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KMID : 0438319950040010073
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Pusan Journal of Psychiatry
1995 Volume.4 No. 1 p.73 ~ p.97
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Diagnosis and Treatment of Insomnia
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Abstract
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Insomnia is a disorder of initiation and maintenance of sleep that results in daytime sleepiness and dysfunction. Insomnia arises from multiple psychological, physiologic, and environmental factors.
In order to give appropriate treatment for insomnia, we have to try to confirm the underlying cause of insomnia because it is a symptom not disease. The differential diagnosis of the various types of insomnia is based primarily on the history,
including information from the sleeping partner.
Transient insomnia usually resolves spontaneously. Short-term insomnia is usually normalized by coping with acute changes in a medical condition or a relationship. In patients with insomnia caused by stressful life events, a short course of a short-or intermediate-acting benzodiazepine hypnotic may be indicated. Long-term insomnia deserves comprehensive evaluation. Psychiatric disorders are common in patients with long-term insomnia. In patients over age 50, intrinsic sleep disorders such as sleep apnea syndrome and periodic limb movements disorder are more prevalent.
Pharmacotherapy(benzodiazepines, imidazopyridine and sedative antidepressants), behavioral therapy(improved sleep hygiene, stimulus control therapy, sleep restriction therapy, relaxation therapy) and cognitive therapy are preferred in the
management of insomnia. The option of treat meant depends on the type and the cause of insomnia.
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