Sleep is necessary for life. Even if we're not exactly sure of all of the benefits of sleep to our mental, physical and emotional health, we know that any breakdown in the body's ability to sleep will certainly have its share of consequences.
Insomnia is a fairly ubiquitous disorder that can lead to a host of undesirable problems, such as emotional highs/lows, decreased work performance and increased risk factors for and correlations with other medical disorders or conditions. According to the second edition of the International Classification of Sleep Disorders(ICSD2), primary insomnias exhibit many faces, presenting both acutely or chronically while being further categorized into multiple subtypes that may or may not also include combinations of other medical disorders and conditions.
Though approximately only 10% of individuals suffer from chronic insomnia, up to one-third of populations in industrialized countries have reported disturbances in their sleep at some point in their lives. For example, in the United States, Sleep disturbances have been reported in approximately 30% of the population, with 10% actually exhibiting impairments from the effects of insomnia. Today, the etiology of insomnia remains poorly understood, with proposed mechanisms that are thought to be a combination of negative cognitions and improperly regulated physiology. Cognitive aspects leading to insomnia are considered to be related to negative thoughts and behaviors. Examples of this can be attributed to personal predispositions such as excessive worrying, experiencing stressful life events and/or inappropriate napping leading to improper regulation of waking states.
Within the proposed physiological aspects involved in insominas, hyperarousal has been most studied. This idea is based on the possibility that the body either has elevated base levels of arousal overall - i.e., increased heart rate, fight-or-flight responses, adrenaline-or that it cannot tone down the usual state of waking arousal at night when it needs to. Other less-studied physiologic correlates of insomnias involve incorrectly regulated circadian rhythms and/or sleep homeostasis, which is the regulated balance between the necessary intensity and length of sleep the body needs.
It is important to remember that while the aforementioned cognitive, behavioral and physiologic mechanisms underlying insomnia are studied independently, what is widely believed is more that insomnias develop due to a complex interplay between several of the proposed mechanisms.
Insomnia is a fairly ubiquitous disorder that can lead to a host of undesirable problems, such as emotional highs/lows, decreased work performance and increased risk factors for and correlations with other medical disorders or conditions. According to the second edition of the International Classification of Sleep Disorders(ICSD2), primary insomnias exhibit many faces, presenting both acutely or chronically while being further categorized into multiple subtypes that may or may not also include combinations of other medical disorders and conditions.
Though approximately only 10% of individuals suffer from chronic insomnia, up to one-third of populations in industrialized countries have reported disturbances in their sleep at some point in their lives. For example, in the United States, Sleep disturbances have been reported in approximately 30% of the population, with 10% actually exhibiting impairments from the effects of insomnia. Today, the etiology of insomnia remains poorly understood, with proposed mechanisms that are thought to be a combination of negative cognitions and improperly regulated physiology. Cognitive aspects leading to insomnia are considered to be related to negative thoughts and behaviors. Examples of this can be attributed to personal predispositions such as excessive worrying, experiencing stressful life events and/or inappropriate napping leading to improper regulation of waking states.
Within the proposed physiological aspects involved in insominas, hyperarousal has been most studied. This idea is based on the possibility that the body either has elevated base levels of arousal overall - i.e., increased heart rate, fight-or-flight responses, adrenaline-or that it cannot tone down the usual state of waking arousal at night when it needs to. Other less-studied physiologic correlates of insomnias involve incorrectly regulated circadian rhythms and/or sleep homeostasis, which is the regulated balance between the necessary intensity and length of sleep the body needs.
It is important to remember that while the aforementioned cognitive, behavioral and physiologic mechanisms underlying insomnia are studied independently, what is widely believed is more that insomnias develop due to a complex interplay between several of the proposed mechanisms.
by David Yang
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