Trouble falling asleep and staying asleep troubles nearly half of all adult Americans. This inability to obtain restorative sleep (insomnia) can be transient, short-term, chronic intermittent or chronic persistent.
The health consequence of non-treatment is severe. The primary treatments for transient, short-term and intermittent insomnia consist of practicing good sleep habits, behavioral modification and cautious use of short acting hypnotics as the last option. For chronic persistent insomnia, an intense evaluation for an underlying physiological or psychological cause must be undertaken and only then can appropriate treatment be considered. The primary causes of chronic persistent insomnia includes sleep apnea syndromes (5-15%), leg movement syndromes (2-5%), neurologic/medical illness (3-5%), delayed sleep phase syndrome (5-10%), mood disorders (30%), anxiety disorder (5-10%), psychophysiologic disorder (10%), poor sleep hygiene (5-10%) and idiopathic (2.5-5%).