Insomnia Diagnostic Criteria and Treatment

Introduction

Insomnia is a prevalent medical condition. Insomnia is a collective indication and medical experts require a diagnostic approach which permits them to identify a specific type of treatment. These diagnostic approaches help in the practical management of insomnia among adults and the formation of basic treatment. Insomnia cases tend to advance with age, however, more prevalent among women than men (Daley et al., 2009). Although medical research unveils that older men experience more interrupted periods of sleep, individuals who have broken up, widowed, or alienated suffer from insomnia than any other group of people. Socioeconomic status influences insomnia levels in most people.

June, a 42-year old lady, was referred to a medical institution after doctors diagnosed her with a chronic sleeping disorder. The chronic insomnia affected her daytime productivity and functionality. June is a single parents of four teenagers. She started presenting insomnia symptoms ten years ago when her business enterprise nearly collapsed due to insufficient capital. Even though her business venture recovered six months later, June’s chronic insomnia persisted for a decade. Based on her medical history, June took Temazepam and Zolpidem together with other antidepressants. The medication never improved her condition. June soon threw in the towel due to the devastating side effects of those drugs. The doctors examined her sleeping patterns and daily routines. After assessing both her medical history and sleeping patterns the doctors recommended the following treatment- improving hygiene, minimizing caffeine consumption, sleeping early, avoiding alarm clocks and reading a book whenever she is unable to fall asleep. After eight months, her condition improved.

Insomnia Diagnostic Criteria

 As stated earlier, insomnia is extensively prevalent, usually incapacitating and frugally challenging sleep disturbance triggered by different circumstances, medication, feelings, environmental factors, and behavioral aspects (Roth, 2007). Even though numerous consensually driven nosology has outlined various insomnia phenotypes, investigations about these phenotypes have been disadvantaged due to insufficient operative studies and diagnostic criteria to define the criteria. The lack of standard diagnostic criteria sometimes leads to unreliable findings hence impeding phenotypes due to the variable definitions. For more than 30 years psychiatrists have struggled with an inconsistent diagnostic system which resulted in insignificance and unchecked results. Largely the inconsistencies were due to operative criteria within the diagnostic manuals. Patients suffering from insomnia usually have numerous challenges such as unrefreshing sleep patterns, inability to sleep peacefully or remain asleep for a long period of time. Insomnia duration has vital diagnostic consequences. Transient insomnia lasts for a short duration and results from stressful situations or even some forms of medications. Other minor instances that can cause transient insomnia are jetlag and some rare forms of medical conditions. On the other hand, insomnia which lasts for more than three weeks is said to be chronic and normally triggered by different causes. The symptom duration is vital as it helps in determining the diagnostic variance and assessing secondary challenges, including the practice and misappropriation of alcohol and substance abuse- this can be both causatives and impact chronic insomnia (Taylor et al., 2007). According to medical reports, insomnia affects 10-18% of the entire adult populace worldwide. Opposite to popular belief, irregular sleepless nights are a common phenomenon among many individuals hence insomnia can be persistent or period depending on the underlying problem causing it. In situations where a patient is symptomatic, the medics try to unveil the underlying disorder causing insomnia (Riemann et al., 2017). For more clarity, primary insomnia is connected to medicinal, psychiatric, or environmental issues. Medical experts ought to determine the causative agents of insomnia while keeping in mind the fundamental issues. Addressing short term insomnia through the identification of certain stressors (Cheuk et al., 2012). One of the first steps is identifying and then defining the key sleep symptom- for instance, insomnia, excess sleepiness, or disruptive behavior while sleeping are some of the overlooked sleeping patterns

Treatment options and guidelines

 Adopting better sleeping practices and addressing matters related to insomnia such as stress or underlying medical conditions can reinstate soothing sleep for most of the patients suffering from insomnia. If the above interventions fail, medics may commend cognitive behavioral therapy to assist in improving sleep quality. Cognitive behavioral medication is designed to assist insomnia patients cope or regulate undesirable thoughts and activities which keeps them vigilant at night (Manber et al., 2008). Cognitive behavioral therapy is the first medication patients receive. Normally, more effective than other forms of medication. The cognitive portion of the treatment focuses on identifying and then changing beliefs that negatively impacts a patient’s sleep. It assists a patient eradicate harmful thoughts and anxieties which keeps him or her awake. More so, the medication may involve eradicating harmful sleep patterns. The behavioral portion assists an insomnia patient produce positive sleeping habits and avoid disruptive behaviors at night. In fact, the behavioral portion of the cognitive behavioral treatment, comprise of stimulus control medication which assists patients eradicate elements which causes the mind resistant to sleep.

 

Neurobiological and Other Influences

As explained above, there is not a definitive insomnia diagnosis. Medics apply various mechanisms to diagnose and interpret the insomnia levels. Insomnia exhausts the brain and incapacitates its ability to carry out key functionalities such as sustaining joyful moods, health status, and high productivity.  During insomnia, the brain loses its ability to focus, innovate, and retain long and short term memories. This negatively impacts the brain usually causes mood swings (Hertenstein, 2017). Consequently, a sleep-deprived person experiences illusions, mania, impulsive mannerisms, unhappiness, mistrust, and forlorn thoughts. Generally, if the brain's functionality is hindered, then other physical aspects of one's life are disrupted.

Previous medical systems centered their research on psychological and behavioral mechanisms for clinical purposes. However, those psychological and behavioral procedures lacked neurobiological specifications. Any insomnia model needs to consider neurobiological aspects before it can be certified effective for the treatment of insomnia. The concurrent occurrence of sleep and rousing neural activities assists in explaining medical phenomenology and medication impacts of insomnia (Morin, & Espie, 2007). Neurobiological mechanisms of assessing insomnia heavily rely on conditioning ideals. Sleep is perceived partly as a conditioned reaction to a stimulant within a sleep surrounding. According to neurobiological aspects, the bedroom is conducive surrounding for inducing sleep. However, under insomnia situations, the bedroom stimulates frustrations and restlessness. Thus, the neurobiological basis forms the regulatory medication in the treatment of chronic insomnia. Therapy tends to try and reconnect the sleep surrounding the stimulus effect it had before insomnia hence the restriction of other activities in the bedroom area. Neurobiological diagnostic approaches lead to examinable medications which can later be verified. In spite of the medical utilities, neurobiological interventions are not effective on their own hence the need to combine these forms of medication with other types of medication.

Insomnia disorder can manifest itself in terms of quantity or quality. The progressive research on comprehending nature, etiology, and other diagnostic features of insomnia has not yet unveiled a standard diagnostic model for the sleeping disorder. The comprehending of insomnia pathophysiology offers medics vital details on conditions, under which the illness develops and how it sustains itself (Ramakrishnan, 2007). Presently, evidence reliant evaluations and medications for insomnia have been formulated. The diagnostic criteria of insomnia are reliant on medical consensus. Extensive advancement is dependent on verified etiology and pathophysiological challenges. Particular frameworks provided through government platforms help in researching insomnia issues within the society.

Insomnia Guidelines

 Insomnia is a significant public health predicament that needs immediate attention and precise diagnosis. The existence of one type of insomnia does not invalidate other conditions. Other disorders may coexist with insomnia. For example, comorbid insomnia can coexist with depression. The primary aim of insomnia medication is to improve sleep quality and duration. This way, the medication improves insomnia related consequences. Besides, insomnia specific results indicate the amount of time one remains awake after waking up and this proves the correlation between staying awake and falling asleep. The balance between sleeping and staying awake should mark the effectiveness of insomnia medical treatment. Each patient should have a sleeping diary where they record sleeping patterns and record any discrepancies experienced each night (Kessler et al., 2011). The formation of a distinctive connection between bedroom and sleeping patterns helps in upgrading sleep-related challenges. It is vital to note that sleep diary details must be gathered before and during active medication and incase the patient relapses into insomnia. Previous medical approaches included one behavioral measure such as incitement control therapy or the combination of mental and stimuli control treatment. The combination of mental and developmental intermediations is effective and commended in the medication of chronic and mild insomnia. These medications are effective for adult patients.

Important Cultural Issues

            Cultural pressures affect sleeping behaviors. Biological clocks influence bedtimes but culture affects waking up time and quality of sleep. Cultural pressures and day to day tasks impact biological clocks and influence sleep duration and patterns. For instance, some cultures praise hard work and sacrifice (Daley et al., 2009). Consequently, people may forego sleep in order to attain success in life. Thus, culture forms a pattern of concepts, customs and traits which in turn affect sleeping patterns. Furthermore, culture affects perspectives on sleep, sickness and even belief systems. How people interpret pain relies heavily on cultural norms. Cultural issues create bias and leads to varied medical preferences and opinions. It is vital to note that cultural competence allows medics to inquire on a patient’s belief system and values. These values and beliefs can then be applied in insomnia treatment and diagnosis. Furthermore, some cultures encourage collectivism- implying that people will welcome beliefs without question.

Cultural norms affect sleep duration and lifestyle. An important element of sleep is assessing sufficient sleeping intervals and the effect of short and long sleeping durations on health. Cultural believes shape the determinants of sleep patterns which are vital for the extension of both health and everyday routine (Roth, 2007). Sleep both a biological function and a behavioral intervention hence cultural sensitivity. Culture can either sensitize the community on the importance of sleep or can dissuade them from normal sleeping patterns. In the end, culture dictates the type of behavior and attitude people will have toward sleep hence influencing the occurrence or rarity of insomnia.  

Different views and perspectives

Even though sleep is a vital biological process, people rarely practice good sleeping habits. Due to acceptable reasons, human culture has paid little to no attention at negative impacts of insomnia. Society is against sleeping pills and other types of medication. Sleeping problems are often overlooked and ignored due to social strains placed upon life. For example, sleeping is associated with laziness or under achievement (Baglioni et al., 2010). Thus patients seek medical advice whenever their conditions worsen. Failure to come up with a standardized diagnostic criteria hinders effectively treatment and advancement in insomnia medication. Insomnia relies on the patient’s account and perspective rather than a specific medication. According to psychologists, improving mood and taking part in constructive work may cure insomnia. On the other hand, for most medics, insomnia is a fundamental indication for numerous illness. Hence, treating the underlying illness will certainly cure insomnia. Thus, medicating an underlying illness may indirectly cure insomnia.

Conclusion    

 In summary, insomnia is a sleeping disorder that affects the amount and quality of sleep one gets each night. The condition can either be chronic or acute and it can also be inconsistent. Acute insomnia lasts for one night or seven days while chronic insomnia lasts for three nights or three months. There are two types of insomnia- primary and secondary. Primary insomnia is not linked to any underlying medical condition while secondary insomnia is directly associated with an underlying medical condition. Primary insomnia is caused by stress-related factors while secondary insomnia is triggered by underlying mental issues such as depression and anxiety. Based on findings from the latest research, sleeping at a specified standard time is recommended for all insomnia patients. A standard sleeping time aligns with the everyday routines of a person's internal clock (Roth, 2007). Evidence also unveils that lack of standard time affects cardiovascular functions of the body hence increasing other risk factors. Having a standard sleeping time. APRNs are advised to observe patient’s sleep patterns and behavior in order to detect effective medication. APRNs also help reset patient’s biological clock. The scope of APRN permits him or her to diagnose, assess and recommend insomnia medication. For example, APRNs influence sleeping time and daily patient routine hence helping in preventing insomnia. These duties allow APRNs to response to overnight stressors, influence patient diet and mental performances.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

References

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