Psychology Online

Problems falling asleep

definition

Problems falling asleep and the associated sleep disorders (insomnias) are caused by a Discrepancy between need for sleep and subjective sleep ability marked. They are the most common form of insomnia.
In order to speak of a difficulty falling asleep and staying asleep, symptoms must appear during the day and persist for at least four weeks in addition to the disturbance of night sleep.

Epidemiology

Over 30% of the population suffer from problems falling asleep and staying asleep at least at times.

Symptoms

Symptoms for this are characteristic

increased sleep times
increased nocturnal waking phases
Twitching when falling asleep
waking early in the morning with sufficient bedtime
likewise a subjectively reduced recovery function

During the day there are complaints such as:

Performance restrictions in the form of Attention and memory disorders
fatigue
general malaise
exhaustion
Reduction of motivation, drive and initiative
Tendency to make mistakes at work or have accidents in traffic
languor
Irritability
increased irritability
Mood impairment
occupational restrictions
social withdrawal especially in the evenings
Worry about the insomnia

With severe problems falling asleep and staying asleep, somatic symptoms such as:

Muscle aches
a headache
and Gastrointestinal complaints

arise.

Find out more about the other consequences of lack of sleep here: Consequences of lack of sleep

Classification

The primary problems falling asleep and sleeping through the night can be divided into eight different forms:

primary forms that are independent sleep disorders acts that are not caused by other diseases
secondary forms in which the sleep disorder is one Symptom of another disease are
Adaptation-related or acute problems with falling asleep and staying asleep are affected by a specific stressor triggered
psychophysiological difficulty falling asleep and staying asleep as part of a psychophysiological symptom complex that is related to learned or sleep-deprived behavior patterns occurs
paradoxical problems falling asleep and staying asleep are caused by the Complaints of a sleep disorder with no objective evidence marked on such
idiopathic problems falling asleep and staying asleep are caused by the Beginning in childhood with no apparent cause marked
Difficulty falling asleep and staying asleep in the context of a mental disorder are a symptom of a underlying mental illness
Difficulty falling asleep and staying asleep through inadequate sleep hygiene means that it is a disorder with mostly unconscious sleep-incompatible behaviors acts

Primary difficulty falling asleep and difficulty sleeping through the night

In the primary form of a sleep disorder, there is only an independent sleep disorder, which means that no other diseases are the trigger for the insomnia.

Secondary problems falling asleep and difficulty sleeping through the night

In the secondary form of sleep disorder, this is insomnia a symptom of another condition.

Adaptation-related or acute primary problems falling asleep and difficulty sleeping through the night

The adaptation-related or acute primary problems falling asleep and sleeping through the night is caused by a specific stressor triggered.
It is usually short-lived from a few days to weeks.

The stressor can be here

psychological,
psychosocial,
physical or organic
environmental

Be nature.

Typical stressors are

Job change,
family conflicts,
Removals,
Hospital stays
a Thyroid disease and other medical diagnoses
positive experiences like falling in love

Typical complaints are

the above symptoms during the night
fatigue-related limitations of performance and emotional well-being during the day
increased irritability
anxiety
mental tension up to Depression
a headache
Gastrointestinal complaints

In the Diagnosis helps

the questioning about general health
drug consumption
the possible use of addictive substances
the physical exam
the laboratory test to identify possible organ disorders
the special sleep medical diagnostics, which includes the sleep survey, the sleep diary and possibly a sleep questionnaire

Attention!

The danger with acute or adjustment-related problems falling asleep and sleeping through the night is that these can turn into a psychophysiological one Insomnia or increase into a falling asleep and staying asleep disorder as part of an affective disorder.

Psychophysiological difficulty falling asleep and staying asleep

With a psychophysiological one insomnia is it a Insomnia as part of a psychophysiological symptom complex that is related to learned or sleep-prevented behavior patterns.
As triggering factors apply stressors like

physical illness with pain
acute psychological stressful situations
a hospital stay
a changed, sleep-disturbing environment
move
shift work

In the course of the disease, the stressors can disappear and become one The sleep disorder becomes independent to lead.
Typical for this form of sleep problems and sleep disorders are

nocturnal tendency to brood
lack of ability to switch off
Focus on the sleep problem with a secondary increase in adaptation, mostly as a result of increased anxiety and negative sleep expectation
excessive effort to fall asleep
Fear of insomnia
poor sleep hygiene, e.g. Irregular bed times, working at night or watching TV

Often the ability to sleep occurs only in the morning hours in association with the base point of the core body temperature and the onset of the excessive effort to fall asleep.
During the day the complaints are over

fatigue
To be exhausted
Listlessness
and moodiness

in the foreground. Stress symptoms occur just as frequently as

a headache
stomach pain

on. The fear of going to bed often increases in the evening with a tendency towards social withdrawal observed. Despite increased tiredness, patients are rarely able to sleep during the day.

Paradoxical problems falling asleep and difficulty sleeping through the night

Paradoxical insomnia is characterized by complaining of a sleep disorder with no objective evidence of it.
Here is the Perception of actual sleep ability disturbed. The impairments of day-to-day experience and behavior are not related to the severity of the complained of sleep disorders.

The Emergence of the paradoxical problems falling asleep and staying asleep to this day unexplained.
In individual cases there is one showy personality with hypochondriac Trains, especially in relation to night sleep.

As Symptoms apply the

Complaints of difficulty falling asleep and staying asleep, especially due to descriptions of uncomfortable sleep and daytime sleepiness.

However, the bed partner reports that the person concerned slept undisturbed. Occasionally the person concerned becomes fixated on the sleep problem.

To Diagnosis In contrast to other problems falling asleep and staying asleep, the External survey (of the partner) in relation to nightly sleep patterns as indispensable.

Idiopathic problems falling asleep and difficulty staying asleep

Idiopathic insomnia is due to the Beginning in childhood with no apparent cause marked.
Usually is no trigger recognizable and it cannot be explained by any other disease.
It is based on a lifelong inability to get enough sleep, which is believed to be due to an abnormality in the neurological or neurochemical control of the sleep-wake system.

Symptoms:

pronounced problems falling and staying asleep
reduced sleep phases
decreased performance during the day
chronic

There may be shorter periods of symptom relief, but these will soon reverse.

Difficulty falling asleep and staying asleep in the context of a mental disorder

Difficulty falling asleep and staying asleep in the context of a mental disorder are a symptom of an underlying one mental illness.
It is only named as such if the problems falling asleep and staying asleep disorder that Main symptom or is a serious symptom of mental illness.
They often occur in the context of a depressive illness and anxiety disorders.

Symptoms:

Symptoms of difficulty falling asleep and difficulty staying asleep
Limitations in well-being
Limitations in daily performance
Often the daytime symptoms are much more pronounced due to the underlying mental illness in relation to the severity of the nocturnal sleep problem
psychiatric complaints of the depression or the Anxiety disorder

Problems falling asleep and difficulty sleeping through the night due to inadequate sleep hygiene

Difficulty falling asleep and difficulty staying asleep Inadequate sleep hygiene is a disorder with mostly unconscious sleep-incompatible behaviors.
These behaviors fall into two groups. On the one hand, those who provoke increased cognitive, emotional or somatic behavior before bed and those who are incompatible with the organization of sleep.
The latter are expressed in irregular bedtime, long bedtime, use of the bed for activities other than sleep, sleeping periods during the day, stimulating activities before going to bed, nighttime activities such as watching TV, getting up and working, and the evening consumption of substances that increase drive or sleep disturbance (e.g. caffeine).
As root cause Above all, the misjudgment of the consequences of staying awake indefinitely and irregularly are seen.
But also stress, ambition and excessive demands can lead to behavioral habits that result in sleep-related complaints or Sleep-wake rhythm disorders flow out.
These include substance abuse from:

nicotine
caffeine
or
other stimulants, but especially the use of the sleep location for purposes other than sleep such as:
watch TV
Read
Learn
eat
Think
and
Make plans.

The clinical picture is shaped by these behaviors, which can be divided into two groups. On the one hand, the striving for more and longer wakefulness, on the other hand, conscious actions against a good sleep organization.
Nicotine and caffeine rather generate alertness and there is a correlation between the amount consumed and individual sensitivity.
alcohol initially has one sedating and thus a hypnotic effect. However, the rapid degradation reverses this effect after a few hours, even with small amounts.
Irregular bedtime, staying in bed too long, sleeping long or even multiple times during the day or in the early evening hours can significantly shorten and unstable night sleep.
There are also behavior-related sleep disorders in childhood, which are characterized by a lack of or inadequate educational measures by the parents. It finds its expression in a lack of boundaries and a lack of discipline in connection with the bedtime situation.
The therapy of the Difficulty falling asleep and difficulty staying asleep is based on various factors such as behavioral medical advice, pharmacological interventions, and psychotherapeutic and behavioral interventions.