Psychophysiological And Paradoxical Insomnia Research

Insomnia is the most common sleep disorder. It can have a devastating impact on one’s emotion, physical, occupation and social life. While it occasionally can be seen in the clinical setting as a primary diagnosis, it most often presents as a comorbidity to a medical or psychiatric issue;

Mr. M, a 54 year old man is taken to a sleep disorder facility for examination of daytime somnolence and insomnia. He has been battling with anxiety and depression, a disorder he is being treated with. He reports that he has been suffering from Insomnia for several years and only turned worse about 7 years ago. He is troubled with sleep initiation, which usually takes him over one hour to fall asleep. As soon as he is asleep, he wakes up several times, which makes him to struggle again to go back to sleep. He turns in bed without sleep until dawn when he gets up feeling fatigued and drained. The major diagnosis is DSM 5 insomnia disorder. Given the comorbid indications of obstructive sleep apnea and depression, it would perhaps be hard to assess whether Mr. M has DSM-IV primary insomnia since DSM 5 enables the clinician to generate an unpremeditated attribution between obstructive sleep disorder and insomnia.

In my paper, I will tackle insomnia from various perspectives: definitions, types, causes, effects, and means of solutions.

In the poem, “Insomnia” by Elizabeth Bishop, the speaker discusses her feelings and experiences of restlessness and loneliness during the night, instigated by her lover’s unrequited love. The poem explores the parallel between the speaker and the moon through their shared dissatisfaction with themselves and the speaker’s aspiration to achieve the strength of the moon. In the poem, the speaker recognizes her paralysis in her feminine role and conveys her desire to escape from the realities of a patriarchal society toward an inverted fantastical reality.

Ebben, M. R., & Narizhnaya, M. (2012). Cognitive and Behavioral Treatment Options for Insomnia. Mount Sinai Journal Of Medicine, 79(4)

Idiopathic insomnia is a rare form of chronic insomnia which is present from birth with no obvious cause and is thought to be a genetic disorder. Dauvilliers et al (2005) asked 256 primary insomniacs to complete psychometric questionnaires about family history and physiological recordings during sleep. They found that 73% of those with insomnia reported relatives with the disorder compared with just 24% in the control group. This suggests that the disorder is inherited.

Insomnia can be defined as a purpose or apparent complexity in falling and staying asleep. Dissimilarities in variables used for measurement sleep-onset time, time asleep, and time awake by some, sleepiness, irritability, or other impairment of daytime function by others, make difficult comparisons between studies. The insomnia treatments for which there is confirmation of efficacy include sleep restriction, in which the patient is instructed to remain in bed only as long as he is actually sleeping, stimulus control no activities in the bedroom except sleep and sex, and a variety of relaxation methods, particularly in the circumstance of multimodal sleep clinics (Rowe, 1995).

The sleep assessment conducted on the patient had an interesting dynamic in how we think we sleep opposed to how our partner says we sleep. The patient wakes up every morning at 6 a.m. and takes a nap right after lunchtime approximately at 1 p.m. The daily naps, according to the patient, last about forty-five minutes to an hour. When asked about restlessness when waking up the patient with a stern voice and pointed finger says, "When I'm up I'm up and ready to go." The patient also explained that they have no trouble staying asleep; however going to sleep can be challenging depending on if anything troubling is on her mind.

According to the National Sleep Foundation, 30 to 40 percent of adults report symptoms of insomnia while 10 to 15 percent say they have chronic insomnia (Rivas, Anthony). Many people suffer from acute to chronic insomnia, an illness which affects the body and mind and often stems from a larger problem. However, this illness can be cured through pharmaceutical measures, cognitive behavioral therapy, and/or complementary and alternative medicines. Treatment may vary for each person, so it is important for one to talk with a doctor about what may work best for them. Insomnia comes in two types, onset and maintenance. Onset insomnia is where an individual has difficulty falling asleep and maintenance insomnia is the trouble of remaining asleep

Insomnia can have a significant impact on men's health. A study has found men are more likely than women to die from insomnia related medical conditions. Men can lower their risk of dying an early death by getting at least six hours of sleep a night.

The rest of both the groups were made up entirely of men totalling in fifty-nine, the insomniac group containing twenty-two men while the controlled group contained thirty-seven. This is important to note as since not only were the groups not gender equal with numbers, the groups themselves were uneven and unmatched, making the conclusions of this study controversial. The results of testing cognitive function showed no distinct difference claiming that the tests’ results were not affected by insomnia. However it was noted that the insomniac group was found to be nervous, irritable, dull, light headed, and seemed to have loss of their motor control. One study did have conclusive results on the study of insomnia and they had the test subjects rest and tested them, then stay up for 62 hours and tested them. Then they allowed the subjects to rest and retested them again. The results on the test of accuracy while the subjects were getting limited sleep their results went down and it was noticed there was a massive decrease in mental efficiency. After regaining their sleep the subjects scores were said to have stayed the same for accuracy. According to the results the memory and speed seemed to be the functions affected

The health consequences of lack of sleep and excessive daytime sleepiness affect 50 to 70 million Americans annually. Sleep deprivation costs the United States 15 billion dollars annually in health care. In addition, industry spend $50 billion dollars in lost productivity (NIH, 2004).

Insomnia comes in many variations and has many causes both physiological and psychological. It’s defined as a dissatisfaction with sleep quantity or quality, associated with difficulty initiating or maintaining sleep; and/or an inability to return to sleep (Ciccarelli). Physiological causes can range from a number of

Sleep has a major function in the physical and mental health of an individual. It is important to assess elements of sleep disorders when evaluating for any mental health condition. According to Perese (2012), “Psychiatric disorders characterized by sleep disturbances include anxiety disorders, depression, bipolar disorders, schizophrenia, and Alzheimer’s disease” (pp 222-223). Normal sleep length should be at least 7 or 7.5 hours per night and when poor sleep pattern exists, it could affect alertness, memory, cognition, creativity and quality of life (Perese, 2012). Sleep-wake disorders can be described as any problem with sleeping including; difficulty falling or staying asleep, sleeping too much, sleeping at the wrong time and abnormal behaviors during sleep (MedlinePlus, 2015). According to DSM-5 (2013), “Sleep-wake disorders encompasses 10 disorders or disorder groups: insomnia disorder, hypersomnolence disorder, narcolepsy, breathing-related sleep disorders, circadian rhythm sleep-wake disorders, non-rapid eye movement (NREM) sleep arousal disorders, nightmare disorder, rapid eye movement (REM) sleep behavior disorder, restless leg syndrome, and substance/medication-induced sleep disorder” (p. 361).

Insomnia affects almost half of adults living in America. (# 8, 2012) This is a shared sleeping disorder that many people across the universe are diagnosed with. Several causes of insomnia include exercising too much, stress, withdrawal from alcohol or a certain drug, physical circumstances, and diseases. People with insomnia usually have trouble going to sleep or staying asleep, which causes people to have poor-quality sleep, which will affect their mood, energy, and productiveness for the next day. (MediLexicon, Intl., 2012) More symptoms of insomnia include waking up earlier than needed, having trouble falling back asleep, and being in a bad mood the following day. Insomnia can cause many more problems such as weight