Keywords
Abstract
Insomnia is one of the most common sleep disorders, affecting nearly one-third of the adult population worldwide. It is characterized by difficulty initiating or maintaining sleep, early morning awakenings, and impaired daytime functioning. Chronic insomnia is strongly associated with psychiatric conditions, cardiovascular disease, metabolic disorders, and reduced quality of life. The disorder arises from a combination of hyperarousal, circadian rhythm disruptions, and psychosocial stressors, with underlying genetic and neurobiological factors also contributing. Modern research highlights the role of dysregulated hypothalamic-pituitary-adrenal (HPA) axis activity, altered neurotransmitter signaling, and maladaptive cognitive patterns in perpetuating insomnia.
Treatment approaches have evolved significantly, with cognitive-behavioral therapy for insomnia (CBT-I) recognized as the gold standard. Pharmacological agents, such as benzodiazepine receptor agonists, melatonin receptor agonists, and dual orexin receptor antagonists, are widely used but require careful management due to side effects and dependency risks. Non-pharmacological strategies, including mindfulness, relaxation techniques, and digital therapeutics, are increasingly employed as complementary options. This article reviews the mechanisms underlying insomnia, its systemic health effects, and recent advances in therapeutic strategies.
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