Secondary Causes of Insomnia - How to Diagnose Sleep Disorders

As I said in prior segments, insomnia often has a different underlying cause where insomnia merely becomes, sort of, a symptom of the cause. People with obstructive sleep apnea often arrive in a sleep disorders office reporting insomnia or daytime fatigue. The insomnia is coming from the multiple awakenings that they are having during the night due to apneas and hypopneas. It's not truly a case of insomnia. Once all diagnostic tests are performed and reviewed, generally this can be shown to the patient and a different course of treatment can be taken that rarely has little to do with actual insomnia.

People with depression and bipolar disorder, both treated and untreated, often experience forms of insomnia. It's not uncommon, in the manic stages of bipolar, for a person to sleep very little or not want to sleep at all. Even once the mania is treated, it's not uncommon for the drugs that get used in that treatment to cause disruptions in sleep or cause a change in the quality of sleep. Certain people with schizophrenia and older atypical anti-psychotics will have sleep issues or just feel that they don't sleep as well as others. Again, it's a thing that's hard to differentiate because you don't always know what a schizophrenic patient is reporting.

Even the most lucid and medicated ones still may not have a good sense of what's going on at night or why they're sleeping poorly. People with restless leg syndrome, of course, generally aren't sleeping well even once they get to sleep because their legs are moving and twitching. They're having issues and their bodies can't fully relax. So, it's important to rule-out the causes of insomnia. Thyroid issues can be a problem. Women sometimes experience insomnia during pregnancy. It is important to rule-out these secondary causes of insomnia and treat them before treating a patient primarily with sedatives and other drugs that can cause physical and psychological dependence. It's just more efficient to treat underlying problems and eliminate any sort of dysfunction that they're creating in a patient's life.

Transient Insomnia - How to Diagnose Sleep Disorders

I want to talk about the differences and talk about some of the underlying reasons for insomnia that can make it last beyond just a week or two. Transient insomnia is something that most of us experience at various points within our lives. It's a response to stress. It's a response to grief or depression. It can also be a response due to a change in sleep schedule or work schedule. Sometimes, people experience transient insomnia because, for whatever reason, they've been consuming caffeine later in the day. Generally, people who drink caffeine only during the morning, for some reason will have a night of bad sleep. They'll need to pick up caffeine later in the day to make-up for that lack of sleep.

Then, the caffeine doesn't leave their body quickly enough, and whether they realize it or not, that extra cup of coffee or that glass of soda that you had around 5 o'clock is keeping you awake at night. Transient insomnia comes and goes. It'll usually go away in about a week or two, when you resolve the grief or stress, or when you treat the depression that's causing it. Chronic insomnia has its own causes. Sometimes chronic insomnia runs in families; rarely it does. It is a combination of not only genetic factors but a learned behavior.

If a child grows up knowing that "we don't sleep well, in this family", it can affect their own mental state as it relates to sleep. There is a strong connection between the psychology of the patient and the quality of their sleep. Sleep is not just a physical thing; there are a lot of psychological factors involved. There is a very rare type of insomnia called fatal familial insomnia and the incident of this is so rare that it is rarely mentioned outside of the corridors of sleep disorders facilities. As the title implies, it's genetic and it's fatal. It's caused by a lack of sleep that cannot be cured through any sort of sedation means.

It progresses to dementia and to death. I mentioned it only because it's something that gets mentioned in the popular culture, every once and awhile. Someone will read something on-line about fatal familial insomnia and they think, "Oh crap, I can't sleep. I have that". It's so rare that a doctor would have to tell you, for sure, whether you have it or didn't have it. It's not anything to be concerned about if you're having about of insomnia or if a number of people in your family have insomnia. I think that you would know if it were to be a fatal or terminal illness.

Insomnia - How to Diagnose Sleep Disorders

The term insomnia comes from the Greek, literally meaning lack of sleep or no sleep. When people think of a sleep disorder, I think insomnia commonly pops into the head. Most people at some point in their lives experience a mild case of insomnia, that comes and goes, sometimes in response to stress, grief or depression. Insomnia has a number of different causes.

It has a number of different ways to be relieved. It all depends on, sort of, what's going on or the underlying cause of the insomnia. It's not uncommon for children to have bouts of insomnia or for adults. Generally, insomnia resolves itself. When insomnia doesn't resolve, when people have chronic problems getting asleep or when that lack of sleep is causing irritability, fatigue or other issues during the day, that's when we see people in the Sleep Disorders Office for insomnia.

Patients are often seen when a primary care physician issues a prescription for a sleep aid, such as, Ambien, Lunesta or something of the like, that you've seen on TV and for some of the other medications that we may have. It's not uncommon for a primary care physician to refer a patient on to a sleep disorders physician when a temporary prescription or something like that fails to aid the insomnia patient or if the insomnia continues beyond the span of 7 to 14 days.