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'''For patient information click [[Insomnia (patient information)|here]]'''
'''For patient information click [[Insomnia (patient information)|here]]'''
{{Insomnia}}
{{Insomnia}}
{{CMG}}; {{Adnan Ezici}} , {{AF}} , {{KS}} , {{JC}} , {{NS}}
{{CMG}}; {{AE}} {{Adnan Ezici}} , {{AF}} , {{KS}} , {{JC}} , {{NS}}


{{SK}} Insomnia disorder
{{SK}} Insomnia disorder
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==Diagnosis==
==Diagnosis==
[[Insomnia history and symptoms|History and Symptoms]] | [[Insomnia physical examination|Physical Examination]] | [[Insomnia laboratory findings|Laboratory Findings]] | [[Insomnia other diagnostic studies|Other Diagnostic Studies]]
[[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]]
===History and Symptoms===
[[DSM-5 diagnostic criteria]] for insomnia includes<ref name="urlEvaluating DSM-5 Insomnia Disorder and the Treatment of Sleep Problems in a Psychiatric Population | Read by QxMD">{{cite web |url=https://read.qxmd.com/read/29394962/evaluating-dsm-5-insomnia-disorder-and-the-treatment-of-sleep-problems-in-a-psychiatric-population |title=Evaluating DSM-5 Insomnia Disorder and the Treatment of Sleep Problems in a Psychiatric Population &#124; Read by QxMD |format= |work= |accessdate=}}</ref>:
*Symptoms occur ≥ 3 days/week for ≥ 3 months
*Symptoms cause functional impairment or distress
*Problems initiating or maintaining sleep, or awakening early in the morning and being unable to return to sleep
*Symptoms occur despite having enough time to sleep
*Symptoms are not caused by an underlying substance or medication use
*No underlying or coexisting psychiatric or medical disorder that explains symptoms
===Laboratory Findings===
*Blood tests: Medical conditions can also cause/exacerbate sleep. Based on the [[questionnaire]] and physical exam, the doctor may recommend blood tests to check for other pre-existing conditions.<ref name="urlDiagnosing Insomnia | Sleep Foundation">{{cite web |url=https://www.sleepfoundation.org/insomnia/diagnosis |title=Diagnosing Insomnia &#124; Sleep Foundation |format= |work= |accessdate=}}</ref>.
===Diagnostic Studies===
The doctor won’t be able to confirm an insomnia diagnosis in some cases without further testing. Following are the tests one might have to undergo
*[[Sleep study]]: Overnight sleep stud or the [[polysomnogram]] test.In this study, one has to spend the night at a sleep center with sensors on the face, scalp, eyelids, one finger, chest and limbs. The sensors then monitor brain wave activity, oxygen level, heart rate, respiratory rate and muscle movement that occur prior, during, and post sleep.  Also, some daytime tests monitor sleep latency during a series of naps, evaluate abilities to stay awake and alert after a night of normal sleep. However, irrespective of home-based monitoring kits or the procedures mentioned above, they will be non-invasive and pain-free.
*[[Actigraphy]]: Actigraphy tests, similar to [[overnight sleep studies]], but most are conducted at home. In this one has to wear a sensor on the wrist or ankle to monitor their sleep and wakefulness pattern. Recommended Duration for wearing the sensors is three to 14 consecutive days. The test is safe for children and adults but the sensor may cause some light albeit temporary irritation.
 
If the diagnostic criteria for chronic or short-term insomnia based on the sleep disorder test are met, then we may advance to insomnia treatment.


==Treatment==
==Treatment==
[[Insomnia medical therapy|Medical Therapy]] | [[Insomnia non-pharmacological therapy|Non-pharmacological therapy]] | [[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]]
[[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]]
 
Management is guided by available [[clinical practice guideline]]s<ref name="pmid32066145">{{cite journal| author=Mysliwiec V, Martin JL, Ulmer CS, Chowdhuri S, Brock MS, Spevak C | display-authors=etal| title=The Management of Chronic Insomnia Disorder and Obstructive Sleep Apnea: Synopsis of the 2019 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guidelines. | journal=Ann Intern Med | year= 2020 | volume=  | issue=  | pages=  | pmid=32066145 | doi=10.7326/M19-3575 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32066145  }} </ref>.


==Case Studies==
==Case Studies==

Latest revision as of 04:03, 5 August 2021


For patient information click here

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Adnan Ezici, M.D[2] , Amber Ehsan Faquih, MD[3] , Kiran Singh, M.D. [4] , Jyostna Chouturi, M.B.B.S [5] , Sanjana Nethagani, M.B.B.S.[6]

Synonyms and keywords: Insomnia disorder

Overview

Historical Perspective

Pathophysiology

Classification

Causes

Differentiating Insomnia from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice | History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | X-ray | Echocardiography and Ultrasound | CT scan | MRI | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Non-pharmacological therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

See also

References


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