By: Catherine Joachin
What is insomnia?
Insomnia is a common sleep disorder defined by difficulties falling or staying asleep (Mayo Clinic, 2024). Insomnia affects both the quality and quantity of sleep, but it can also lead to medical or psychiatric complications (Mayo Clinic, 2024).
Classification and symptoms
Insomnia can be classified into two categories: acute (short-term) or chronic (long-term) (Cleveland Clinic, 2024). People suffering from acute insomnia experience sleep disturbances for a few days or weeks as a result of stress or a troubling life event whereas people with chronic insomnia deal with symptoms for three months or more (Cleveland Clinic, 2024; Mayo Clinic 2024).
Insomnia can take on many forms; symptoms may include:
- Trouble falling asleep
- Waking up in the middle of the night and struggling to fall back asleep
- Waking up too early
The consequences of these sleep problems can make people with insomnia prone to daytime sleepiness, forgetfulness, and feelings of irritability, anxiety, or depression which can negatively impact their performance at work and their concentration levels throughout the day (Cleveland Clinic, 2024).
Causes and risk factors
While insomnia does not always have an underlying cause, certain factors can contribute to its genesis including:
- Mental health problems (e.g., stress)
- The consumption of substances that can disrupt normal sleep cycle (e.g., caffeine, alcohol, antidepressant medication)
- Age
- Hormonal changes during menstrual cycle or menopause.
- Medical conditions (e.g. Parkinson’s or Alzheimer’s disease)
- Pre-existing sleep-related disorder (e.g. sleep apnea)
(Cleveland Clinic, 2024; Mayo Clinic, 2024)
Insomnia can also be caused by several environmental factors such as poor sleeping habits or jet-lag and lifestyle changes such as a new work schedule or pregnancy (Mayo Clinic, 2024).
Diagnosis and Treatment
A physical exam and a review of sleep habits by a medical provider can identify signs related to insomnia (Mayo Clinic, 2024). If the cause of insomnia symptoms cannot be determined, a visit to a sleep clinic can help rule out similar conditions through tests (e.g., polysomnography) designed to diagnose sleep apnea, restless leg syndrome or other sleep disturbances (Mayo Clinic, 2024).
Adopting better sleep habits, addressing mental health issues, and taking sedatives or hypnotic drugs are the most commonly recommended treatment options for insomnia (Cleveland Clinic, 2024). Cognitive behavioral therapy (CBT) is another effective choice in managing insomnia, especially when it is resistant to the aforementioned steps (Mayo Clinic, 2024).
Insomnia and Epilepsy
Insomnia is more prevalent in people with epilepsy than in the general population (Macêdo et al., 2017). Studies on the role of insomnia on seizure control and quality of life in patients with epilepsy revealed that not only is insomnia a common comorbid condition to epilepsy but it is also associated with poor seizure control and worse quality of life in those patients (Quigg et al., 2016, Macêdo et al., 2017).
Furthermore, people with epilepsy suffering from insomnia experience higher levels of depression and excessive daytime sleepiness (EDS) (Tan et al., 2024). Nocturnal seizures and anxiety have also been linked to their condition (Tan et al., 2024).
Conclusion
Insomnia is a common obstacle to better seizure control and quality of life for people with epilepsy. Further research into the relationship between epilepsy and sleep disorders could shed light on factors potentially influencing seizure severity.
References
Cleveland Clinic. Insomnia. (2024). Cleveland Clinic. Retrieved from: https://my.clevelandclinic.org/health/diseases/12119-insomnia#symptoms-and-causes
Macêdo, P. J. O. M., Oliveira, P. S. de, Foldvary-Schaefer, N., & Gomes, M. da M. (2017). Insomnia in people with epilepsy: A review of insomnia prevalence, risk factors and associations with epilepsy-related factors. Epilepsy Research, 135, 158–167. https://doi.org/10.1016/j.eplepsyres.2017.05.014
Mayo Clinic. (2024). Insomnia – Symptoms and causes – Mayo Clinic. Mayo Clinic. Retrieved from: https://www.mayoclinic.org/diseases-conditions/insomnia/symptoms-causes/syc-20355167#:~:text=Insomnia%20is%20a%20common%20sleep,level%20and%20affect%20your%20mood.
Mayo Clinic. (2024). Insomnia – Diagnosis and treatment – Mayo Clinic. Retrieved from: https://www.mayoclinic.org/diseases-conditions/insomnia/diagnosis-treatment/drc-20355173
Quigg, M., Gharai, S., Ruland, J., Schroeder, C., Hodges, M., Ingersoll, K. S., Thorndike, F. P., Yan, G., & Ritterband, L. M. (2016). Insomnia in epilepsy is associated with continuing seizures and worse quality of life. Epilepsy Research, 122, 91–96. https://doi.org/10.1016/j.eplepsyres.2016.02.014
Tan, B., Liu, Q., Qin, Y., Chen, Q., Chen, R., Jin, Y., Li, M., Jia, X., Xu, X., & Zhang, Q. (2024). Insomnia in epilepsy is associated with nocturnal seizures and anxiety. Epilepsy & Behavior, 150, 109559–109559. https://doi.org/10.1016/j.yebeh.2023.109559
