{"id":6203,"date":"2022-03-17T09:15:55","date_gmt":"2022-03-17T01:15:55","guid":{"rendered":"https:\/\/scc.sg\/e\/?page_id=6203"},"modified":"2022-03-17T09:16:54","modified_gmt":"2022-03-17T01:16:54","slug":"insomnia","status":"publish","type":"page","link":"https:\/\/scc.sg\/e\/insomnia\/","title":{"rendered":"Insomnia"},"content":{"rendered":"<section class=\"av_textblock_section \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock  '   itemprop=\"text\" ><p style=\"text-align: center;\"><a href=\"#insomnia1\"><strong>What is Insomnia?<\/strong><\/a> | <strong><a href=\"#insomnia2\">Symptoms<\/a><\/strong> | <a href=\"#insomnia3\"><strong>Risk Factors &#038; <\/strong><strong>Causes<\/strong><\/a> | <b><a href=\"#insomnia4\">Diagnosis<\/a> <\/b>| <strong><a href=\"#insomnia5\">Treatment<\/a><\/strong> | <strong><a href=\"#insomnia6\">FAQ<\/a><\/strong><\/p>\n<\/div><\/section>\n<div   class='hr hr-short hr-center   avia-builder-el-1  el_after_av_textblock  el_before_av_image '><span class='hr-inner ' ><span class='hr-inner-style'><\/span><\/span><\/div>\n<div  class='avia-image-container  av-styling-    avia-builder-el-2  el_after_av_hr  el_before_av_heading  avia-align-center '  itemprop=\"image\" itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/ImageObject\"  ><div class='avia-image-container-inner'><div class='avia-image-overlay-wrap'><img class='avia_image' src='https:\/\/scc.sg\/e\/wp-content\/uploads\/2021\/12\/insomnia-1-1500x430.jpeg' alt='' title='SCC_Insomnia' height=\"430\" width=\"1500\"  itemprop=\"thumbnailUrl\"  \/><\/div><\/div><\/div>\n<div  id=\"insomnia1\"  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h2    avia-builder-el-3  el_after_av_image  el_before_av_textblock  '><h2 class='av-special-heading-tag '  itemprop=\"headline\"  >What is Insomnia?<\/h2><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div>\n<section class=\"av_textblock_section \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock  '   itemprop=\"text\" ><p><span style=\"font-weight: 400;\">Insomnia is characterised by difficulties falling or staying asleep, and\/or difficulties returning to sleep after early morning awakenings. It is a common condition that can develop into Insomnia Disorder when it becomes associated with significant distress or impairment in daytime functioning, and occurs despite an adequate opportunity for sleep. Marked impairment in function and quality of life, psychiatric and physical morbidity, and accidents are associated with insomnia disorder, leading to serious consequences on an individual\u2019s physical health and wellbeing when not managed properly [<a href=\"https:\/\/dx.doi.org\/10.1002%2Fwps.20674\">1<\/a>].<\/span><\/p>\n<\/div><\/section>\n<div  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h3  blockquote modern-quote  avia-builder-el-5  el_after_av_textblock  el_before_av_heading  '><h3 class='av-special-heading-tag '  itemprop=\"headline\"  >Types of Insomnia<\/h3><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div>\n<div  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h4  blockquote modern-quote  avia-builder-el-6  el_after_av_heading  el_before_av_textblock  '><h4 class='av-special-heading-tag '  itemprop=\"headline\"  >Primary Insomnia<\/h4><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div>\n<section class=\"av_textblock_section \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock  '   itemprop=\"text\" ><p><span style=\"font-weight: 400;\">Primary insomnia refers to difficulties falling and\/or staying asleep that cannot be explained by other existing medical, psychiatric or substance (such as substance abuse or medication) [<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/19768930\/\">2<\/a>].<\/span><\/p>\n<\/div><\/section>\n<div  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h4  blockquote modern-quote  avia-builder-el-8  el_after_av_textblock  el_before_av_textblock  '><h4 class='av-special-heading-tag '  itemprop=\"headline\"  >Secondary Insomnia (Comorbid Insomnia)<\/h4><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div>\n<section class=\"av_textblock_section \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock  '   itemprop=\"text\" ><p><span style=\"font-weight: 400;\">Secondary insomnia is the most common form of insomnia characterised by difficulties sleeping or staying asleep caused or aggravated by other medical (e.g., back problems, headaches, etc.) or psychiatric conditions (e.g., <a href=\"https:\/\/scc.sg\/e\/?page_id=5732\">depression<\/a>, <a href=\"https:\/\/scc.sg\/e\/?page_id=5711\">anxiety<\/a>, etc.) or substances [<a href=\"https:\/\/www.med.upenn.edu\/cbti\/assets\/user-content\/documents\/LichsteinSIreview.pdf\">3<\/a>].<\/span><span style=\"font-weight: 400;\">\u00a0One can determine if he\/she is experiencing secondary insomnia by checking if the severity of the insomnia follows the course of another disorder. For instance,<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Does the beginning of your sleeplessness follow shortly after the onset of another disorder?<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Does your sleeplessness get better after your primary condition improves?<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Insomnia can also be classified based on the duration and frequency of symptoms (DSM-V) [<a href=\"https:\/\/doi.org\/10.1176\/appi.books.9780890425596\">4<\/a>]:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Episodic insomnia (or short-term insomnia, according to the International Classification of Sleep Disorders, ICSD-3): when symptoms last at least 1 month but less than 3 months<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Persistent (or chronic insomnia): when symptoms last for at least 3 months<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Recurrent insomnia: repeated episodes of insomnia within a year, each lasting 1-3 month in duration<\/span><\/li>\n<\/ul>\n<\/div><\/section>\n<div  id=\"insomnia2\"  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h2    avia-builder-el-10  el_after_av_textblock  el_before_av_textblock  '><h2 class='av-special-heading-tag '  itemprop=\"headline\"  >Symptoms of Insomnia<\/h2><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div>\n<section class=\"av_textblock_section \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock  '   itemprop=\"text\" ><p><span style=\"font-weight: 400;\">Some signs of insomnia based on the DSM-V include [<a href=\"https:\/\/doi.org\/10.1176\/appi.books.9780890425596\">5<\/a>]:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Difficulties falling asleep and\/or staying asleep \u2014 constantly waking up at night<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Waking up early and experiencing difficulties returning to sleep<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Fatigue; daytime sleepiness<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Irritability or moodiness<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Difficulties concentrating<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Having poor memory<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Decreased performance at school or work<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\"><a href=\"https:\/\/scc.sg\/e\/?page_id=5711\">Anxiety<\/a> related to sleep<\/span><\/li>\n<\/ul>\n<\/div><\/section>\n<div  id=\"insomnia3\"  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h2    avia-builder-el-12  el_after_av_textblock  el_before_av_heading  '><h2 class='av-special-heading-tag '  itemprop=\"headline\"  >Risk Factors <span class='special_amp'>&amp;<\/span> Causes of Insomnia<\/h2><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div>\n\n<section class=\"av_textblock_section \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock  '   itemprop=\"text\" ><p><span style=\"font-weight: 400;\">Risk factors, also known as predisposing factors, increase one\u2019s vulnerability to insomnia. Exposure to precipitating events like major life change or long-term stress cause individuals predisposed to insomnia to develop sleep difficulties. Some risk factors include (DSM-V):<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Genetic and physiological factors<\/span>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">insomnia occurs more commonly among those who have a family history of insomnia\u00a0<\/span><\/li>\n<\/ul>\n<\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Environmental factors\u00a0<\/span>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">unconducive environments for sleeping such as noise, light, uncomfortably high or low temperature, and high altitude<\/span><\/li>\n<\/ul>\n<\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Temperamental factors\u00a0<\/span>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">Insomnia occurs more among those who have a tendency to ruminate\/have an anxious predisposition\u00a0<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div><\/section>\n<div  id=\"psychotherapy2\"  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h3  blockquote modern-quote  avia-builder-el-15  el_after_av_textblock  el_before_av_textblock  '><h3 class='av-special-heading-tag '  itemprop=\"headline\"  >Causes (Precipitating Factors)<\/h3><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div>\n<section class=\"av_textblock_section \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock  '   itemprop=\"text\" ><p><span style=\"font-weight: 400;\">Causes are also known as precipitating factors that contribute to insomnia. There are many causes of insomnia, but they are difficult to pinpoint with precision given the multitude of factors influencing our body at any given time. Nevertheless, there are still some common causes of insomnia that many experiencing insomnia share:<\/span><\/p>\n<\/div><\/section>\n<div  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h4  blockquote modern-quote  avia-builder-el-17  el_after_av_textblock  el_before_av_textblock  '><h4 class='av-special-heading-tag '  itemprop=\"headline\"  >For Primary Insomnia <\/h4><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div>\n<section class=\"av_textblock_section \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock  '   itemprop=\"text\" ><p><span style=\"font-weight: 400;\">Primary insomnia is not a cause or symptom of another disorder and does not have obvious identifiable causes, unlike secondary insomnia [<a href=\"https:\/\/www.aafp.org\/afp\/1999\/0401\/p1911.html\">6<\/a>]<\/span><span style=\"font-weight: 400;\">.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">While the causes remain unclear, primary insomnia is often related to psychological conditioning that interferes with sleep. Initially, most cases of insomnia develop due to external causes. If sleeplessness continues in the long term, this can cause patients to associate sleep with distress and eventually, lead to a vicious cycle \u2014 as one tries harder to sleep, the more stress and frustration accumulates which further interferes with sleep. This conditioning outcome can persist even after the initial psychiatric or media stressor has been resolved. It can also be perpetuated as long as thoughts and feelings of apprehension, related to difficulties sleeping, continue in the environment one has been struggling to sleep in. As a result, some individuals may find it easier to fall asleep when outside of their bedrooms or outside of their usual routines as opposed to in their own beds (DSM-V) [<a href=\"https:\/\/www.aafp.org\/afp\/1999\/0401\/p1911.html\">7<\/a>]<\/span><span style=\"font-weight: 400;\">.<\/span><\/p>\n<\/div><\/section>\n<div  id=\"psychotherapy2\"  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h4  blockquote modern-quote  avia-builder-el-19  el_after_av_textblock  el_before_av_heading  '><h4 class='av-special-heading-tag '  itemprop=\"headline\"  >For Secondary Insomnia<\/h4><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div>\n<div  id=\"psychotherapy2\"  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h5  blockquote modern-quote  avia-builder-el-20  el_after_av_heading  el_before_av_textblock  '><h5 class='av-special-heading-tag '  itemprop=\"headline\"  >Psychiatric Factors<\/h5><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div>\n<section class=\"av_textblock_section \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock  '   itemprop=\"text\" ><p><span style=\"font-weight: 400;\">Common psychiatric causes of secondary insomnia include [<a href=\"https:\/\/www.med.upenn.edu\/cbti\/assets\/user-content\/documents\/LichsteinSIreview.pdf\">8<\/a>]:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/scc.sg\/e\/?page_id=5711\"><span style=\"font-weight: 400;\">Anxiety<\/span><\/a><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/scc.sg\/e\/?page_id=5732\"><span style=\"font-weight: 400;\">Depression<\/span><\/a><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Panic disorder<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Adjustment disorders<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Somatoform disorders<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Personality disorders<\/span><\/li>\n<\/ul>\n<\/div><\/section>\n<div  id=\"psychotherapy3\"  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h5  blockquote modern-quote  avia-builder-el-22  el_after_av_textblock  el_before_av_textblock  '><h5 class='av-special-heading-tag '  itemprop=\"headline\"  >Physical Factors<\/h5><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div>\n<section class=\"av_textblock_section \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock  '   itemprop=\"text\" ><p><span style=\"font-weight: 400;\">There are many medical conditions that can cause disturbances to sleep such as but not limited to [<a href=\"https:\/\/www.med.upenn.edu\/cbti\/assets\/user-content\/documents\/LichsteinSIreview.pdf\">9<\/a>]:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Asthma<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Pulmonary disease<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Heart disease<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Back problems<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Headaches<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Alzheimer\u2019s disease\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Seizures<\/span><\/li>\n<\/ul>\n<\/div><\/section>\n<div  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h5  blockquote modern-quote  avia-builder-el-24  el_after_av_textblock  el_before_av_textblock  '><h5 class='av-special-heading-tag '  itemprop=\"headline\"  >Substances<\/h5><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div>\n<section class=\"av_textblock_section \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock  '   itemprop=\"text\" ><p><span style=\"font-weight: 400;\">Substances such as prescription and over-the-counter medication, and substance abuse can also interfere with sleep, leading to Secondary Insomnia [<a href=\"https:\/\/www.med.upenn.edu\/cbti\/assets\/user-content\/documents\/LichsteinSIreview.pdf\">10<\/a>].<\/span><\/p>\n<\/div><\/section>\n<div  id=\"psychotherapy3\"  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h4  blockquote modern-quote  avia-builder-el-26  el_after_av_textblock  el_before_av_textblock  '><h4 class='av-special-heading-tag '  itemprop=\"headline\"  >Other Factors<\/h4><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div>\n<section class=\"av_textblock_section \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock  '   itemprop=\"text\" ><p><span style=\"font-weight: 400;\">Insomnia can also be caused by the following:\u00a0<\/span><\/p>\n<ol>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Stress and <a href=\"https:\/\/scc.sg\/e\/?page_id=5711\">anxiety<\/a>: <\/b><span style=\"font-weight: 400;\">Worries and stress resulting from work, school, relationships, health or finances can cause sleep disturbances. Trauma and sudden adverse life events can also result in insomnia. The body\u2019s physical response to stress contributes to hyperarousal, and mental stress can have the same effect [<a href=\"https:\/\/doi.org\/10.1111\/jsr.12710\">11<\/a>].<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Lifestyle factors: <\/b><span style=\"font-weight: 400;\">Insufficient exercise, or consumption of alcohol and caffeine late in the evening or night contribute to difficulty falling asleep.\u00a0 Shift work or jet lag results in poor sleep quality as night shift work forces individuals to sleep at times when activities in our natural environment and our own biological rhythms signal us to be awake [<a href=\"https:\/\/www.winchesterhospital.org\/health-library\/article?id=19705\">12<\/a>].<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Age<\/b><span style=\"font-weight: 400;\">: Researchers have found that people over the age of 60 have less sleep efficiency. They spend less time in deep sleep and Rapid Eye Movement (REM) sleep, which makes it easier for their sleep to be disturbed [<a href=\"https:\/\/doi.org\/10.2174\/1874609809666151130220343\">13<\/a>].<\/span><\/li>\n<\/ol>\n<p><span style=\"font-weight: 400;\">Generally, short-term insomnia is more often related to life stresses, acute illnesses, or medications, whereas chronic insomnia is more likely to be related to behavioural factors or the effects of chronic mental or medical disorders [<a href=\"https:\/\/doi.org\/10.1176\/appi.ajp.2008.08010129\">14<\/a>].<\/span><\/p>\n<\/div><\/section>\n<div  id=\"insomnia4\"  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h2    avia-builder-el-28  el_after_av_textblock  el_before_av_textblock  '><h2 class='av-special-heading-tag '  itemprop=\"headline\"  >Diagnostic Criteria for Insomnia<\/h2><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div>\n<section class=\"av_textblock_section \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock  '   itemprop=\"text\" ><p><span style=\"font-weight: 400;\">According to the DSM-5, the following criteria are to be met to be diagnosed with Insomnia Disorder [<a href=\"https:\/\/doi.org\/10.1176\/appi.books.9780890425596\">15<\/a>]<\/span><span style=\"font-weight: 400;\">:\u00a0\u00a0<\/span><\/p>\n<ol>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">A predominant complaint of dissatisfaction with sleep quantity or quality, associated with one (or more) of the following symptoms:<\/span>\n<ol>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Difficulty falling asleep. (In children, this may manifest as difficulty initiating sleep without caregiver intervention.)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">Difficulty maintaining sleep, characterised by frequent awakenings or problems returning to sleep after awakenings. (In children, this may manifest as difficulty returning to sleep without caregiver intervention.)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">Early-morning awakening with inability to return to sleep.<\/span><\/li>\n<\/ol>\n<\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">The sleep disturbance causes disruption to daily functioning in the social, occupational, educational, behavioural aspects.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Sleep difficulty occurs at least 3 nights per week.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">The sleep difficulty is present for at least 3 months.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Sleep difficulty occurs despite adequate opportunity for sleep.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Insomnia is not better explained by and does not occur exclusively during the course of another sleep-wake disorder (e.g., Narcolepsy, a breathing-related sleep disorder, a circadian rhythm sleep-wake disorder, or\u00a0 parasomnia).<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Insomnia is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication).<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Coexisting mental disorders and medical conditions do not adequately explain the predominant complaint of insomnia.<\/span><\/li>\n<\/ol>\n<p><span style=\"font-weight: 400;\">While insomnia may exist either as an independent condition or a condition comorbid with other disorders, mental health professionals will diagnose individuals with Insomnia Disorder if it causes significant distress and impairments in their daily functioning.<\/span><\/p>\n<\/div><\/section>\n<div  id=\"insomnia5\"  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h2    avia-builder-el-30  el_after_av_textblock  el_before_av_heading  '><h2 class='av-special-heading-tag '  itemprop=\"headline\"  >Treatment of Insomnia<\/h2><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div>\n<div  id=\"psychotherapy4\"  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h3  blockquote modern-quote  avia-builder-el-31  el_after_av_heading  el_before_av_heading  '><h3 class='av-special-heading-tag '  itemprop=\"headline\"  >Pharmacological Treatment<\/h3><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div>\n<div  id=\"psychotherapy4\"  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h4  blockquote modern-quote  avia-builder-el-32  el_after_av_heading  el_before_av_textblock  '><h4 class='av-special-heading-tag '  itemprop=\"headline\"  > Prescription Medication<\/h4><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div>\n<section class=\"av_textblock_section \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock  '   itemprop=\"text\" ><p><span style=\"font-weight: 400;\">For effective treatment of insomnia in the short-term, mental health professionals commonly prescribe Benzodiazepines. Due to side effects including physical dependence, sedation and impairment of motor abilities, they will not recommend long-term consumption [<a href=\"https:\/\/www.aafp.org\/afp\/1999\/0401\/p1911.html\">16<\/a>]. In <\/span><span style=\"font-weight: 400;\">addition, the use of medication in general should be carefully considered if a patient currently is undergoing treatment for existing primary conditions [<a href=\"https:\/\/www.med.upenn.edu\/cbti\/assets\/user-content\/documents\/LichsteinSIreview.pdf\">17<\/a>].<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Other medications used to treat insomnia include [<a href=\"https:\/\/www.aafp.org\/afp\/1999\/0401\/p1911.html\">18<\/a>]<\/span><span style=\"font-weight: 400;\">:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">flurazepam (Dalmane) and quazepam (Doral) which are longer-acting medications that are less likely to result in rebound insomnia, but increases chances of causing daytime sleepiness.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">triazolam (Halcion), temazepam (Restoril) and zolpidem (Ambien) which are shorter-acting medications with effects that discontinue by morning, hence reducing the likelihood of sleepiness during daytime.<\/span><\/li>\n<\/ul>\n<\/div><\/section>\n<div  id=\"psychotherapy4\"  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h4  blockquote modern-quote  avia-builder-el-34  el_after_av_textblock  el_before_av_textblock  '><h4 class='av-special-heading-tag '  itemprop=\"headline\"  >Non-prescription Drugs<\/h4><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div>\n<section class=\"av_textblock_section \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock  '   itemprop=\"text\" ><p><span style=\"font-weight: 400;\">\u200b\u200bMelatonin is a popular choice of remedy for insomnia, however its effectiveness remains controversial. Research has shown its effectiveness in addressing insomnia resulting from circadian schedule changes (e.g., jetlag, shift work changes) by quickening our body\u2019s adaptation process, but there is no research supporting its effectiveness for chronic insomnia. We should be careful with the amount of Melatonin we consume as high doses of melatonin can cause side effects including sleep disruption, daytime fatigue, headache, dizziness and increased irritability. Melatonin is also not controlled for in terms of its purity, concentration and absence of harmful impurities, unlike prescription drugs [<a href=\"https:\/\/www.aafp.org\/afp\/1999\/0401\/p1911.html\">19<\/a>]<\/span><span style=\"font-weight: 400;\">, which could potentially pose additional risks to one\u2019s health.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">As such, while melatonin may be a quick solution for short term adaptation to jet lag of work shift changes, other safer forms of treatment are still recommended.<\/span><\/p>\n<\/div><\/section>\n<div  id=\"psychotherapy4\"  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h3  blockquote modern-quote  avia-builder-el-36  el_after_av_textblock  el_before_av_textblock  '><h3 class='av-special-heading-tag '  itemprop=\"headline\"  >Psychotherapy<\/h3><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div>\n<section class=\"av_textblock_section \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock  '   itemprop=\"text\" ><p><span style=\"font-weight: 400;\">Research has illustrated the effectiveness of psychological intervention on alleviating primary insomnia. Some forms of intervention include [<a href=\"https:\/\/www.med.upenn.edu\/cbti\/assets\/user-content\/documents\/LichsteinSIreview.pdf\">20<\/a>]<\/span><span style=\"font-weight: 400;\">:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\">\n<h4><b>Cognitive therapy<\/b><\/h4>\n<p><b><\/b>It uses techniques to address maladaptive beliefs an individual may hold about sleep.<\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\">\n<h4><a href=\"https:\/\/scc.sg\/e\/?page_id=6168\"><b>Cognitive-behavioural Therapy<\/b><\/a><\/h4>\n<p><b><\/b><span style=\"font-weight: 400;\">It targets beliefs clients may hold about sleep and behavioural patterns that hinder one from falling and\/or staying asleep.\u00a0<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">Some behavioural techniques include <\/span><b>relaxation methods<\/b><span style=\"font-weight: 400;\"> such as progressive muscular relaxation, imagery techniques and body focusing which can help induce feelings of calm and relaxation, both physically and mentally<\/span><\/li>\n<\/ul>\n<\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\">\n<h4><b>Sleep Restriction Therapy<\/b><\/h4>\n<p><span style=\"font-weight: 400;\">It involves restricting time an individual spends in bed to the time he\/she generally spends sleeping before gradually increasing the time spent as the individual\u2019s duration of sleep increases. This helps to accumulate a sleep debt in the initial stages which allows the individual to fall asleep more quickly on subsequent nights [<a href=\"https:\/\/www.aafp.org\/afp\/1999\/0401\/p1911.html\">21<\/a>].<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\">\n<h4><b>Stimulus Control Therapy<\/b><\/h4>\n<p><span style=\"font-weight: 400;\">It comprise a set of instructions to help individuals reassociate bed with sleep by eliminating counterproductive habits that interfere with sleep. The list of instructions include [<a href=\"https:\/\/www.aafp.org\/afp\/1999\/0401\/p1911.html\">22<\/a>] [<a href=\"https:\/\/www.med.upenn.edu\/cbti\/assets\/user-content\/documents\/btsd--stimuluscontrol-bsmtxprotocols.pdf\">23<\/a>]:<\/span><\/li>\n<\/ul>\n<ol>\n<li style=\"list-style-type: none;\">\n<ol>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Try to use your bed only for sleep. This helps your brain associate your bed with rest instead of stimulating activities that are not productive for sleep e.g. watching television or playing games.\u00a0\u00a0\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Go to bed only when you are sleepy. If you find yourself being unable to sleep, get out of bed and leave the bedroom. Return to bed when you are sleepy.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">If you cannot fall asleep within 15-20 minutes upon returning to bed, repeat step 2 as many times as needed until sleep occurs within 15 to 20 minutes.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Get out of bed at the same time every morning regardless of how much you slept. This helps to establish a consistent sleep cycle.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Do not nap during the day or sleep in locations other than your bed.<\/span><\/li>\n<\/ol>\n<\/li>\n<\/ol>\n<p><span style=\"font-weight: 400;\">Overall, pharmacological treatment is effective in addressing insomnia in the short term, but psychological interventions have more lasting effects [<a href=\"https:\/\/www.aafp.org\/afp\/1999\/0401\/p1911.html\">24<\/a>]<\/span><span style=\"font-weight: 400;\">. They also better address chronic insomnia which are typically associated with maladaptive cognitions and behaviours that represent major perpetuating factors. These factors must be addressed therapeutically to achieve a successful long-term outcome [<a href=\"https:\/\/doi.org\/10.1378\/chest.14-0970\">25<\/a>].<\/span><\/p>\n<\/div><\/section>\n<div  id=\"psychotherapy4\"  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h3  blockquote modern-quote  avia-builder-el-38  el_after_av_textblock  el_before_av_heading  '><h3 class='av-special-heading-tag '  itemprop=\"headline\"  >Lifestyle Changes<\/h3><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div>\n<div  id=\"psychotherapy4\"  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h4  blockquote modern-quote  avia-builder-el-39  el_after_av_heading  el_before_av_textblock  '><h4 class='av-special-heading-tag '  itemprop=\"headline\"  >Healthy Sleeping Habits<\/h4><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div>\n<section class=\"av_textblock_section \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock  '   itemprop=\"text\" ><p><span style=\"font-weight: 400;\">Having healthy sleep habits can make it easier for you to fall asleep and stay asleep. This can include [<a href=\"https:\/\/www.nhlbi.nih.gov\/health-topics\/insomnia\">26<\/a>]:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Arranging a conducive sleep environment for yourself by setting a comfortable room temperature while minimising artificial light from electronic devices.\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Having a regular wake and sleep time schedule to prevent sleep disruption.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Abstaining from consuming caffeine, nicotine, and alcohol close to your bedtime. While alcohol may make it easier to fall asleep, it causes sleep to be lighter as well. Hence, people are more likely to be awakened in the middle of the night.\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Adopting healthy coping mechanisms to manage stress. You can set a routine that helps you to relax before bedtime such as reading a book, listening to your favourite music, or meditating.\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Avoid medication that can disrupt sleep if possible.<\/span><\/li>\n<\/ul>\n<\/div><\/section>\n<div  id=\"insomnia6\"  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h2    avia-builder-el-41  el_after_av_textblock  el_before_av_toggle_container  '><h2 class='av-special-heading-tag '  itemprop=\"headline\"  >FAQ<\/h2><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div>\n<div  class=\"togglecontainer   toggle_close_all  avia-builder-el-42  el_after_av_heading  el_before_av_hr \" >\n<section class=\"av_toggle_section\"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\"  >    <div role=\"tablist\" class=\"single_toggle\" data-tags=\"{All} \"  >        <p data-fake-id=\"#toggle-id-1\" class=\"toggler \"  itemprop=\"headline\"    role=\"tab\" tabindex=\"0\" aria-controls=\"toggle-id-1-container\">1. How many hours of sleep is enough?<span class=\"toggle_icon\" >        <span class=\"vert_icon\"><\/span><span class=\"hor_icon\"><\/span><\/span><\/p>        <div id=\"toggle-id-1-container\" class=\"toggle_wrap \"  >            <div class=\"toggle_content invers-color \"  itemprop=\"text\"   ><p>While the amount of rest required varies from person to person, most adults need about 7-8 hours of sleep per day, with teenagers and children needing more [<a href=\"https:\/\/www.helpguide.org\/articles\/sleep\/sleep-needs-get-the-sleep-you-need.htm\">27<\/a>]. Telltale signs of insufficient rest include fatigue, daytime sleepiness, difficulty focusing and irritability.<\/p>\n            <\/div>        <\/div>    <\/div><\/section>\n<section class=\"av_toggle_section\"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\"  >    <div role=\"tablist\" class=\"single_toggle\" data-tags=\"{All} \"  >        <p data-fake-id=\"#toggle-id-2\" class=\"toggler \"  itemprop=\"headline\"    role=\"tab\" tabindex=\"0\" aria-controls=\"toggle-id-2-container\">2. What\u2019s the optimal temperature for sleep?<span class=\"toggle_icon\" >        <span class=\"vert_icon\"><\/span><span class=\"hor_icon\"><\/span><\/span><\/p>        <div id=\"toggle-id-2-container\" class=\"toggle_wrap \"  >            <div class=\"toggle_content invers-color \"  itemprop=\"text\"   ><p><span style=\"font-weight: 400;\">Researchers suggest that bedroom temperatures of 15.5 &#8211; 19.5<\/span><span style=\"font-weight: 400;\">\u00b0C can aid one in falling asleep and achieving quality rest. As our body temperature falls to transition us into a state of sleep, a cooler bedroom can help us fall asleep more easily [<a href=\"https:\/\/www.medicinenet.com\/insomnia_quiz\/faq.htm#faq-5579\">28<\/a>].<\/span><\/p>\n            <\/div>        <\/div>    <\/div><\/section>\n<\/div>\n<div   class='hr hr-default   avia-builder-el-43  el_after_av_toggle_container  avia-builder-el-last '><span class='hr-inner ' ><span class='hr-inner-style'><\/span><\/span><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"content-type":"","footnotes":""},"class_list":["post-6203","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Insomnia - Singapore Counselling Centre<\/title>\n<meta name=\"description\" content=\"Insomnia refers to difficulties falling or staying asleep, and\/or difficulties returning to sleep after early morning awakenings.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/scc.sg\/e\/insomnia\/\" \/>\n<meta property=\"og:locale\" content=\"en_GB\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Insomnia - 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