These include non‐medication therapies as well as medication options 25, 26, 27, 28. On this basis, as well as due to the fact that insomnia is associated with impairments in quality of life and an increased risk for accidents and falls, it is recommended that treatment be targeted specifically to addressing insomnia whenever it is present, including when it occurs along with physical or psychiatric conditions 24, 25.įor those who meet the diagnostic criteria for insomnia, a number of empirically supported treatments are available. In fact, insomnia is a risk factor for major depression, anxiety disorders, substance use disorders, suicidality, hypertension and diabetes 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23. Although it had long been believed that, when this was the case, insomnia was a symptom of those conditions, the available evidence suggests that the relationship between such conditions and insomnia is complex and sometimes bidirectional 7, 8, 9, 10. In the vast majority of cases, insomnia co‐occurs with psychiatric or physical conditions. It is a common condition, with an approximate general population point prevalence of 10% 3, 4, 5, 6. Insomnia is defined as a complaint of difficulty falling or staying asleep which is associated with significant distress or impairment in daytime function and occurs despite an adequate opportunity for sleep 1, 2. We review this evidence base and highlight areas where more studies are needed, with the aim of providing a resource for improving the clinical management of the many patients with insomnia. These interventions can form the basis for systematic, evidence‐based treatment of insomnia in clinical practice. However, there are an array of interventions which have been demonstrated to have therapeutic effects in insomnia in trials with the above features, and whose risk/benefit profiles have been well characterized. A review of the available research indicates that rigorous double‐blind, randomized, controlled trials are lacking for some of the most commonly administered insomnia therapies. These options include both non‐medication treatments, most notably cognitive behavioral therapy for insomnia, and a variety of pharmacologic therapies such as benzodiazepines, “z‐drugs”, melatonin receptor agonists, selective histamine H1 antagonists, orexin antagonists, antidepressants, antipsychotics, anticonvulsants, and non‐selective antihistamines. To this end, this paper reviews critical aspects of the assessment of insomnia and the available treatment options. As such, it is important that effective treatment is provided in clinical practice. It is a common condition associated with marked impairment in function and quality of life, psychiatric and physical morbidity, and accidents. Terminal insomnia can pose major health risks to individuals, but conducive sleep habits and the concerted effort from employers to foster sleep wellness can mitigate and/or prevent many sleep disturbance cases.Insomnia poses significant challenges to public health. Employers can emphasize the benefits of proper sleep hygiene, help develop stress management techniques, make flexible work schedules available, furnish treatment modalities and/or medication, and set reasonable job expectations. Medical evidence indicates that insomnia and other sleep disorders lead to escalating cases of morbidity where people are candidates for cancer, hypertension, and obesity.Įmployee assistance programs can serve as an effective initiative in addressing sleep disorders and establishing methods to dampen the impact on its workforce. In the workplace, environmental stressors can also influence terminal insomnia in employees, carrying significant financial repercussions for businesses resulting in absenteeism, productivity loss, and a high incidence rate of accidents. A doctor’s consultation can help identify concomitant health concerns based on a patient’s medical history, lifestyle habits, and occupational circumstances.įor instance, alcohol and/or caffeine consumption coupled with heavy meals prior to bed can compound sleep insomnia. and 4 a.m., often attributed to an underlying causative factor(s). Terminal insomnia is a subset of a primary insomnia diagnosis in which early morning awakenings occur typically between 2 a.m. Many individuals experience a wide range of sleep disorders including insomnia, restless legs syndrome, and sleep apnea, disrupting regular biorhythms that can interfere with daily activities. WorkplaceTesting Explains Terminal Insomnia
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