Psychiatry
Chronic Insomnia Disorder
만성 불면장애
Difficulty initiating/maintaining sleep ≥3 months, ≥3 nights/week
- How common
- Common
- Typical age
- Variable age
What is it?
Core neurobiological/psychological mechanisms of Chronic Insomnia Disorder.
Commonly affected: Limbic and prefrontal circuits
How it develops
- Genetic/environmental vulnerabilityFamily history and environmental factors for Chronic Insomnia Disorder
- Neural circuit changesAffected brain regions and neurotransmitter dysregulation
- Symptom emergenceCharacteristic mental symptoms appear
- Course/comorbidityCourse depends on treatment and comorbidities
Symptoms
- Characteristic symptomsCore Chronic Insomnia Disorder features
- Affective/behavioral changeAssociated mood/behavior changes
- Functional impairmentSocial/work/academic decline
How it is examined
- DSM-5 criteriaConfirm DSM-5 criteria for Chronic Insomnia Disorder
- Rating scale/suicide riskStandardized rating scale and suicide assessment
Imaging
Mostly clinical diagnosis; brain MRI to rule out organic cause if needed.
- Clinical diagnosis
Research fMRI findings reported; not used for diagnosis.
- Research fMRI changes
Non-surgical care
- PharmacotherapyDiagnosis-specific psychotropic medication
- Psychotherapy (CBT)CBT effective for most conditions
- Psychosocial supportFamily/social support, psychoeducation
Conservative options are generally tried first. Medications listed here can have side effects — discuss them with your prescriber.
When surgery is considered
Treatment-resistant or crisis
Procedures that may be discussed
- Inpatient hospitalization
- ECT/rTMS (if indicated)
- Combination therapy
Outlook
Good with early treatment; risk of chronicity.