Insomnia is a common sleep disorder that makes it difficult to fall asleep, stay asleep and/or return to sleep after waking. Insomnia can be chronic or acute, meaning long-term or short-term, and often comes and goes over time. Depending on its severity, insomnia can lead to health complications and lifestyle disruptions.
Insomnia is the most common sleep disorder in the general population. It is defined as a persistent difficulty with sleep initiation, duration, consolidation or quality that occurs despite adequate opportunity for sleep, and leads to impairment in health and functioning. It may also be a symptom of another medical condition such as obstructive sleep apnea (OSA). Recent findings show that insomnia is on the rise. Factors such as stress and anxiety have contributed to an increase in its prevalence in the United States with diagnosis rising from 33% (pre-pandemic) to 56% (post-pandemic). Cognitive behavioral therapy for insomnia (CBT-I) is the first-line recommendation for managing chronic insomnia. The American College of Physicians released recommendations for chronic insomnia in 2016 stating that only after patients fail CBT-I should medication options be considered. Seventy-five percent respond to CBT-I, therefore, why are so many people that are suffering from insomnia still taking sleep medications?
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It is very common to have patients with occasional to frequent restless nights followed by increased sleepiness during the day, and subsequent performance issues. In addition to the immediate impact of excessive daytime sleepiness and dysfunction, there is potential to develop chronic insomnia. There is also considerable data that links chronic insomnia to increased risk for diabetes, obesity, hypertension, plus an impact on the personal safety of an individual with chronic insomnia.
Daniel Erichsen, MD, saw it time and time again. Patients would come into his sleep clinic in Oregon complaining of insomnia, and he would tell them the same thing: If you don’t try to sleep, eventually you will. But they weren’t always listening. “I got frustrated with just saying the same thing over and over,” Erichsen says. “I thought, ‘There’s got to be a better way I can communicate with a lot of people at once.’”
