |
| | |
| ====Benzodiazepines====
| |
| {{main|Benzodiazepine}}
| |
| The most commonly used class of hypnotics prescribed for insomnia are the [[benzodiazepine]]s. [[Benzodiazepine]]s bind unselectively to the [[GABAA receptor|GABA<sub>A</sub> receptor]].<ref name="pmid17619935"/> This includes drugs such as [[temazepam]], [[diazepam]], [[lorazepam]], [[flurazepam]], [[nitrazepam]] and [[midazolam]]. These medications can be addictive, especially after taking them over long periods of time.
| |
| | |
| ====Non-benzodiazepines====
| |
| {{main|Nonbenzodiazepine}}
| |
| [[Nonbenzodiazepine]] prescription drugs, including the [[nonbenzodiazepine]]s [[zolpidem]](Stilnoct) and [[zopiclone]](Imovane), are more selective for the [[GABAA receptor|GABA<sub>A</sub> receptor]]<ref name="pmid17619935"/> and may have a cleaner side effect profile than the older benzodiazepines; however, there are controversies over whether these non-benzodiazepine drugs are superior to benzodiazepines. These drugs appear to cause both [[Addiction#Psychological addiction|psychological dependence]] and [[physical dependence]], and can also cause the same memory and cognitive disturbances as the benzodiazepines along with morning sedation.
| |
| | |
| ====Antidepressants====
| |
| {{main|Antidepressants}}
| |
| Some [[antidepressant]]s such as [[mirtazapine]], [[trazodone]] and [[doxepin]] have a sedative effect, and are prescribed [[off label]] to treat insomnia. The major drawback of these drugs is that they have [[antihistaminergic]], [[anticholinergic]] and [[antiadrenergic]] properties which can lead to many side effects. Some also alter sleep architecture.
| |
| | |
| ====Melatonin====
| |
| [[Melatonin]] has proved effective for some insomniacs in regulating the sleep/waking cycle, but lacks definitive data regarding efficacy in the treatment of insomnia. Melatonin agonists, including Ramelteon ([[Rozerem]]), seem to lack the potential for abuse and dependence. This class of drugs has a relatively mild side effect profile and lower likelihood of causing morning sedation.
| |
| | |
| ====Antihistamines====
| |
| The [[antihistamine]] [[diphenhydramine]] is widely used in nonprescription sleep aids, with a 50 mg recommended dose mandated by the FDA. In the United Kingdom, Australia, New Zealand, South Africa, and other countries, a 50 to 100 mg recommended dose is permitted. While it is available over the counter, the effectiveness of these agents may decrease over time and the incidence of next-day sedation is higher than for most of the newer prescription drugs. Dependence does not seem to be an issue with this class of drugs.
| |
| | |
| ====Atypical antipsychotics====
| |
| Low doses of certain [[atypical antipsychotics]] such as [[quetiapine]] (Seroquel) are also prescribed for their sedative effect but the danger of neurological and cognitive side effects make these drugs a poor choice to treat insomnia.
| |
| | |
| ===Other substances===
| |
| Some insomniacs use [[herb]]s such as [[valerian plant|valerian]], [[chamomile]], [[lavender]], [[hops]], and [[passion-flower]]. Valerian has undergone multiple studies and appears to be modestly effective.<ref name="pmid10761819">{{cite journal |author=Donath F, Quispe S, Diefenbach K, Maurer A, Fietze I, Roots I |title=Critical evaluation of the effect of valerian extract on sleep structure and sleep quality |journal=Pharmacopsychiatry |volume=33 |issue=2 |pages=47-53 |year=2000 |pmid=10761819 |doi=}}</ref><ref name="pmid16335333">{{cite journal |author=Morin CM, Koetter U, Bastien C, Ware JC, Wooten V |title=Valerian-hops combination and diphenhydramine for treating insomnia: a randomized placebo-controlled clinical trial |journal=Sleep |volume=28 |issue=11 |pages=1465-71 |year=2005 |pmid=16335333 |doi=}}</ref><ref name="pmid17561634">{{cite journal |author=Meolie AL, Rosen C, Kristo D, ''et al'' |title=Oral nonprescription treatment for insomnia: an evaluation of products with limited evidence |journal=Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine |volume=1 |issue=2 |pages=173-87 |year=2005 |pmid=17561634 |doi=}}</ref> [[Cannabis]] has also been suggested as a very effective treatment for insomnia. <ref>[http://www.cannabis.net/medical-marijuana/pot-docs.html http://www.cannabis.net/medical-marijuana/pot-docs.html ]</ref>
| |
| | |
| [[Alcohol]] may have sedative properties, but the [[Rapid eye movement sleep|REM sleep]] suppressing effects of the drug prevent restful, quality sleep. Middle-of-the-night awakenings due to [[polyuria]] or other effects from alcohol consumption are common, and hangovers can also lead to morning grogginess.
| |
| | |
| Insomnia may be a symptom of [[magnesium deficiency (medicine)|magnesium deficiency]], or lower [[magnesium]] levels. A healthy diet containing [[magnesium]], can help to improve sleep in individuals without an adequate intake of [[magnesium]].<ref name="pmid9703590">{{cite journal |author=Hornyak M, Voderholzer U, Hohagen F, Berger M, Riemann D |title=Magnesium therapy for periodic leg movements-related insomnia and restless legs syndrome: an open pilot study |journal=Sleep |volume=21 |issue=5 |pages=501-5 |year=1998 |pmid=9703590 |doi=}}</ref>
| |
| | |
| Other reports cite the use of an elixir of cider vinegar and honey but the evidence for this is only anecdotal. <ref>{{cite web|url=http://www.cidervinegar.org/2007/06/cider-vinegar-rocks.html|title=Cider Vinegar and Insomnia}}</ref>
| |
| | |
| ===Non-medicinal, complimentary and alternative medicine===
| |
| Recent research has shown that [[Cognitive therapy|cognitive behavior therapy]] can be more effective than medication in controlling insomnia [http://archinte.ama-assn.org/cgi/content/abstract/164/17/1888]. In this therapy, patients are taught improved sleep habits and relieved of counter-productive assumptions about sleep.<ref>{{cite journal
| |
| | last = Jacobs, PhD
| |
| | first = Gregg
| |
| | authorlink = http://www.bidmc.harvard.edu/display.asp?leaf_id=3956
| |
| | coauthors = Edward F. Pace-Schott, MA; Robert Stickgold, PhD; Michael W. Otto, PhD
| |
| | title = Cognitive Behavior Therapy and Pharmacotherapy for Insomnia: A Randomized Controlled Trial and Direct Comparison
| |
| | journal = Archives of Internal Medicine
| |
| | volume = 164
| |
| | issue = 17
| |
| | pages = 1888-1896
| |
| |date=September 27, 2004
| |
| | url = http://archinte.ama-assn.org/cgi/content/abstract/164/17/1888}}</ref>
| |
| | |
| Some traditional remedies for insomnia have included drinking warm milk before bedtime, taking a warm bath in the evening; exercising vigorously for half an hour in the afternoon, eating a large lunch and then having only a light evening meal at least three hours before bed, avoiding mentally stimulating activities in the evening hours, and making sure to get up early in the morning and to retire to bed at a reasonable hour.
| |
| | |
| Using [[aromatherapy]], including jasmine oil, [[lavender oil]], [[Mahabhringaraj]] and other relaxing [[essential oil]]s, may also help induce a state of restfulness. [[Horlicks]] is marketed as a sleeping aid.
| |
| | |
| Many believe that listening to slow paced music will help insomniacs fall asleep. <ref name="pmid16269944">{{cite journal |author=Robinson SB, Weitzel T, Henderson L |title=The Sh-h-h-h Project: nonpharmacological interventions |journal=Holistic nursing practice |volume=19 |issue=6 |pages=263-6 |year=2005 |pmid=16269944 |doi=}}</ref>
| |
| | |
| The more relaxed a person is, the greater the likelihood of getting a good night's sleep. [[Relaxation techniques]] such as [[meditation]] have been shown to help people sleep. Such techniques can lower stress levels from both the mind and body, which leads to a deeper, more restful sleep.
| |
| | |
| [[Traditional Chinese medicine]] has included treatment for insomnia. A typical approach may utilize [[acupuncture]], dietary and lifestyle analysis, [[Herbalism|herbology]] and other techniques, with the goal of resolving the problem at a subtle level.
| |
|
| |
|
| In the Buddhist tradition, people suffering from insomnia or nightmares may be advised to meditate on "loving-kindness", or ''[[metta]]''. This practice of generating a feeling of love and goodwill is claimed to have a soothing and calming effect on the mind and body<ref>{{cite journal |author=Lutz A, Greischar LL, Rawlings NB, Ricard M, Davidson RJ |title=Long-term meditators self-induce high-amplitude gamma synchrony during mental practice |journal=Proc. Natl. Acad. Sci. U.S.A. |volume=101 |issue=46 |pages=16369-73 |year=2004 |pmid=15534199 |doi=10.1073/pnas.0407401101 |url=http://www.pnas.org/cgi/content/full/101/46/16369 }}</ref>. This is claimed to stem partly from the creation of relaxing positive thoughts and feelings, and partly from the pacification of negative ones. In the ''Mettā (Mettanisamsa) Sutta''<ref>http://www.accesstoinsight.org/tipitaka/an/an11/an11.016.than.html</ref>, Siddhartha Gautama, the Buddha, tells the gathered monks that easeful sleep is one benefit of this form of meditation.
| | *[[Chronic colestites|Chronic colestites/total insomnia]] |
|
| |
|
| ==See also==
| |
| *[[Chronic colestites]], also known as "total insomnia"
| |
| *[[Fatal familial insomnia]] | | *[[Fatal familial insomnia]] |
| *[[Sleep deprivation]] | | *[[Sleep deprivation]] |
Line 848: |
Line 51: |
| {{reflist|2}} | | {{reflist|2}} |
|
| |
|
| | {{WikiDoc Help Menu}} |
| | {{WikiDoc Sources}} |
|
| |
|
| {{Mental and behavioural disorders}} | | {{Mental and behavioural disorders}} |
Line 855: |
Line 60: |
| [[Category:Sleep]] | | [[Category:Sleep]] |
| [[Category:Psychiatry]] | | [[Category:Psychiatry]] |
| [[Category:Overview complete]]
| |
| [[Category:Symptoms]]
| |
| [[Category:Signs and symptoms]]
| |
|
| |
|
| |
| [[es:Insomnio]]
| |
| [[fr:Insomnie]]
| |
| [[ja:不眠症]]
| |
| [[pl:Bezsenność]]
| |
| [[pt:Insônia]]
| |
| [[ru:Бессонница]]
| |
| [[vi:Mất ngủ]]
| |
| [[tr:İnsomnia]]
| |
| [[zh:失眠]]
| |
|
| |
| {{WikiDoc Help Menu}}
| |
| {{WikiDoc Sources}}
| |