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Insomnia is a condition in which patients have difficulty initiating sleep or difficulty maintaining sleep. Fifty percent of all men and women suffer insomnia at some point in their life. Insomnia is often a short-term problem associated with emotional or medical conditions. Should this problem become more long-standing, referral to a sleep specialist may be useful to assess the specific cause of the insomnia and recommend therapy.

Patients who have difficulty initiating sleep may have a psychological cause such as depression or anxiety that may trigger a variety of stressors that offset the body's ability to "turn on sleep". Difficulty initiating sleep may also be caused by a variety of medical conditions including pain syndromes, fibromyalgia, and thyroid disease. This type of insomnia also can lead to dependence on hypnotic medications (sleeping pills) that may be undesirable. Conditions that cause difficulty maintaining sleep are snoring, sleep apnea, limb movement disorders, and other medical conditions. Patients with this insomnia related to medical conditions usually are more troubled by frequent awakenings throughout the night rather than difficulty with initiating sleep at bedtime.

The workup and treatment for insomnia is generally more complicated than the evaluation for patients with daytime sleepiness. This evaluation requires a thorough sleep and medical history by a sleep specialist, neurologist or psychiatrist. The evaluation for this condition may not require a nighttime sleep study, as frequently limited information will be gained from such an evaluation.

The treatments for insomnia vary depending on the cause. Short-term therapy with hypnotic medications may be necessary to reestablish a sleep pattern. Often a variety of behavioral strategies such as relaxation therapy may be helpful.

PCCAB has a dedicated web site related to our Sleep Services. Please click the link below to learn more about this division of our services.

Sleep Medicine Associates of Maryland