Karl Doghramji, MD: Insomnia Distinctions


A clinical breakdown of what constitutes primary, secondary, chronic, and acute forms of insomnia.

Though there may not be significant differences between the symptoms of short-term or long-term insomnia, but the weight of duration on a patient may be enough to qualify the distinction.

In an interview with MD Magazine®, Karl Doghramji, MD, a professor at Thomas Jefferson University, explained how months’ worth of insomnia duration—as well as its comorbidities—influence modern definitions of the sleep condition subtypes.

Doghramji will also be moderating a discussion on sleep disorders at the 1st annual International Congress on the Future of Neurology. The Congress, to be held on September 27-28, 2019 in New York City, will feature a rigorous agenda of presentations, question and answer sessions, and lightning rounds highlighting topics across the breadth of neurology.

Included in the agenda is Doghramji’s session, titled “Beyond Counting Sheep: Effective Therapies for Sleep Disorders. Attendees can learn firsthand from experts in the field, as they discuss new insomnia therapeutic approaches, optimal narcolepsy management, and therapeutic abuse risks.

For more information on the Congress and to register, click here. Receive 25% off registration fees with code Neuro19SI.

MD Mag: What are the disparities between acute, chronic, primary, and secondary insomnia?

Doghramji: So we used to make a great deal of acute insomnia and chronic insomnia and the difference between those 2. Acute insomnia is variously defined as being insomnia which lasts around a month or shorter. And long-term, or chronic, insomnia lasts between a month and 6 months, or even longer.

Unfortunately, that distinction has not allowed us to really tease insomnia apart into 2 very diverse categories, because those categories don't seem to have differences in terms of causes. So, acute insomnia could be caused by major depression, and so can long-term insomnia.

But I do think it's important to ask about these durations of insomnia, and their toll on the individual to find out how long they've been suffering with this problem, because the longer one suffers, possibly the greater entrenched insomnia may become, and the more problematic it may become in terms of daytime consequences.

The primary and secondary categorization of course is something which we no longer adhere to. We now call insomnia the comorbid or non-comorbid, because of the understanding or suspicion that insomnia, when it exists with another disorder, may or may not be causing that, may not be caused by that disorder, and may be an independent phenomenon.

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