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Sömnlöshet, insomni

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Sakkunnig:


Definition:
En subjektiv känsla av dålig sömn trots tillrättalagda förhållanden, och som ger nedsatt funktion dagtid.
Förekomst:
Vanlig problemställning i primärvården. 10 % av den vuxna befolkningen beräknas ha besvär med sömnen.
Symtom:
Insomni kan uppträda sekundärt till både psykiska och medicinska tillstånd. Cirka hälften av de med insomni har en samtida psykisk sjukdom – vanligast är ångest eller depression.
Kliniska fynd:
Vissa patienter kan ha synliga tecken på sömnbrist, men oftast finns det en avsaknad av kliniska fynd.
Diagnostik:
Blodprover kan i vissa fall vara relevant för differentialdiagnostik. Sömndagbok bör användas för att rikta behandlingen mot långvariga sömnproblem. 
Behandling:
Vid primär insomni är sömnrestriktion, sömnhygieniska råd och KBT förstahandsval. Läkemedel kan ges i andra hand som korttidsbehandling.
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  • Athena Adeli, ST-läkare internmedicin, S:t Görans sjukhus
  • Remy Waardenburg, specialist i allmänmedicin, medicinsk redaktör Medibas