8 Aging is often accompanied by changes in sleep patterns (disrupted sleep, frequent waking, early waking) that can lead to insomnia. Older adults and women have higher prevalence of insomnia and about half of insomnia cases coexist with a psychiatric diagnosis.

1,5-7 Previous diagnostic criteria for insomnia did not specify a minimum timeframe for sleep difficulties chronic insomnia was used to describe cases that lasted from weeks to months, and insomnia was considered chronic in 40 – 70 percent of cases. adults reporting “regularly having insomnia or trouble sleeping in the past 12 months” to 6 – 10 percent of adults meeting established diagnostic criteria.

Estimates range from nearly 33 percent in an international sample of primary care patients to 17 percent of U.S. Prevalence estimates of insomnia vary by how the condition is defined. Dysfunction that can accompany insomnia disorder includes fatigue, poor cognitive function, mood disturbance, and distress or interference with personal functioning. Additionally, the diagnosis requires that symptoms not be better explained by other sleep disorders or occur exclusively during the course of another sleep-wake disorder (narcolepsy, breathing-related sleep disorder, circadian rhythm disorder) not be attributable to the physiological effects of a substance and not be explained by coexisting mental disorders or medical conditions. 5 For an insomnia disorder diagnosis according to the American Psychiatric Association’s Diagnostic and Statistical Manual, Fifth Edition (DSM-5), 5 these symptoms must cause clinically significant distress or impairment(s) in functioning (social, occupational, educational, academic, behavioral or other) and occur despite adequate opportunity for sleep on at least 3 nights per week for at least three months. It is associated with one or more of the following subjective complaint(s): difficulty with sleep initiation, difficulty maintaining sleep, or early morning waking with inability to return to sleep. Insomnia involves dissatisfaction with sleep quantity or quality. The remainder includes indirect costs such as lost productivity due to absenteeism and presenteeism (attending work while sick, fatigued), reduced quality of life, and accidents and injuries. 4 These include direct costs of $12 – $14 billion for expenses such as medical appointments, over-the-counter sleep aids, and prescription medication. 2Įstimates of the annual costs of insomnia in the United States range between $30 and $107 billion. 3 Insomnia may be associated with long-term health consequences such as increased morbidity, respiratory disease, rheumatic disease, cardiovascular disease, cerebrovascular conditions, and diabetes. Individuals with insomnia report higher levels of anxiety, physical pain and discomfort, and cognitive deficiencies than those without sleep problems. In the literature, the term insomnia can describe a symptom and/or a disorder and definitions used are not consistent.

1 These difficulties, associated with a decline in overall health status and perception of poor health, can have negative personal and social consequences. Sleep difficulties are one of the most common complaints for adults in primary care. Background and Objectives for the Systematic ReviewĪdults around the globe struggle to achieve an appropriate duration and quality of sleep.

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