What is insomnia?
Insomnia is a condition characterized by difficulties in either initiating or maintaining sleep. The person suffering from insomnia usually has as a result of all this difficulties to sleep enough hours to be able to function during the day. During the day they have symptoms such as difficulty concentrating and remembering, irritability, tiredness, etc. In the long term, insomnia facilitates the onset of some diseases such as hypertension, cardiovascular diseases, diabetes and some others. Insomnia is not only frequent, but also when it is severe it is a disease; it is a disease that has its own dynamics and that is not necessarily secondary to something that caused it in its origin.
What are its main causes?
The causes of sleep problems can be multiple. They can have a respiratory origin, they can have a neurological origin, they can have a psychological origin, they can have an origin of any other dysfunction of the organism, sometimes there are drugs that are altering the sleep at night. The important thing is that we must bear in mind that behind a picture of insomnia it is often difficult in the clinic to differentiate what caused it, so sometimes we need to perform sleep studies.
What process does the patient follow in the sleep clinic?
The patient who comes to a sleep clinic is initially seen by a sleep specialist who is going to look for the history and is going to try to establish a diagnosis of suspicion. Based on this suspected diagnosis, we will indicate a series of tests to be performed in the sleep laboratory. Of all of them, perhaps the best known is the sleep study, which consists of spending the night in a room, in what we call the sleep laboratory, with a series of wires attached to various points on the skin that will collect biological signals that give us information about what is happening during sleep. This is not the only test. There are many others depending on the disease we are suspecting, from immobilization tests to melatonin secretion tests for possible sleep rhythm problems, to biofeedback tests to detect problems in the deactivation of muscle tone. The number of tests is multiple and will be aimed at diagnosing the specific problem that is affecting the patient.
How is insomnia cured?
The treatment of insomnia depends on the cause that is producing the insomnia. We have already mentioned that the causes that produce insomnia can be multiple. In those cases in which we see a medical cause, i.e., something of a neurological, respiratory, digestive, etc. type. What we are going to do is to treat that cause. Now, in cases of primary insomnia, i.e., those in which there is no medical cause that is producing it, what we are going to do is a treatment based on behavior modification measures. We can understand it as a sleep re-education program. It usually lasts two to three months, with very specific guidelines, supervised by an expert and usually produces a substantial improvement. After this time the patient usually no longer needs any type of medication and can sleep on his or her own.