Table Of ContentCAN'T SLEEP?
ISSUES OF BEING
AN INSOMNIAC
Edited by Saddichha Sahoo
Can't Sleep? Issues of Being an Insomniac
Edited by Saddichha Sahoo
Published by InTech
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Copyright © 2012 InTech
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First published March, 2012
Printed in Croatia
A free online edition of this book is available at www.intechopen.com
Additional hard copies can be obtained from [email protected]
Can't Sleep? Issues of Being an Insomniac, Edited by Saddichha Sahoo
p. cm.
ISBN 978-953-51-0261-8
Contents
Preface VII
Part 1 Epidemiology and Risk Factors 1
Chapter 1 Epidemiology of Insomnia:
Prevalence and Risk Factors 3
Claudia de Souza Lopes, Jaqueline Rodrigues Robaina
and Lúcia Rotenberg
Chapter 2 Drugs Inducing Insomnia as an Adverse Effect 23
Ntambwe Malangu
Part 2 Clinical Issues, Diagnosis and Management 37
Chapter 3 Specific Quality of Life Measures for Sleep Disorders 39
Sermin Timur and Nevin Hotun Şahin
Chapter 4 Fatigue 49
Per Hartvig Honoré
Chapter 5 The Diagnosis and Treatment of Insomnia 65
Michał Skalski
Part 3 Psychopharamcology of Insomnia 81
Chapter 6 Treatment of Insomnia with Comorbid Mental Illness 83
Tracy L. Skaer
Chapter 7 Structural Relationship Study of Octanol-Water
Partitioning Coefficients and Total Biodegradation
of Barbiturate Medicines by Randić Descriptor 99
Avat (Arman) Taherpour, Zhiva Taherpour and Omid Taherpour
Preface
The word "insomnia" originates from the Latin "in" (no) and "somnus" (sleep). It is a
disorder characterized by inability to fall asleep or a total lack of sleep. Being the first
psychosomatic disorder to be described by Johann Heinroth in 1818, insomnia
clinically presents as a subjective perception of dissatisfaction with the amount and/or
quality of the sleep. The presenting complaints are often that of difficulties falling
asleep in spite of being in bed, waking up several times during the night and having
trouble going back to sleep, waking up too early in the morning or having an un-
refreshing sleep.
Various studies have noted insomnia to be quite a common condition with symptoms
present in about 33-50% of the adult population. The prevalence, however, ranges
from 10 to 15% among the general population, with higher rates seen among divorced,
separated, or widowed people, older ages, female gender, White population, and in the
presence of a co-morbid medical or psychiatric illness. About 30% of all adults
complain of occasional insomnia and 10% of chronic insomnia, of whom 40% may
have an underlying psychiatric illness. Despite these high prevalence rates, evidence
suggests that insomnia is mostly under-recognized, under-diagnosed, and under-
treated, with the condition continuing to remain persistent in most individuals over
follow-up intervals of one to several years.
Chronic insomnia represents a more complex condition than acute insomnia, which
may be transient. Patients with chronic insomnia usually have accompanying daytime
impairment of cognition, mood, or performance that impacts not only the patient and
his family, but also affects friends, coworkers, and caretakers. Insomnia patients are
more likely to visit hospitals and physicians, have increased absenteeism, make errors
or have accidents at work, and have more fatal road accidents. There is also an
increased risk for depression, anxiety, substance use, suicide, and possible immune
dysfunction. It is imperative that clinicians remain alert to these possible individual
and societal risks during the evaluation.
This book deals with several issues that are pertinent to the clinician and researcher in
insomnia practice. The first chapter deals with the current knowledge of the
epidemiology and risk factors for developing insomnia. A review of medications that
may also induce insomnia follows which details out the common mistakes that a
VIII Preface
clinician does while examining a patient with insomnia. Since insomnia is directly
linked to issues such as productivity and quality of life, comprehensive reviews cover
these subjects. The diagnosis and management of insomnia is detailed out next with a
brief and lucid description of barbiturates which are often used in the treatment of
insomnia.
Dr. Saddichha Sahoo, DPM MD,
Clinical Fellow, Dept of Psychiatry, University of British Columbia,
Vancouver, BC,
Canada
