DSM-V classification identifies nearly all mental disorders health practitioners encounter in the course of their careers. Moreover, DSM-V also provides a comprehensive way of diagnosing these disorders. This paper diagnoses insomnia disorder by focusing on the various components outlined by the DSM-V criteria.
Insomnia Disorder
Broadly, insomnia falls under the sleep-wake disorder, and conditions under the broad category present patients with sleep-wake complaints. Most patients with sleep-wake disorders feel dissatisfied with the quality, amount, and timing of sleep, and the dissatisfactions make them develop distress and certain forms of impairment (APA, 2013). Such distress and impairments in these individuals make them prone to depression, anxiety, and cognitive changes, and when persistent, develop into mental disorder or substance disorder (APA, 2013). Sleep-wake disorders may also be early symptoms of some mental disorders; therefore, it could allow for the intervention of these mental disorders when noticed early.
Delegate your assignment to our experts and they will do the rest.
Insomnia disorder, as mentioned, falls under sleep-wake disorder occurs when individuals predominantly complain of being dissatisfied with the quality and quantity of sleep they receive. Patients with this condition have difficulties initiating sleep, maintaining sleep as frequent awakenings characterize their periods of sleep or waking up very early, and not going back to sleep (APA, 2013). These difficulties, especially as they deprive patients of enough sleep, may cause distress and impairments to patients' social lives, such as education and work ( Heyat , 2017). For a sleep-wake condition to be categorized as insomnia, the sleep difficulties occur in patients despite them having the opportunity to sleep and must occur for three nights a week for a continuous three months. This difficulty should not be because of the physiological effects of substance abuse and have no association with sleep-wake difficulties occurring when one already suffers another sleep-wake disorder such as when patients suffer parasomnia.
Diagnosis
APA (2013) establishes that when diagnosing insomnia disorder, it is essential to establish whether the disorder is occurring independently or is associated with another mental disorder (comorbid). The establishment is necessary because insomnia in most cases manifest from other mental illnesses such as depressive disorder and become more predominant than the initial disorder; therefore, it is necessary because concurrent insomnia can only be diagnosed if it is severe to warrant a clinical condition; however, when not severe insomnia should not be diagnosed.
Diagnosis of primary insomnia, which is not attributable to other mental disorders, should conform to DSM V standards. Health practitioners can obtain patients' reports for diagnosis through sleep studies, sleep habits review, and thorough physical exams.
Sleep Study
Patients being dissatisfied with the quality and quantity of sleep or inabilities to maintain and start sleep characterize insomnia. This dissatisfaction leads to distress, which causes several social impairments and, at times, insomnia may occur in other mental disorders.
Sleep Habits Review
This disorder can manifest in patients at different times; initial insomnia makes sleep initiation a problem, middle insomnia makes patients frequently awake during sleep, and late insomnia makes patients wake up very early. These manifestations alternate in patients suffering from this disorder.
Physical exams
The exams can incorporate obtaining data from sleep diaries, polysomnographic, actigraphy, mental health exams, and the Epworth sleepiness scale. All they come from patients' subjective report or caretakers reports. These reports, which give the frequency and duration of sleep, are necessary for diagnosing insomnia and should involve quantitative criteria to illustrate sleep qualities. The exams only occur in patients who face distress and impairments because they have difficulties sleeping at night. Insomnia disorder patients complain of fatigue, decreased energy depressions, and more effort required to maintain cognitive performance and cognitive and physiological arousals.
Diagnosis Criteria
There is no established method for testing insomnia; therefore, DSM-V acts as a reference point in making conclusions based on the stated symptoms. The patients, therefore, must meet;
Unhappy with the quality and quantity of sleep they get, including finding it hard to fall asleep, staying asleep for longer hours, and abnormally waking up early with the inability to fall back to sleep.
Due to the sleep pattern disturbance, the patient faces distress and impairments, affecting their social functioning, personal life, emotions, and behaviors.
The disturbance occurs at least three times a week and for three months.
Sleep disturbance occurs even though the patient has ample time to sleep.
The disturbance is not because of other disorders.
The disturbance is not caused by medication or substance abuse.
Treatment
Management and treatment of insomnia incorporate both pharmacologic and psychologic treatment methods. These methods help manage insomnia by reducing the number of awakening in patients, increasing sleep times, and reducing sleep onset latency. Pharmacologic treatment methods involve both prescribed drugs and non-prescribed drugs. The primary non-prescription drug in the market and popular with insomnia disorder patients is melatonin, which is believed to induce sleep. Prescription drugs for insomnia include benzodiazepines, trazodone, antihistamines, and antipsychotics, among others ( Riemann et al., 2017) . Psychologic treatment methods are used to make patients engage in sleeping and avoid non-sleeping activities, and they include stimulus control therapy, sleep hygiene education, and sleep restriction therapy.
Personal Perception About Working With Patients Of Insomnia As A Human Service Worker
Even though they may present average challenges to the health worker, working with insomnia patients is not as bad as other mental conditions. Patients with this disorder only lack sleep and can do most of their daily tasks by themselves unless suffering from other conditions or disabilities. This means that as a human service worker, the only duty you have for these patients is inducing sleep, which can be through medications or psychological methods. Monitoring, advocating, and coordinating with these patients is relatively easy as they talk and act normally ( Summers, 2015) . Managing this condition does not require complicated procedures as human service workers can themselves through promoting comfort, and relaxations in these patients can promote sleep. Comfort and relation procedures may include providing good night wears and making beds comfortable enough for sleep.
Changes Expected In Treating Insomnia In The Next 5-10 Years
Even though pharmacologic methods have been used for a long time in treating and managing insomnia disorder in patients, they may be banned entirely in the future due to many side effects they cause to these patients. Besides side effects, medications used for insomnia disorder are only reliable for shorter durations, therefore brings the essence of lack of effectiveness in the end ( Riemann et al., 2017) . Polysomnographic, a tool used to carry out physical tests, may be defaced soon as tests under it only check the possibility of insomnia with the environment. In contrast, now, the relationship between insomnia and the environment faces debates.
Insomnia is a mental disorder whose diagnosis, extermination, and treatment, as observed, are very tricky. Insomnia, in most cases, manifest from other mental disorders and become predominant that the initial disorder. Examining a patient's sleep quality is also very tricky because sleep is also affected by other factors such as sleep environment. On treatment, pharmacologic means offer the shortest possible outcomes but have side effects; therefore, psychologic methods should prevail.
References
APA. (2013). DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS 5 .
Heyat, M. B. B. (2017). Insomnia: Medical sleep disorder & diagnosis . Anchor Academic Publishing.
Riemann, B. (2017). European guideline for the diagnosis and treatment of insomnia. Journal of Sleep Research , 26 (6), 675–700. https://doi.org/10.1111/jsr.12594.
Summers, N. (2015). Fundamentals of Case Management Practice: Skills for the Human Services . Cengage Learning.
