Fast Five Quiz: Insomnia

Stephen Soreff, MD


June 05, 2020

Alpha-blockers have been linked to decreased rapid eye movement (REM) sleep. REM sleep is also called dream sleep. Reduced REM sleep is associated with difficulty in learning as well as with memory. Likewise, beta-blockers are commonly associated with sleep disturbances, including awakenings at night. Patients with insomnia should undergo a careful medication history, focusing on agents that commonly cause insomnia, including the following additional drugs:

  • Clonidine

  • Theophylline

  • Certain antidepressants

  • Decongestants

  • Stimulants

  • Statins

  • Over-the-counter and herbal remedies

Many clinicians assume that insomnia is often secondary to a psychiatric disorder. Although psychiatric disorders are the most common comorbidities associated with insomnia, they are present in less than half (40%) of all cases. A diagnosis of insomnia does increase the future risk for depression or anxiety.

Women are more likely than men to report insomnia symptoms. Chronic insomnia increases in frequency with age, and is therefore more common in the elderly. Greater psychosocial stressors, losses, and medical illnesses may contribute to the increased incidence of insomnia with age.

Insomnia is often secondary to other disorders or conditions, or is caused by primary sleep disorders such as obstructive sleep apnea, restless legs syndrome, or circadian rhythm disorders. Therefore, it is imperative to take a complete medical history and conduct a thorough physical examination for a patient with insomnia.

Read more about the etiology and epidemiology of insomnia.


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