The ICSD (International Classification of Sleep Disorders) defines sleep disorders/insomnia (synonyms: Asomnia; respiratory sleep disorder; chronic sleep disorder; sleep-through disorder; dyssomnia; sleep onset disorder; excessive somnolence; hypersomnia; insomnia (sleep disorders); narcolepsy; insomnia; Sleep Initiation and Maintenance Disorders; ICD-10-GM G47.-: Sleep Disorders) as a “complaint of insufficient sleep or not feeling refreshed after the usual sleep time”; in DSM-IV, unrestorative sleep is mentioned in addition to complaints of falling asleep or staying asleep. Insomnia is thus a deviation from healthy sleep patterns. For the definition of insomnia, see Classification: “Diagnostic criteria for insomnia disorder according to DSM-5 A”. For the diagnosis of insomnia
They are divided into, among others:
- Insomnia* :
- Difficulty falling asleep and/or
- Trouble sleeping through the night
- Excessive sleeping (hypersomnia)
- Sleepwalking (somnambulism, somnambulism)
- Nightmares; Pavor nocturnus (nocturnal startling; night terrors; night terrors).
- Etc.
* Note: The diagnosis of insomnia requires the presence of two main criteria: Sleep disturbance and associated impairment during the day. Chronic insomnia is diagnosed according to ICSD-3 when complaints occur three times per week for more than three months, or when shorter episodes occur over several years.Insomnia is often chronic; approximately 70% of patients with insomnia still meet diagnostic criteria one year later. See for classification of sleep disorders under the topic of the same name. Sleep duration (total sleep episode, SPT) depends on age and physical and mental condition. Infants need about 16 hours of sleep, children about 7 to 12 hours and adults up to 8 hours.The sleep latency (SL), i.e. the time between the extinguishing of the light and the appearance of the first signs of sleep, should be less than 30 minutes.The wake after sleep onset (WASO), i.e. the sum of the wake time after falling asleep and before the final awakening, may be up to two hours in older age. Insomnia may be a symptom of many diseases (see under “Differential diagnoses”). In more than 50% of cases of insomnia requiring treatment, psychiatric disorders (including addiction) are responsible. Other causes of secondary insomnia are diseases of the central and peripheral nervous system (e.g. restless legs syndrome, RLS). Gender ratio: Women are more frequently affected by sleep disorders than men with increasing age. Prevalence peak: Pavor nocturnus (night terrors) is experienced by 56% of children once between the ages of 1 ½ and 13 years; about one in ten ten-year-olds tosses and turns during sleep (somnambulism).The tendency to awaken at night (sleep-through disorders) increase with aging, as periods of deep sleep and depth of sleep decrease. The prevalence for Pavor nocturnus is 56% and for Somnambulism 29.1%.For Insomnia the prevalence is 10-50% (in Germany). Occasional insomnia affects 25-30% and chronic insomnia affects 10-13%.In China, the prevalence of insomnia is 20.4% in younger people (≤ 43.7 years) than in people older than 43.7 years. Course and prognosis: sleep disturbances can lead to daytime sleepiness and impaired concentration. Note: Daytime sleepiness is not normal even in old age and always indicates an underlying disease or disorder. Short sleepers, who only need a few hours of rest at night and feel well rested in the morning, do not show an increased risk of disease. On the contrary, short sleepers without insomnia showed reduced rates of heart disease and hypercholesterolemia by about 40 percent, and hypertension by about 25 percent. In contrast, participants in a study with nine to ten hours of sleep were 27% more likely to die and 10% more likely to suffer cardiovascular events than those with six to eight hours of sleep. These extreme long sleepers were more likely to suffer from hypertension (high blood pressure) and chronic obstructive pulmonary disease (COPD). Comorbidities (concomitant diseases): Chronic insomnia is associated with psychiatric diseases, among others. The risk of depression is increased by a factor of 2.6.Likewise, the risk of myocardial infarction (heart attack) and apoplexy (stroke) is increased by up to 70%. Furthermore, affective disorders/bipolar disorders, anxiety disorders, panic disorder, post-traumatic stress disorder (PTSD), alcohol abuse (alcohol dependence), borderline disorders, dementias, eating disorders, and schizophrenia are associated with sleep disorders (see below secondary disorders).
