As I said in prior segments, insomnia often
has a different underlying cause where insomnia merely becomes, sort of, a symptom of the
cause. People with obstructive sleep apnea often arrive in a sleep disorders office reporting
insomnia or daytime fatigue. The insomnia is coming from the multiple awakenings that
they are having during the night due to apneas and hypopneas. It’s not truly a case of insomnia.
Once all diagnostic tests are performed and reviewed, generally this can be shown to the
patient and a different course of treatment can be taken that rarely has little to do
with actual insomnia. People with depression and bipolar disorder, both treated and untreated,
often experience forms of insomnia. It’s not uncommon, in the manic stages of bipolar,
for a person to sleep very little or not want to sleep at all. Even once the mania is treated,
it’s not uncommon for the drugs that get used in that treatment to cause disruptions in
sleep or cause a change in the quality of sleep. Certain people with schizophrenia and
older atypical anti-psychotics will have sleep issues or just feel that they don’t sleep
as well as others. Again, it’s a thing that’s hard to differentiate because you don’t always
know what a schizophrenic patient is reporting. Even the most lucid and medicated ones still
may not have a good sense of what’s going on at night or why they’re sleeping poorly.
People with restless leg syndrome, of course, generally aren’t sleeping well even once they
get to sleep because their legs are moving and twitching. They’re having issues and their
bodies can’t fully relax. So, it’s important to rule-out the causes of insomnia. Thyroid
issues can be a problem. Women sometimes experience insomnia during pregnancy. It is important
to rule-out these secondary causes of insomnia and treat them before treating a patient primarily
with sedatives and other drugs that can cause physical and psychological dependence. It’s
just more efficient to treat underlying problems and eliminate any sort of dysfunction that
they’re creating in a patient’s life.