Insomnia Diagnosis And Treatment

By | March 23, 2017

What is Insomnia Diagnosis and Treatments

My name is Rachel Salas. I'm a sleep neurologist, boardcertified in both specialties. I'm Virginia Runco. I'm a Johns Hopkinsbehavioral sleep medicine specialist. Insomnia is difficulty falling asleep,difficulty staying asleep, poor sleep quality or some kind of combination of those symptoms. And, we all have a night of bad sleep from here or there, but really what insomnia is. is a more long pattern of a sleep problem that's not only a nighttime issue but it tricklesinto the daytime in some ways

so there is some kind of daytime symptom, whether that's, um, it can be just sleepinessor fatigue, struggling to stay awake during work, concentration issues at work.quot;I'm feelinggrumpy or moodyquot; or even just having a lot of worries during the daytime about the sleep. So, typically it's more commonly found in women, however you know from down from kids all the wayup to older adults.we can all onexperience it at one time or another

and most people have experienced it.youknow, when when you're studying for a test, or you have a veryhighstakes job interview, you can suffer from some acute insomnia butwhen that becomes chronic, usually more than three months and you'reexperiencing it three or more times a week then itcan be actually a sleep disorder. Insomnia is diagnosed based onwhat you tell the sleep specialist, so there's no

kind of lab test or blood work that you can do to say quot;You have insomnia.quot; They look at your medical history, your psychiatric history, how you describe your insomnia symptoms. However, sleep studies.the overnightsleep studies aren't uncommon to do sometimes ininsomnia patients because they want to rule out if there's some underlying sleep disorderlike sleep apnea that can cause the insomnia. So, insomnia is a complicated

sleep disorder because there's alwaysdifferent factors for different individuals that are contributing to it. So, the first thing that we look at is tosee, you know, what kind of behavioral issues that the patient, that may befeeding the insomnia. so things like maintaining good sleephabits are very important and those are things that we do investigate. A lot of times there some simple thingsthat patients can change

to help as part of the treatment. There's several medications that are available.We typically. try not to go straight to those because you know a lot of times they don't work, andthese medications do you know, they do have a side effectprofile, so you have to be very careful .you know, when you give these. There isthe mainstay which is cognitivebehavioral sleep therapy and you know, any time I diagnose apatient with insomnia I usually

How to Diagnose Sleep Disorders Secondary Causes of Insomnia

As I said in prior segments, insomnia oftenhas a different underlying cause where insomnia merely becomes, sort of, a symptom of thecause. People with obstructive sleep apnea often arrive in a sleep disorders office reportinginsomnia or daytime fatigue. The insomnia is coming from the multiple awakenings thatthey are having during the night due to apneas and hypopneas. It's not truly a case of insomnia.Once all diagnostic tests are performed and reviewed, generally this can be shown to thepatient and a different course of treatment can be taken that rarely has little to dowith actual insomnia. People with depression and bipolar disorder, both treated and untreated,often experience forms of insomnia. It's not

uncommon, in the manic stages of bipolar,for a person to sleep very little or not want to sleep at all. Even once the mania is treated,it's not uncommon for the drugs that get used in that treatment to cause disruptions insleep or cause a change in the quality of sleep. Certain people with schizophrenia andolder atypical antipsychotics will have sleep issues or just feel that they don't sleepas well as others. Again, it's a thing that's hard to differentiate because you don't alwaysknow what a schizophrenic patient is reporting. Even the most lucid and medicated ones stillmay not have a good sense of what's going on at night or why they're sleeping poorly.People with restless leg syndrome, of course,

generally aren't sleeping well even once theyget to sleep because their legs are moving and twitching. They're having issues and theirbodies can't fully relax. So, it's important to ruleout the causes of insomnia. Thyroidissues can be a problem. Women sometimes experience insomnia during pregnancy. It is importantto ruleout these secondary causes of insomnia and treat them before treating a patient primarilywith sedatives and other drugs that can cause physical and psychological dependence. It'sjust more efficient to treat underlying problems and eliminate any sort of dysfunction thatthey're creating in a patient's life.

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