What is Insomnia - Meaning and definition

Published by Roberto Wenk. Reviewed by Alison Ramsey. Last updated date: January 7, 2019.

A subjective complaint of difficulty falling or staying asleep, or poor sleep quality.

Types of insomnia.
- Initial insomnia. Difficulty in falling asleep.
- Middle insomnia. Awakening in the middle of the night followed by eventually falling back to sleep, but with difficulty.
- Terminal insomnia. Awakening before one's usual waking time and being unable to return to sleep.

Adapted from American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC. American Psychiatric Association. 2013. p. 824.

Published by Roberto Wenk. Reviewed by Alison Ramsey. Last updated date: January 7, 2019.

Insomnia is a subjective complaint by the patient of sleep disturbance despite adequate opportunity to sleep. There may be difficulty in initiating or maintaining sleep, interrupted sleep, or poor-quality sleep.
Disturbances in sleep are seen in up to 50% of patients with advanced cancer and chronic respiratory disease, while it is reported in 77% of patients undergoing hemodialysis for end-stage renal failure.
Some factors that contribute to insomnia are depression, anxiety, pain, respiratory distress, and medications.
For palliative care patients, it may not be feasible to treat the underlying primary disease but it may be possible to control the factors contributing to sleep disturbances
Some suggestions for sleep hygiene for palliative care patients are: minimize nighttime sleep disturbance due to medication, noise, etc.; be as active as possible during the day; maintain adequate pain relief and use of sleep medication, if required.

Sateia MJ, Byock IR. Sleep in Palliative Care. Hanks G, Cherny NI, Christakis NA, Fallon M, Kaasa S, Portenoy RK (Ed).Oxford Textbook of Palliative Medicine. Oxford University Press, 4th ed. 2010, pp.1059-1083.

Insomnia

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