Journal of Sleep Disorders & Therapy
Open Access

Insomnia Related Mental Condition and its Treatment

Alona Shari^{* *}Correspondence: Alona Shari, Department of Psychology, Melbourne Sleep Disorders Centre, Melbourne, Australia, Email:

Author info »

Description

Insomnia affects 10 to 30% of people worldwide. Night-time sleep abnormalities brought on by chronic insomnia include extended sleep latency, disturbed sleep maintenance, and nonrestorative sleep. Additionally, it may result in a number of Impairments of Daytime Functioning (IDFs) like fatigue, mood swings, irritability, decreased interest and motivation, attention deficit, and memory problems, which can all lead to a decline in the quality of one's job, relationships with others, or leisure time.

IDFs are expected to have a bigger impact on the world economy than insomnia-related sleep disruptions, according to a socioeconomic study. Nevertheless, in the fifth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), which will be issued in 2013, the criteria for "Primary Insomnia" will be altered to "insomnia disorder." Contrary to the conventional, vague definitions of IDFs, this update will clearly define IDFs as determined sequelae based on distinct biological vulnerabilities to sickness.

It was proposed that the classification of insomnia's subtypes influences the type and severity of subjective symptoms linked to IDFs. Psychophysiological insomnia and poor sleep hygiene were related to symptoms of daily tension and low weariness, while idiopathic insomnia and insomnia associated with a mental condition were related to symptoms of mood disturbance and low sleepiness. Whereas insomnia related with a mental condition had the most severe IDFs, paradoxical insomnia displayed subtle symptoms with mild intensity. Despite this rather thorough understanding and classification, there is a dearth of information regarding the severity of cognitive dysfunction associated with IDFs resulting from various insomnia subtypes. Particularly, whether or not primary insomniacs display cognitive dysfunctions as IDFs is still up for debate. Insomniacs had mild to moderate cognitive impairment, including some difficulty with episodic memory and problemsolving, according to new meta-analysis working memory skill domains.

A significant variety in the size of these effects on cognitive skills, however, raises the possibility that other factors may have contributed to the differences between these investigations. This variation in cognitive functioning may be influenced by the varied subtype of insomnia. One of the biological vulnerabilities is a vulnerability to sleep loss per se, and the other is a vulnerability to stress that may cause IDFs in people with chronic insomnia way of a variety of cognitive dysfunctions.

It is well known that attention is one of the cognitive processes that is most susceptible to sleep loss, despite the fact that it is crucial to almost all cognitive activities.

Consequently, cumulative sleep loss may affect a variety of cognitive functions. Inversely, stress vulnerability, which also includes susceptibility to disease or insanity, is a prevalent cause of sleeplessness as well as a variety of other physical and mental conditions. Recent findings from our own research suggest that a personality trait known as neuroticism, which frequently manifests as subjective sleep quality deterioration (sleep dissatisfaction) as its main complaint, can actually improve daytime attention and higher cognitive performance by overcoming sleep loss.

This personality feature of neuroticism is shared by the majority of paradoxical and psychophysiological insomniacs, and as a result, they may exhibit somewhat improved daytime cognitive functions compared to healthy participants with a less prominent neuroticism trait. So, their reported subjective mental and physical issues and the ensuing social and vocational maladaptation may be the extent of their daytime dysfunctions. We cannot assign IDFs to a particular common cause in all cases of insomnia because of the interaction between these 2 vulnerabilities, which results in differences in IDFs amongst insomnia subtypes. This concept aids in our comprehension of the therapeutic dynamics of CBT for insomnia (CBT-I). Given the therapeutic approach and effectiveness of CBT-I, it may lessen stress vulnerability rather than sleep vulnerability.