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Insomnia: a sleeping problem with multiple causes

Insomnia is one of the most common sleeping problems. It affects women more so than men and is more frequently experienced by older adults. It can have consequences during the day, such as tiredness, drowsiness, concentration difficulties, memory problems and mood disorders.

What is insomnia?

There is no unique and universal definition of the term “insomnia”. According to the latest international classification of sleeping problems, insomnia is one of seven listed categories of sleep disorder:

  • insomnia disorders
  • sleep-related breathing disorders (central sleep apnoea, obstructive sleep apnoea, hypoventilation etc. syndromes)
  • sleep-related movement disorders (restless leg syndrome)
  • central disorders of hypersomnolence (hypersomnia, narcolepsy)
  • circadian rhythm sleep disorders
  • parasomnias (sleepwalking, nightmares, sleep terrors)
  • other sleep disorders.

What are the characteristics of insomnia?

Insomnia can be considered as a problem of excessive "wakefulness". According to the “Baromètre santé 2010” produced by the French national institute for disease prevention and health education, insomnia affects 15.8 % of people between the ages of 15 and 85: 19.3% of women and 11.9% of men. Women are more likely to suffer from insomnia than men. The risk of chronic insomnia is greater for people who work shifts (3-shift pattern, night shifts, etc.).

The criteria selected to identify insomnia are:

  • difficulties falling asleep (more than 30 minutes)
  • or waking in the night or too early in the morning
  • or non-restorative or poor quality sleep with consequences during the day (tiredness, attention or concentration difficulties, irritability, etc.).

These problems may occur at least three times a week, even when the sleeping environment is good (no light or noise, suitable temperature). According to the French Société de Formation des Thérapeutiques du Généraliste, (a society concerned with training GPs), if these problems persist for 3 months, the term chronic insomnia is used. Adjustment insomnia tends to be a short-term form of insomnia and is often caused by a one-off event that triggers stress and an adaptation response.

How to manage insomnia?

There are many causes of insomnia, and an individual may be affected by more than one at a time. They may relate to other pathologies or sleeping problems and/or mental health issues.
A dedicated consultation and keeping a sleep diary are good ways to assess the condition, inform a diagnosis, assess its severity and detect a possible cause.
Melatonin or plants such as eschscholtzia or valerian can also support the management of certain disorders

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