Insomnia, Trouble Sleeping, and Complementary and Alternative Medicine

Abstract

Insomnia is a complex and common disorder. According to previous studies,^1-3 it affects anywhere from 10% to 34% of the US population. The recent State of the Science Conference on Manifestations and Management of Chronic Insomnia defined insomnia as “complaints of disturbed sleep in the presence of adequate opportunity and circumstance for sleep.”^2(p1) Several similar, but not identical, definitions of insomnia exist.^2,4,5 Primary insomnia can be defined as insomnia not associated with another identifiable disease. Secondary insomnia is defined as insomnia associated with another disease or disorder. The State of the Science Conference also suggested that secondary insomnia should be renamed comorbid insomnia because it is often not clear that a cause-and-effect relationship exists between the associated condition and insomnia or whether insomnia is the primary or secondary condition in such a relationship. In this regard, recent studies^6-12 suggest that insomnia and other sleep disorders may have more complex relationships with several comorbid diseases than once thought. In some cases, insomnia and other sleep disorders may exacerbate or even be part of the cause of the comorbid condition.^6-12 For example, Suka et al¹² have shown that chronic insomnia is a good predictor of future hypertension in Japanese workers. In addition, Stepanski and Rybarczyk¹⁰ summarized several studies that indicate that insomnia may predict psychiatric disorders, including depression. How these comorbid conditions are related to insomnia on a physiological level is not completely understood.