| |
Insomnia commonly
occurs secondarily to other conditions (McCrae
and Lichstein, 2001). Secondary insomnia is characterized
by reported poor sleep that is precipitated or worsened by another
disorder, either physical or mental. Secondary insomnia is often
associated with other symptoms, e.g. pain. In fact, the reciprocal
nature of sleep and pain has long been recognized but not carefully
studied. Interestingly in a recent study of pain and hospitalized
burn patients, a night of poor sleep was followed by a significantly
more painful day although the opposite relationship was not observed
(Raymond
et al., 2001).
Insomnia is
a major correlate to other conditions, particularly:
- Musculoskeletal
discomfort (e.g. rheumatoid arthritis or fibromyalgia);
- Neurocognitive
conditions such as Parkinson's disease;
- Cardiovascular
conditions;
- Pulmonary
dysfunction;
- Renal
conditions.
Treatment
for secondary insomnia is generally directed at the primary condition
and insomnia is treated separately only if it is severe or does
not improve with treatment of the primary condition. The associations
between insomnia and various medical conditions, however, have
not been thoroughly investigated. A few studies have shown that
sleep interventions have improved insomnia in patients with cancer,
chronic pain, and various medical problems (McCrae
et al., 2001) but few studies have explored the effects of
improved sleep on other manifestations of a primary condition.
The growing recognition of the effects of sleep on cytokine-immune
functions and the host defense system (Benca
and Quintas, 1997) may fuel the pursuit of greater understanding
of these effects. I believe such studies may show that sleep quality
is closely related to improved healing, disease status, and the
amelioration of other symptoms.
|