We are fortunate to have several nosologies that recognize insomnia as a primary disorder. This is a more accurate definition especially given the large proportion of insomniacs with comorbid medical conditions, the most common being psychiatric illnesses. Thus, it is no longer either a symptom (secondary) or a diagnosis (primary) but both. Perhaps what is different in the modern era is that initially the distinction between primary insomnia and secondary insomnia allowed for difficulty initiating and maintaining sleep to be both a disorder in its own right and symptom of other disorders, while the most recent international classification of sleep disorders divides up the category of insomnia into 11 diagnostic entities based on etiological and pathophysiological criteria. After two decades or more of sleep research and sleep medicine, insomnia is considered a distinct nosological entity. Nocturnal seizures can also interfere with sleep.In the early 1980s, insomnia was thought to be a symptom, not a disorder. read more ), particularly those that worsen with movement, cause transient awakenings and poor sleep quality. The tear causes pain due to irritation of sensory nerves in the disk, and. read more, herniated disks Cervical Herniated Nucleus Pulposus Herniated nucleus pulposus is prolapse of an intervertebral disk through a tear in the surrounding annulus fibrosus. Its prominent properties are A lack of cell differentiation Local invasion of adjoining tissue Metastasis, which is spread to distant sites through. read more, cancer Overview of Cancer Cancer is an unregulated proliferation of cells. Disorders that cause pain or discomfort (eg, arthritis Osteoarthritis (OA) Osteoarthritis is a chronic arthropathy characterized by disruption and potential loss of joint cartilage along with other joint changes, including bone hypertrophy (osteophyte formation). Physical disorders may interfere with sleep and cause insomnia and EDS. Patients typically have insomnia, excessive daytime sleepiness. Falling asleep early and awakening early suggest advanced sleep phase syndrome Circadian rhythm sleep disorder, altered sleep phase types Circadian rhythm sleep disorders are caused by desynchronization between internal sleep-wake rhythms and the light-darkness cycle. read more, periodic limb movement disorder Periodic Limb Movement Disorder (PLMD) and Restless Legs Syndrome (RLS) Periodic limb movement disorder (PLMD) and restless legs syndrome (RLS) are characterized by abnormal motions of and, for RLS, usually sensations in the lower or upper extremities, which may. read more, obstructive sleep apnea Obstructive Sleep Apnea (OSA) Obstructive sleep apnea (OSA) consists of multiple episodes of partial or complete closure of the upper airway that occur during sleep and lead to breathing cessation (defined as a period of. Most of these conditions cause asymptomatic changes. read more, central sleep apnea Central Sleep Apnea Central sleep apnea (CSA) is a heterogeneous group of conditions characterized by changes in ventilatory drive without airway obstruction. Sleep maintenance insomnia suggests major depression Major depression (unipolar disorder) Depressive disorders are characterized by sadness severe enough or persistent enough to interfere with function and often by decreased interest or pleasure in activities. read more, chronic psychophysiologic insomnia, restless legs syndrome Periodic Limb Movement Disorder (PLMD) and Restless Legs Syndrome (RLS) Periodic limb movement disorder (PLMD) and restless legs syndrome (RLS) are characterized by abnormal motions of and, for RLS, usually sensations in the lower or upper extremities, which may. Sleep-onset insomnia suggests delayed sleep phase syndrome Circadian rhythm sleep disorder, altered sleep phase types Circadian rhythm sleep disorders are caused by desynchronization between internal sleep-wake rhythms and the light-darkness cycle. Difficulty falling asleep (sleep-onset insomnia) should be distinguished from difficulty maintaining sleep and early awakening (sleep maintenance insomnia) because the causes differ.
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