Primary Insomnia

Primary insomnia is characterized as a sleep disorder and causes an individual to have trouble falling asleep, staying asleep or achieving proper sleep which replenishes the body's store of energy. Insomnia is a symptom of many other illnesses and disorders, but to be considered primary insomnia, no other symptoms are present. Insomnia appears to be more common in women and elderly patients, but can occur at any age for men, women or children. Often, people with insomnia find more success maintaining sleep when they are away from home or in an unusual area, such as a living room or guest bedroom, and this may be due to what is called "negative conditioning".

Symptoms of Primary Insomnia

Symptoms of primary insomnia focus not only on the lack of sleep, but the behavioral and functional interference in the rest of daily life. Without proper sleep, an individual may have trouble maintaining necessary tasks and duties throughout the day. Following is a list of symptoms that may classify as primary insomnia:

  • Inability to fall asleep
  • Inability to remain asleep
  • Inability to achieve restorative sleep
  • Lack of energy, fatigue
  • Inability to function properly at work, home or school due to the lack of proper sleep
  • Symptoms may subside when away from home

Causes of Primary Insomnia

There are many things which can lead to primary insomnia, but not all will qualify a patient for this particular diagnosis. Insomnia is often a symptoms of drug use, medication, pain or an accompanying mental disorder. Some situations which may lead to primary insomnia are the following:

  • Neurological disorders
  • Certain medical conditions, such as arthritis or restless legs syndrome
  • Abuse of prescription and non-prescription sleep aids
  • Noise
  • Exercise
  • Hormonal shifts
  • Jet lag or a change in work shifts
  • Stress or anxiety

Diagnosis of Primary Insomnia

Many people experience periods of insomnia, but there are certain criteria that must be present to qualify for a diagnosis of primary insomnia. Transient insomnia lasts for less than a week, and acute insomnia lasts for one month or less, per episode. Insomnia becomes primary when symptoms have occurred habitually for longer than one month, and work, home or social obligations are significantly impaired due to lack of energy, sleepiness or other behaviors of sleep deprivation. A doctor who specializes in sleep disorders will perform an evaluation by ruling out the use of drugs and prevalence of any other sleep or mental conditions.

Treatment Options for Primary Insomnia

There are several different treatment options for primary insomnia, ranging from prescription medication or self-medication to therapy and alternative options. Medication still appears to be the first choice for health care professionals, but research is beginning to show that there are some short and long term side effects which may be hazardous. While many medications may seem to alleviate symptoms, it's possible that a patient still may not receive restorative sleep, which can significantly impact daily life. Additionally, insomnia medications can be addictive and can lead to other forms of illness. Following is a list of treatment options, including medication, that a patient with primary insomnia may consider:

  • Prescription pills – available drugs may include hypnotics, opioids, antidepressants, antihistamines or anti-psychotic medication.
  • Self-medication – drinking alcohol or taking other forms of self-medication may inhibit proper sleep, which can actually perpetuate the problem.
  • Therapy – stimulus control therapy can help if negative conditioning (such as to the patient's own bedroom) has developed. Certain types of cognitive therapy may also assist the patient in becoming aware of triggers and performing exercises to help alleviate symptoms.
  • Alternative remedies – increasing studies validate many natural or herbal remedies as beneficial for symptoms of insomnia. Valerian root, chamomile and other herbs have been proven to show reliable results.