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Chronic Insomnia

sleeping-child-812181_640By Nikita Katz, M.D., Ph.D.

Chronic insomnia is associated with an increased risk of depression, anxiety, excess disability, reduced quality of life, and increased use of health care resources.

Insufficient sleep can result in industrial and motor vehicle accidents, somatic complaints, cognitive dysfunction, depression, and decrements in daytime work performance owing to fatigue or sleepiness. It is also associated with hypertension, heart disease, and greater risk of mortality.

Statistical evidence highlights the scope and gravity of the problem of sleep loss among Americans.

  • More than one-third of all Americans suffer from sleep disorders at some point in their lives.
  • Up to two-thirds of adults report difficulty sleeping at some point each year. Approximately 20 percent of adults consider the problem to be serious.
  • Twenty percent of adults (approximately 40 million) report having a chronic sleep disorder.
  • The prevalence of insomnia is about 1.4 times higher among women than among men.
  • Mature age predisposes one to sleep disorders. The rate increases from 5 percent in persons aged 30 to 50 to approximately 30 percent in those more than 50 years old. In the National Institute on Aging’s Established Populations for Epidemiologic Studies of the Elderly, 42 percent of senior citizens who participated in the survey had difficulty falling and staying asleep.
  • Twenty-three percent of adults report having difficulties concentrating because they do not get enough sleep: For this reason, 18 percent say they have trouble remembering things; 38 percent report unintentionally falling asleep during the day at least once in the preceding month; and 5 percent, while driving, report nodding off or falling asleep at least once in the prior month.
  • Up to one in four adults reports using a “sleep aid” at least a few nights a week.
  • According to the 2011 Sleep In America Poll, conducted by the National Sleep Foundation, the growing use of cell phones and electronic devices (for phone calls, texting, or emailing) — shortly before going to bed and being awakened after going to sleep by one of these forms of communication — is causing individuals to get less sleep at night, negatively affecting millions of Americans’ functioning the next day.

Although insomnia is very common, evidence suggests that only a small proportion of people who suffer from sleep disturbance report it to their physicians. Moreover, physicians may not detect or adequately assess or treat insomnia. Factors that contribute to under-diagnosis and under-treatment of insomnia include reluctance on the part of patients to discuss it; physicians’ limited training in this condition; time constraints in medical practice; misperceptions about the impact poor sleep can have on patients’ daytime functioning, health, and safety (such as putting insomnia sufferers at risk for serious accidents); and misconceptions about the benefits and risks associated with the use of hypnotic medications.

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