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İnsomni: kısa bir gözden geçirme

Yıl 2025, Cilt: 5 Sayı: 1, 6 - 13, 30.06.2025

Öz

İnsomni, yaygın görülmesine rağmen yeterince tanınmayan ve sıklıkla tedavi edilmeyen bir uyku bozukluğudur. Genellikle uykusuzluk, yorgunluk ve baş ya da vücut ağrısı gibi somatik semptomlarla kendini gösterir. İnsomni, tek başına görülebileceği gibi diğer sağlık sorunlarıyla birlikte de ortaya çıkabilir. Psikiyatrik hastalığı olanlar, menopoz gibi geçiş dönemlerinde bulunan bireyler ve yaşlılar gibi hassas gruplarda daha yaygındır. İnsomni tedavisinde bilişsel davranışçı terapi (CBT-I) tercih edilen yöntemdir; ancak semptomların giderilmesinde yaygın olarak farmakolojik tedavilere de başvurulmaktadır. Bu derlemede, insomni ile diğer uyku bozuklukları arasındaki farkların açıklığa kavuşturulması amaçlanmıştır. Ayrıca makalede, uykusuzluğun mekanizmaları ve tedavi yaklaşımları güncel bilgiler ışığında ele alınmaktadır.

Kaynakça

  • Sateia MJ. International classification of sleep disorders-third edition: highlights and modifications. Chest. 2014;146:1387-94.
  • Perlis ML, Posner D, Riemann D, Bastien CH, Teel J, Thase M. Insomnia. Lancet. 2022;400:1047-60.
  • Dopheide JA. Insomnia overview: epidemiology, pathophysiology, diagnosis and monitoring, and nonpharmacologic therapy. Am J Manag Care. 2020;26:76-84.
  • Brown RE, Basheer R, McKenna JT, Strecker RE, McCarley RW. Control of sleep and wakefulness. Physiol Rev. 2012;92:1087-1187.
  • Ahmad SF, Buckley AW, Glaze DG. Neurology of sleep. Neurol Clin. 2021;39:867-82.
  • Winkelman JW. Insomnia disorder. N Engl J Med. 2015;373:1437-44.
  • Colten HR, Altevogt BM, Institute of Medicine (US) Committee on Sleep Medicine and Research, eds. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Washington (DC): National Academies Press (US); 2006.
  • Siegel JM. Clues to the functions of mammalian sleep. Nature. 2005;437:1264-71.
  • de Zambotti M, Cellini N, Goldstone A, Colrain IM, Baker FC. Wearable sleep technology in clinical and research settings. Med Sci Sports Exerc. 2019;51:1538-57.
  • Pace-Schott EF, Spencer RM. Sleep-dependent memory consolidation in healthy aging and mild cognitive impairment. Curr Top Behav Neurosci. 2015;25:307-30.
  • Levenson JC, Kay DB, Buysse DJ. The pathophysiology of insomnia. Chest. 2015;147:1179-92.
  • National Institutes of Health. Sleep; National Institutes of Health State of the Science Conference statement on Manifestations and Management of Chronic Insomnia in Adults; June 13–15, 2005; 2005;28:1049–57.
  • Ohayon MM. Epidemiology of insomnia: what we know and what we still need to learn. Sleep Med Rev. 2002;6:97–111.
  • Ellis JG, Perlis ML, Espie CA, Grandner MA, Bastien CH, Barclay NL, Altena E, Gardani M. The natural history of insomnia: predisposing, precipitating, coping, and perpetuating factors over the early developmental course of insomnia. Sleep. 2021;44(9):zsab095.
  • Krystal AD, Prather AA, Ashbrook LH. The assessment and management of insomnia: an update. World Psychiatry. 2019;18:337–52.
  • Gellis LA, Lichstein KL, Scarinci IC, Durrence HH, Taylor DJ, Bush AJ, Riedel BW. Socioeconomic status and insomnia. J Abnorm Psychol. 2005;114:111–8.
  • Papadopoulos D, Etindele Sosso FA. Socioeconomic status and sleep health: a narrative synthesis of 3 decades of empirical research. J Clin Sleep Med. 2023;19:605–20.
  • Taylor DJ, Mallory LJ, Lichstein KL, Durrence HH, Riedel BW, Bush AJ. Comorbidity of chronic insomnia with medical problems. Sleep. 2007;30:213–8.
  • Mai E, Buysse DJ. Insomnia: prevalence, impact, pathogenesis, differential diagnosis, and evaluation. Sleep Med Clin. 2008;3:167–74.
  • Kessler RC, Berglund PA, Coulouvrat C, Hajak G, Roth T, Shahly V, Shillington AC, Stephenson JJ, Walsh JK. Insomnia and the performance of US workers: results from the America insomnia survey. Sleep. 2011;34:1161–71.
  • Drake CL, Friedman NP, Wright KP Jr, Roth T. Sleep reactivity and insomnia: genetic and environmental influences. Sleep. 2011;34:1179-88.
  • Gehrman PR, Meltzer LJ, Moore M et al. Heritability of insomnia symptoms in youth and their relationship to depression and anxiety. Sleep. 2011;34:1641-46.
  • Wing YK, Zhang J, Lam SP et al. Familial aggregation and heritability of insomnia in a community-based study. Sleep Med. 2012;13:985-90.
  • Wang CC, Lung FW. The role of PGC-1 and Apoε4 in insomnia. Psychiatr Genet. 2012;22:82-7.
  • Brower KJ, Wojnar M, Sliwerska E, Armitage R, Burmeister M. PER3 polymorphism and insomnia severity in alcohol dependence. Sleep. 2012;35:571-77.
  • Zeitzer JM, Fisicaro RA, Grove ME, Mignot E, Yesavage JA, Friedman L. Faster REM sleep EEG and worse restedness in older insomniacs with HLA DQB1*0602. Psychiatry Res. 2011;187:397-400.
  • Serretti A, Benedetti F, Mandelli L et al. Genetic dissection of psychopathological symptoms: insomnia in mood disorders and CLOCK gene polymorphism. Am J Med Genet B Neuropsychiatr Genet. 2003;121B:35-8.
  • Deuschle M, Schredl M, Schilling C et al. Association between a serotonin transporter length polymorphism and primary insomnia. Sleep. 2010;33:343-47.
  • Ban HJ, Kim SC, Seo J, Kang HB, Choi JK. Genetic and metabolic characterization of insomnia. PLoS ONE. 2011;6:e18455.
  • Perlis ML, et al. Cognitive behavioral treatment of insomnia: A session-by-session guide. Vol. 1. Springer Science & Business Media. 2005.
  • Sateia MJ, Buysse DJ, Krystal AD, Neubauer DN, Heald JL. Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: An American Academy of Sleep Medicine Clinical Practice Guideline. J Clin Sleep Med. 2017;13:307-49.
  • Walker J, Muench A, Perlis ML, Vargas I. Cognitive Behavioral Therapy for Insomnia (CBT-I): a primer. Klin Spec Psihol. 2022;11:123-37.
  • Madari S, Golebiowski R, Mansukhani MP, Kolla BP. Pharmacological management of insomnia. Neurotherapeutics. 2021;18:44-52.

Insomnia: a brief review

Yıl 2025, Cilt: 5 Sayı: 1, 6 - 13, 30.06.2025

Öz

Insomnia is a common yet underrecognized and frequently undertreated sleep disorder. It typically manifests with symptoms such as difficulty falling or staying asleep, fatigue, and somatic complaints (e.g., headache or body pain). Insomnia may occur on its own or in conjunction with other health conditions. It is more prevalent among vulnerable populations, including individuals with psychiatric comorbidities, those undergoing transitional life phases such as menopause, and the elderly. Cognitive Behavioral Therapy for Insomnia (CBT-I) is the preferred treatment method; however, pharmacological interventions are also commonly employed to manage symptoms. This review aims to clarify the distinctions between insomnia and other sleep disorders. Additionally, it discusses the underlying mechanisms and treatment approaches for insomnia based on current scientific evidence.

Kaynakça

  • Sateia MJ. International classification of sleep disorders-third edition: highlights and modifications. Chest. 2014;146:1387-94.
  • Perlis ML, Posner D, Riemann D, Bastien CH, Teel J, Thase M. Insomnia. Lancet. 2022;400:1047-60.
  • Dopheide JA. Insomnia overview: epidemiology, pathophysiology, diagnosis and monitoring, and nonpharmacologic therapy. Am J Manag Care. 2020;26:76-84.
  • Brown RE, Basheer R, McKenna JT, Strecker RE, McCarley RW. Control of sleep and wakefulness. Physiol Rev. 2012;92:1087-1187.
  • Ahmad SF, Buckley AW, Glaze DG. Neurology of sleep. Neurol Clin. 2021;39:867-82.
  • Winkelman JW. Insomnia disorder. N Engl J Med. 2015;373:1437-44.
  • Colten HR, Altevogt BM, Institute of Medicine (US) Committee on Sleep Medicine and Research, eds. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Washington (DC): National Academies Press (US); 2006.
  • Siegel JM. Clues to the functions of mammalian sleep. Nature. 2005;437:1264-71.
  • de Zambotti M, Cellini N, Goldstone A, Colrain IM, Baker FC. Wearable sleep technology in clinical and research settings. Med Sci Sports Exerc. 2019;51:1538-57.
  • Pace-Schott EF, Spencer RM. Sleep-dependent memory consolidation in healthy aging and mild cognitive impairment. Curr Top Behav Neurosci. 2015;25:307-30.
  • Levenson JC, Kay DB, Buysse DJ. The pathophysiology of insomnia. Chest. 2015;147:1179-92.
  • National Institutes of Health. Sleep; National Institutes of Health State of the Science Conference statement on Manifestations and Management of Chronic Insomnia in Adults; June 13–15, 2005; 2005;28:1049–57.
  • Ohayon MM. Epidemiology of insomnia: what we know and what we still need to learn. Sleep Med Rev. 2002;6:97–111.
  • Ellis JG, Perlis ML, Espie CA, Grandner MA, Bastien CH, Barclay NL, Altena E, Gardani M. The natural history of insomnia: predisposing, precipitating, coping, and perpetuating factors over the early developmental course of insomnia. Sleep. 2021;44(9):zsab095.
  • Krystal AD, Prather AA, Ashbrook LH. The assessment and management of insomnia: an update. World Psychiatry. 2019;18:337–52.
  • Gellis LA, Lichstein KL, Scarinci IC, Durrence HH, Taylor DJ, Bush AJ, Riedel BW. Socioeconomic status and insomnia. J Abnorm Psychol. 2005;114:111–8.
  • Papadopoulos D, Etindele Sosso FA. Socioeconomic status and sleep health: a narrative synthesis of 3 decades of empirical research. J Clin Sleep Med. 2023;19:605–20.
  • Taylor DJ, Mallory LJ, Lichstein KL, Durrence HH, Riedel BW, Bush AJ. Comorbidity of chronic insomnia with medical problems. Sleep. 2007;30:213–8.
  • Mai E, Buysse DJ. Insomnia: prevalence, impact, pathogenesis, differential diagnosis, and evaluation. Sleep Med Clin. 2008;3:167–74.
  • Kessler RC, Berglund PA, Coulouvrat C, Hajak G, Roth T, Shahly V, Shillington AC, Stephenson JJ, Walsh JK. Insomnia and the performance of US workers: results from the America insomnia survey. Sleep. 2011;34:1161–71.
  • Drake CL, Friedman NP, Wright KP Jr, Roth T. Sleep reactivity and insomnia: genetic and environmental influences. Sleep. 2011;34:1179-88.
  • Gehrman PR, Meltzer LJ, Moore M et al. Heritability of insomnia symptoms in youth and their relationship to depression and anxiety. Sleep. 2011;34:1641-46.
  • Wing YK, Zhang J, Lam SP et al. Familial aggregation and heritability of insomnia in a community-based study. Sleep Med. 2012;13:985-90.
  • Wang CC, Lung FW. The role of PGC-1 and Apoε4 in insomnia. Psychiatr Genet. 2012;22:82-7.
  • Brower KJ, Wojnar M, Sliwerska E, Armitage R, Burmeister M. PER3 polymorphism and insomnia severity in alcohol dependence. Sleep. 2012;35:571-77.
  • Zeitzer JM, Fisicaro RA, Grove ME, Mignot E, Yesavage JA, Friedman L. Faster REM sleep EEG and worse restedness in older insomniacs with HLA DQB1*0602. Psychiatry Res. 2011;187:397-400.
  • Serretti A, Benedetti F, Mandelli L et al. Genetic dissection of psychopathological symptoms: insomnia in mood disorders and CLOCK gene polymorphism. Am J Med Genet B Neuropsychiatr Genet. 2003;121B:35-8.
  • Deuschle M, Schredl M, Schilling C et al. Association between a serotonin transporter length polymorphism and primary insomnia. Sleep. 2010;33:343-47.
  • Ban HJ, Kim SC, Seo J, Kang HB, Choi JK. Genetic and metabolic characterization of insomnia. PLoS ONE. 2011;6:e18455.
  • Perlis ML, et al. Cognitive behavioral treatment of insomnia: A session-by-session guide. Vol. 1. Springer Science & Business Media. 2005.
  • Sateia MJ, Buysse DJ, Krystal AD, Neubauer DN, Heald JL. Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: An American Academy of Sleep Medicine Clinical Practice Guideline. J Clin Sleep Med. 2017;13:307-49.
  • Walker J, Muench A, Perlis ML, Vargas I. Cognitive Behavioral Therapy for Insomnia (CBT-I): a primer. Klin Spec Psihol. 2022;11:123-37.
  • Madari S, Golebiowski R, Mansukhani MP, Kolla BP. Pharmacological management of insomnia. Neurotherapeutics. 2021;18:44-52.
Toplam 33 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Klinik Tıp Bilimleri (Diğer)
Bölüm Derleme
Yazarlar

Özlem Dal 0009-0007-8319-8161

Yayımlanma Tarihi 30 Haziran 2025
Gönderilme Tarihi 30 Nisan 2025
Kabul Tarihi 7 Mayıs 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 5 Sayı: 1

Kaynak Göster

AMA Dal Ö. İnsomni: kısa bir gözden geçirme. Çukurova Tıp Öğrenci Derg. Haziran 2025;5(1):6-13.