Risk Factors & Development
Factors of the 3P model that contribute to the development of insomnia disorder include:
Predisposing factors that place an individual at greater risk of developing insomnia
- Predisposition to anxiety, stress or worry
- Inappropriate expectations about sleep
- Genetic factors
Precipitating factors that trigger/cause the initial sleep disturbance
- Stressful life event including death in family, relationship difficulties, job loss, starting a new job, newborn
- Pain
- Menopause
- Shift work including hospitality work
- Travel between time zones and circadian disruption (daylight savings)
- Environmental factors (noise disturbance, temperature)
- Caffeine and alcohol
- Medication with stimulant properties
- Mental health disorders (which often have a bidirectional relationship with insomnia)
- Medical disorders including respiratory, cardiovascular, endocrine, neurological, gastro-oesophageal reflux, frequent nocturia, and itch
- Other sleep health disorders including obstructive sleep apnea, restless legs syndrome
Perpetuating factors that self-maintain the chronic insomnia over time
- Conditioned insomnia or learned insomnia
- Anxiety about sleep
- Counter-productive compensatory behaviours
- Misperceptions about the quality and quantity of sleep
- Dysfunctional beliefs about sleep
Source: Alexander Sweetman
AHI - Apnoea-Hypopnoea Index
BBTi - Brief Behavioural Therapy for Insomnia
BMI - Body Mass Index (kg/m2)
BQ - Berlin Questionnaire
CBTi - Cognitive Behavioural Therapy for Insomnia
CELL - Coblation Endoscopic Lingual Lightening
COPD - Chronic Obstructive Pulmonary Disease
CVA - Cerebrovascular Accident
CPAP - Continuous Positive Airway Pressure
CSA - Central Sleep Apnoea
DASS - Depression Anxiety Stress Scale
DBAS - Dysfunctional Beliefs and Attitudes about Sleep
DBP - Diastolic Blood Pressure
DIMS - Difficulties Initiating and/or Maintaining Sleep
DISE - Drug-Induced Sleep Endoscopy
DISS - Daytime Insomnia Symptom Scale
ENT - Ear Nose and Throat
ESS - Epworth Sleepiness Scale
FOSQ - Functional Outcomes of Sleep Questionnaire
FSH - Follicle-Stimulating Hormone
FTP - Friedman Tong Position
GP - General Practitioner
HANDI - RACGP Handbook of Non-Drug Interventions
HGNS - Hypoglossal Herve Htimulation
ISI - Insomnia Severity Index
K10 - Kessler Psychological Distress Scale
MAD - Mandibular Advancement Device
MAS - Mandibular Advancement Rplint
MBS - Medicare Benefits Schedule
MMA - Maxillomandibular Advancement Surgery
MRA - Mandibular Repositioning Appliance
ODI - Oxygenation Desaturation Index
OSA - Obstructive Sleep Apnoea
PLMD - Periodic Limb Movement Disorder
PT - Positional Therapy
PTSD - Post-Traumatic Stress Disorder
PSG - Polysomnography
QSQ - Quebec Sleep Questionnaire
REM - Rapid Eye Movement
RFTB - Radiofrequency Thermotherapy of the Tongue Base
SBP - Systolic Blood Pressure
SCI - Sleep Condition Indicator
SE - Sleep Efficiency
SF36 - Short-Form (36) Health Survey
SMILE - Submucosal Minimally Invasive Lingual Excision
SNRIs - Serotonin-Norepinephrine Reuptake Inhibitors
SOL - Sleep Onset Latency
SSRI - Selective Serotonin Reuptake Inhibitors
TFTs - Thyroid Function Tests
TIB - Time In Bed
TORS - Transoral Robotic Surgery
TST - Total Sleep Time
UPPP - Uvulopalatopharyngoplasty
WASO - Wake After Sleep Onset