Insomnia – definition, clinic, classification

Insomnia is a condition that requires attention from the doctor, since the treatment of the patient depends not only on the purpose of the drug, but also on understanding its cause and nature. Patients complaining of insomnia are convinced or feel that they are not sleeping long enough. The concept of “insomnia” includes the following conditions: • the patient cannot fall asleep within 45 minutes or • the patient has insufficient duration of night sleep (six or more awakenings during the night or less than 6 hours of sleep); • one or the other is repeated at least four nights a week. Patients complaining of insomnia tend to overestimate the duration of the period of falling asleep (sleep waiting time) and underestimate the duration of sleep. So, if such patients, who are in the phase of slow sleep, are awakened, they often claim that they did not sleep. However, some studies have shown that nurses usually overestimate patients’ sleep duration. Clinical types of insomnia: • Persons in a state of tension, lying with their eyes open in bed for several hours, not able to relax and fall asleep. • Exhausted or weakened faces, falling asleep early in the evening and waking up early in the morning. Most likely, they do not need medical treatment, but they need rest in the middle of the day. • People waking up several times during the night for no reason. • Persons re-awakening from pain or discomfort; they need treatment depending on the underlying disease and the temporary prescription of sleeping pills. • Persons in a state of depression, whose sleep is less prolonged (early awakening), more superficial, intermittent and restless, patients need treatment aimed at eliminating depression, rather than prescribing sleeping pills. • People with difficulty falling asleep (worse with age) are caused by caffeine. Alcohol promotes falling asleep, but can also cause early awakening (small withdrawal syndrome). • Persons suffering from excessive use of sleeping pills with the development of tolerance to them (3-14 days) and insomnia when trying to refrain from taking them.