Chronic insomnia

Abstract

Insomnia is commonly defined as the subjective report of difficulty in initially falling asleep, difficulty in maintaining sleep (long or multiple awakenings during the sleep period), or awakening too early with the inability to go back to sleep. In recent years,1 a diagnosis of insomnia has also included a report of decreased daytime function associated with the poor sleep at night to differentiate a patient with insomnia from an individual who simply requires less sleep. Insomnia may be either an acute or a chronic problem. Acute insomnia, usually defined as poor sleep associated with a specific life event, such as an important examination, resolves when the event passes or within a period of 3 weeks. Chronic insomnia may begin after an acute episode, if conditioning factors are involved, but typically presents as a long-standing complaint despite varied attempts at treatment.