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Insomnia Disorder: Clinical Features and Diagnosis


Sleep is essential for cerebral growth, learning, and metabolic activities. However, there are some instances where an individual finds it hard to sleep. Based on the duration of the symptoms, this disorder can be grouped into transient, short-term, and long-term (Cleveland Clinic, 2021). Common causes of insomnia are stress, poor sleeping habits, mental health disorders, and medications. It can also be caused by taking alcohol, caffeine, and nicotine. Insomnia can have an adverse effect on an individual’s mental and physical health. For example, it can increase the risk of long-term complications such as heart disease and high blood pressure (Cleveland Clinic, 2021). Therefore, this report aims to create an understanding of insomnia, its causes, effect, and treatment.

An Overview of Insomnia

Insomnia is characterized by the inability to fall or stay asleep. It is described as persistent sleep onset and maintenance difficulties that occur despite adequate sleep time and opportunity (Cleveland Clinic, 2021). However, other people may find it hard to remain asleep, either they are frequently waking up or waking up early. Insomnia affects people of all ages, including youngsters, adults, and the elderly. Insomnia affects nearly one-third of adults in the United States. It is a burden to the US healthcare system and vulnerable patient groups. For example, they affect approximately 70 million Americans every year (Cleveland Clinic, 2021). As a result, insomnia is a common disorder that needs proper attention.

The Common Types of Insomnia

Insomnia is grouped into acute, transient, and chronic, depending on its duration. Acute insomnia is a well-known type caused by work stress, family pressure, or traumatic experiences (Roller, 2018). Depending on the stress, it can persist for up to a month. Stress, sadness, or other conditions can induce transient insomnia, which lasts shorter than a week. Chronic insomnia is defined as insomnia that lasts longer than one month. Most chronic insomnia instances are secondary, which means they are signs or side effects of some medications or other health issues (Roller, 2018). It can also result from long-lasting stress, emotional and work-related stress.

Clinical Features and Diagnosis of Insomnia

The most prevalent indicators of insomnia are tiredness, social dysfunction, memory lapses, diminished motivation, anger, and stress about sleep. These features can lead to the inability to work during the day (Roller, 2018). Some of the features of insomnia are absenteeism, poor work capacity, and social isolation. In addition, the inability to get enough sleep causes the inability to perform their operations effectively (Roller, 2018). For example, people with chronic insomnia commonly report feeling drowsy and wanting to sleep but unable to do so and achieve the things they want. Therefore, these features can help a provider to diagnose insomnia.

Insomnia is a major health concern that demands a proper diagnosis and effective treatment. Insomnia is essentially a clinical diagnosis, with patient histories and sleep diaries being the most common sources of information (Roller, 2018). The International Classification of Sleep Disorders is also used to diagnose sleep disorders (ICSD-3). To fulfill the analytical procedure for chronic insomnia, the person must have symptoms at least three times every week for 12 weeks or longer. The procedure for short-term insomnia is the same as for chronic insomnia, except that the symptoms must have continued for not less than 12 weeks.

Management and Treatment of Insomnia

Cognitive-Behavioral Therapy

People prefer cognitive-behavioral treatment over medication therapy for insomnia because it improves sleep outcomes with little or no side effects. The therapy is suggested for persistent insomnia, especially those with co-morbidities, because treatment tackles dysfunctional beliefs and behaviors that underpin insomnia (Chigome et al., 2018). Sleep education, cognitive treatment, relaxation, stimulus control, and sleep constraint therapy are all part of the therapy. In addition, a sleep diary is kept during this therapy since it helps a patient and therapist determine progress.

The Use of Medication

Prescription drugs, over-the-counter pharmaceuticals, and herbal treatments are used to manage insomnia. In the treatment of insomnia, off-label usage of non-prescription drugs such as antihistamines is prevalent (Chigome et al., 2018). Various factors influence drug selection when pharmacological treatment is indicated, such as symptom trends, treatment goals, previous treatment responses, patient preference, cost, and potential side effects (Chigome et al., 2018). The common type of medicine used in the treatment of insomnia is hypnotics. In addition, doxepin is approved for treating people who have trouble staying asleep. Therefore, medicine is used as an alternative to the therapy process.


Insomnia is a major problem that can negatively impact a person’s health. Chronic insomnia has been linked to an increased risk of chronic illness development; hence the underlying reasons should be identified and treated. Pharmacological therapy and cognitive behavioral therapy are all used to treat insomnia. They may be used separately or in combination, depending on the severity of insomnia. However, behavioral therapy is usually suggested as the first line of treatment. The primary goal of therapy is to enhance sleep quality, duration, daytime function, and anxiety levels.


Chigome, A. K., Nhira, S., & Meyer, J. C. (2018). An overview of insomnia and its management. SA Pharmaceutical Journal, 85(2), 32-38.

Cleveland Clinic. (2021). Insomnia: Causes, risks & treatments. Cleveland. Web.

Roller, L. (2018). Disease state management: Sleeping disorders: Insomnia. AJP: The Australian Journal of Pharmacy, 99(1171), 60-69. Web.

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