Sleep Care

Primary and Secondary Insomnia

Insomnia refers

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to a condition in which a person has trouble falling asleep, staying asleep, or in unfortunate cases, both falling and staying asleep. It can be acute, lasting only a few days or a week, or it can be chronic, meaning that the insomnia symptoms last longer than a month. About 30% of the population suffers from insomnia, with the percentage rising to 40-60% for those over sixty years of age. One in three people will suffer from insomnia at some point in their lifetime.

When looking to treat insomnia, a good starting point is determining if it is primary or secondary. What are the differences between the two?

Primary Insomnia

Primary insomnia is insomnia that occurs in the absence of any medical conditions, health problems, or medications that could be causing the poor sleep quality. It is often chronic in nature and the result of poor lifestyle or health habits. For example, if a person has poor sleep hygiene and does not maintain a fairly consistent bedtime (and awakening time), his body may not know what time to naturally start “shutting down” for sleep which would lead to insomnia symptoms. Awake_in_Bed

Environmental conditions may also prompt primary insomnia. Sustained stress, workplace changes, family problems, etc. can lead to sleepless nights. Trying to sleep in front of a TV or in an environment that is not sufficiently quiet may also affect getting to or maintaining sleep.

Since the causes of primary insomnia tend to be lifestyle or environmental, improving the symptoms is often a matter of changing lifestyle habits or environmental conditions. Developing good sleep hygiene habits, including a regular bedtime routine and having a quiet, cool, and sufficiently dark sleeping environment can take some time but will pay the dividends of a better night’s sleep. Regular exercise and learning relation techniques can be helpful for defusing the periods of high stress.

Secondary insomnia

Secondary insomnia is insomnia that occurs because of another health condition (such as depression or fibromyalgia), or possibly as a side-effect to medication. It may be acute or chronic depending on the specific source. The symptoms will generally feel similar to primary insomnia, although because the cause is different, the treatments often need to be different as well.

Usually, effectively treating the underlying condition will improve the insomnia symptoms. For example, if a person is having difficulty sleeping due to severe pain, finding an effective medication for the pain will often lead to a quality night’s sleep. Those suffering from depression and insomnia often find their sleep quality improved when their depression is controlled.

If the insomnia is due to medication, consulting with the ordering physician about the difficulty sleeping can lead to a trial of a different medication with fewer (if any) effects on sleep. For individuals with complex medical histories who take multiple medications, this may take a little while to find the right combination of medications that minimally affect their sleep quality.

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