insomnia, abnormal wakefulness or inability to sleep. The condition may result from illness or physical discomfort, or it may be caused by stimulants such as coffee or drugs. However, frequently some psychological factor, such as worry or tension, is the cause. Mild insomnia may often be relieved by a soothing activity like reading or listening to soft music. Chronic or severe insomnia requires treatment of the underlying physical or psychological disorder. In a few, very rare cases, individuals in certain families are subject to an incurable inherited insomia caused by prions that form plaques in the thalamus; the disease appears suddenly in adulthood and ultimately is fatal.
Many patients respond to the assurance that their sleeplessness is a result of normal anxieties or a treatable physical disorder. Opportunities to ventilate anxieties often ease distress and helps resume normal sleeping patterns. Elderly persons are encourage to exercise more during the day; instructed relaxation, administration of tryptophan, and intake of warm milk helps some patients sleep. Sedatives and hypnotics drugs may be employed if the sleeplessness is impairing the subject's sense of well being. Those who wake because of pain receive an analgesic at bedtime; for those who experience insomnia accompanied with depression, an antidepressant often suffices.