12/7/2023 0 Comments Acute insomnia guidelines21 The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) calls for the independent clinical importance of a sleep disorder regardless of the presence of a coexisting mental or medical condition. 19, 20 Among individuals with mental disorders, the presence of sleep disturbance independent of the patients' primary condition was also associated with higher symptom severity, higher disorder severity, lower level of functioning, and fewer benefits from treatment. Daytime consequences include increased risks of accidents, decreased work productivity and concentration, and impaired daily performance. The presence of insomnia symptoms can have adverse implications on sufferers in terms of their emotional and mental health and quality of life. 16 In Singapore, the lifetime prevalence of MDD, bipolar disorders, and anxiety disorders was 5.8%, 1.2%, and 3.6%, respectively, 17 whereas the lifetime prevalence of any psychotic experience was 3.8% 18 based on findings from the Singapore Mental Health Study. 13, 14 Lastly, sleep difficulties have been frequently reported among those with schizophrenia, possibly secondary to the hyperarousal caused by positive psychotic symptoms, 15 and approximately 40% of an outpatient sample was found to meet the criteria for clinical insomnia. 12 Insomnia is also prevalent among those with anxiety disorders, particularly among those with generalized anxiety disorder and posttraumatic stress disorder given that sleep disturbance has been identified as a diagnostic criterion for these disorders. 11 In bipolar disorder, the diagnostic criteria indicate that there may be a decreased need for sleep during the manic phase and a decreased inability to sleep during the depression phase with about 69% to 99% of the patients being affected. 9, 10 Insomnia has been recognized as a core symptom of depression. 3, 5 – 8 Depression is by far the most extensively studied in terms of sleep disturbance with more than 90% of individuals with MDD having reported insomnia-related sleep disturbance. 3įew psychiatric disorders have been consistently identified in the sleep literature due to their strong associations with insomnia-major depressive disorder (MDD), bipolar disorder, anxiety disorders, and schizophrenia spectrum disorder. 4 Evidence supporting this interrelationship has found that treating certain psychiatric conditions may help to improve sleep and treating sleep disturbances can have a beneficial effect on their psychiatric treatment. 3 Data from the large-scale Epidemio-logic Catchment Area project revealed that 40% of insomnia sufferers meet criteria for at least one psychiatric disorder, with 23% of them also receiving a diagnosis of major depression or dysthymia 24%, anxiety disorders 7%, alcohol abuse and 4%, drug abuse. The relationship between sleep and mental disorders has been described as complex and is possibly marked by bidirectional causality. 2 Research has shown that insomnia is strongly associated with psychiatric disorders and it can be primary or secondary to a mental disorder. Approximately 50% to 80% of adult patients with mental illnesses had difficulty with falling or staying asleep in a typical year. Of these, chronic sleep problems have been most commonly reported among those with psychiatric disorders. 1 Research in insomnia has been undertaken in different populations and settings, including primary care, outpatient clinics, and the general population. Insomnia is a common sleep problem and is marked by the difficulty in initiating or maintaining sleep or when the sleep that is obtained is nonrefreshing or of poor quality.
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