Middle-of-the-Night Insomnia

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Middle-of-the-Night Insomnia (MOTN) is insomnia characterized by difficulty returning to sleep after awakening in the middle of the night. Also referred to as nocturnal awakenings, middle of the night awakenings and middle insomnia, this category of insomnia is different from initial or sleep-onset insomnia, which is a difficulty falling asleep at bedtime.

Due to the disrupted sleep pattern of MOTN insomnia, many sufferers of the condition complain of fatigue the following day. Daytime sleepiness has been noted as being nearly two times higher in individuals with nocturnal awakenings compared to those without awakenings. [1]


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[edit] Prevalence

Waking up in the middle of the night, or nocturnal awakening, is the most frequently reported insomnia symptom, with approximately 35% of Americans over 18 reporting MOTN three or more times per week.1 Of those who experience nocturnal awakenings, 43% report difficulty in resuming sleep after waking, while over 90% report the condition persisting for more than six months. Greater than 50% contend with MOTN conditions for more than 5 years.

In the 2008 “Sleep in America” poll, conducted by the National Sleep Foundation, 42% of respondents said they were awake a lot during the night at least a few nights a week, and 29% said they woke up too early and couldn’t get back to sleep. [2] Other clinical studies have reported between 25% and 35% of people experience nocturnal awakenings at least 3 nights a week. [3]


[edit] Common Causes of Middle of the Night Awakenings

  • Pain
  • Difficulty Breathing
  • Need to use the bathroom
  • Children
  • Hunger or Thirst
  • Dreams
  • Noise

Nocturnal awakenings are more common in older patients and have been associated with depressive disorders, chronic pain, obstructive sleep apnea, obesity, alcohol, hypertension, gastro-esophageal reflux, heart disease, menopause and bipolar disorders. [4]


[edit] Treatment

Middle-of-the-Night Insomnia is often treated with sleep medication. Because most medications usually require 6-8 hours of sleep to avoid lingering effects the next day, these are often used every night at bedtime to prevent awakenings in patients with MOTN. There are no current FDA approved medications specifically for administration after a MOTN awakening.


[edit] References

  1. ^ “Nocturnal awakenings and comorbid disorders in the American general population” - Journal of Psychiatric Research (in press), Maurice M. Ohayon, MD, DSc, PhD. Retrieved on 2008-05-06.
  2. ^ 2008 Sleep in America Poll. Retrieved on 2008-05-06.
  3. ^ “Epidemiology of Insomnia: What We Know and What We Still Need to Learn.” – Sleep Medicine Reviews 2002; 6:97-111, Maurice M. Ohayon, MD, DSc, PhD. Retrieved on 2008-05-06.
  4. ^ “Daytime pharmacodynamic and pharmacokinetic evaluation of low-dose sublingual transmucosal zolpidem hemitartrate”- Human Psychopharmacology: Clinical and Experimental, 2008;23(1):13-20, Thomas Roth, David Mayleben, Bruce C. Corser, Nikhilesh N. Singh. Retrieved on 2008-05-27.