HOW TO FIGHT INSOMNIA: UNDERSTANDING THE CAUSES, SYMPTOMS, AND TREATMENT OPTIONS

Insomnia, one of the most common sleep disorders worldwide, affects between 10 and 15 percent of the population, with a significantly higher prevalence among women during and after menopause, as well as older adults. Studies show that as many as half of elderly individuals experience some form of sleep difficulty.

The condition is characterized by problems falling asleep, staying asleep, or achieving restorative sleep. Insomnia may be short-term, lasting for days or weeks, or chronic when symptoms persist for three months or longer.

Common symptoms include difficulty falling asleep, often spending a long time awake in bed before finally drifting off, frequent awakenings during the night with trouble returning to sleep, restless sleep, and waking up earlier than intended.

Diagnosing insomnia requires a comprehensive evaluation of a patient's medical history, including detailed questions about sleep habits and daily routines. A physical examination is also important to rule out other medical or mental health conditions that may contribute to sleep disturbances. In certain cases, sleep studies such as polysomnography may be recommended to ensure an accurate diagnosis.

One of the most widely used tools for assessing sleep quality is the Pittsburgh Sleep Quality Index (PSQI). This self-assessment questionnaire is considered one of the most reliable subjective measures of sleep quality. It consists of 24 questions that evaluate seven different dimensions, including sleep quality, sleep latency, sleep duration, sleep efficiency, sleep disturbances, the use of sleep medication, and daytime dysfunction.

Each question is scored on a scale from 0 to 3, where 0 represents the best outcome and 3 the worst. For example, sleeping more than seven hours scores 0, while sleeping less than five hours scores 3. The total PSQI score ranges from 0 to 21. A score between 0 and 4 indicates good sleep quality, whereas scores between 5 and 21 suggest poor sleep. Despite its simplicity, the PSQI is recognized for its high reliability and validity in measuring sleep quality.

When insomnia becomes persistent, treatment should be considered. Various medications may help improve both sleep onset and sleep maintenance. These include drugs that regulate the sleep-wake cycle, non-benzodiazepine and benzodiazepine medications, melatonin receptor agonists, and certain antidepressants that have sedative effects. Some other medications are also used, although evidence supporting their effectiveness remains limited.

Experts emphasize that early recognition of insomnia and appropriate treatment can significantly improve quality of life, daily functioning, and overall health.