![]() Some cases of insomnia are not really insomnia in the traditional sense, because people experiencing sleep state misperception often sleep for a normal amount of time. Nocturnal polyuria, excessive night-time urination, can also result in a poor quality of sleep. Major depression leads to alterations in the function of the hypothalamic–pituitary–adrenal axis, causing excessive release of cortisol which can lead to poor sleep quality. ![]() Poor sleep quality is defined as the individual not reaching stage 3 or delta sleep which has restorative properties. Poor sleep quality can occur as a result of, for example, restless legs, sleep apnea or major depression. Some of these symptoms include tension, compulsive worrying about the future, feeling overstimulated, and overanalyzing past events. Anxiety symptoms may well lead to insomnia. Early morning awakening is often a characteristic of depression. Įarly morning awakening is an awakening occurring earlier (more than 30 minutes) than desired with an inability to go back to sleep, and before total sleep time reaches 6.5 hours. Two-thirds of these patients wake up in the middle of the night, with more than half having trouble falling back to sleep after a middle-of-the-night awakening. It is common for patients who have difficulty falling asleep to also have nocturnal awakenings with difficulty returning to sleep. Delayed sleep phase disorder can be misdiagnosed as insomnia, as sleep onset is delayed to much later than normal while awakening spills over into daylight hours. Sleep onset insomnia is difficulty falling asleep at the beginning of the night, often a symptom of anxiety disorders.
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