Insomnia is an extremely common health problem that affects roughly one third of the population per year. It is the inability for an individual to fall asleep and/or to maintain sleep, resulting in nonrestorative sleep. About 10% of adults suffer from insomnia.
Humans require 6 to 10 hours of sleep per night. Less than 4 hours or more than 9 hours of sleep is associated with an increased risk of mortality. Sleeplatency is the time required to fall asleep and is on average 15-20 minutes. Insomnia is associated with involuntary increased sleep latency.
Type of insomnia:
Temporary insomnia: It can happen for a couple of days to people who usually sleep well. Your sleep may be disturbed by noise, shift work, jet lag, or short-term anxiety or depression. Short-term insomnia may last for a few weeks. And it may happen again. You may find it difficult to sleep because you’re worried about something (such as an illness or anxieties about money) or because of an emotional problem (such as the death of someone close to you).
Longer-lasting insomnia: If you’ve had problems sleeping on at least three nights a week for one month or more, you probably have longer-lasting (or chronic) insomnia. Some people don’t sleep well because of a medical or psychiatric condition, such as sleep apnoea, depression or dementia. If you have one of these conditions, you may sleep better if it’s treated.
The main symptom of insomnia is trouble falling and/or staying asleep, which leads to lack of sleep. If you have insomnia, you may:
1. Lie awake for a long time before you fall asleep.
2. Sleep for only short periods.
3. Be awake for much of the night.
4. Feel as if you haven’t slept at all.
5. Wake up too early.
In most cases insomnia — the inability to sleep or inability to sleep well at night — is a symptom, not a disease. It usually reflects some underlying process. While medication is often used to treat insomnia, you should discuss this with your physician first. Insomnia, is, in fact, best dealt with by including cognitive-behavioral therapy. This simply means education about sleep, and a few simple methods that may help patients sleep.
Treatment options for insomnia
Treatment options include behavior and lifestyle changes, medicines, and complementary medicines.
Behavior and lifestyle changes
To improve your sleep, here are some things you can try:
1. Breathing exercises for relaxation.
2. Doing guided imagery to relax.
3. Doing meditation.
4. Doing progressive muscle relaxation.
5. Relaxing your mind and body.
Positive thinking with cognitive-behavioral therapy: Positive thinking, or healthy thinking, is a way to help you stay well or cope with a health problem by changing how you think. Cognitive-behavioral therapy is a type of counseling that can help you understand why you have sleep problems and can show you how to deal with them. Research shows that cognitive-behavioral therapy helps reduce interrupted sleep over time.
Lifestyle changes are simple things you can do that may help you sleep better. These include changing your sleep area or schedule, watching what and when you eat and drink, and being more active. It’s also important to keep regular bedtimes and wake times-7 days a week-and to try to avoid taking naps during the day.
Causes and Risk factors:
Causes of insomnia generally are fall into on of two groups, temporary and chronic insomnia. The causes of temporary insomnia can fill many pages these include stress, pain, unusual sleep environment, too much caffeine, etc. Chronic insomnia needs to be addressed by treating the cause if one can be identified. If no cause is identified (known as idiopathic) then the approach of NeuroResearch Clinics is highly effective in restoring the neurotransmitter levels for optimal sleep control.
Risk Factors: Studies estimate that 25 – 33% of adults experience some insomnia each year. In spite of this widespread problem, however, studies suggest that only about 30% of American adults who visit their doctor ever discuss sleep problems. And, doctors seem rarely to ask patients about their sleep habits or problems.
Psychosocial Problems: Stressful events do not cause insomnia in everyone. However, negative thoughts and attitudes toward events can be significant factors in insomnia. Those with insomnia, however, tend to experience stressful events more intensively than the healthy sleepers.
Gender Factors: Overall, insomnia is more common in women than men, although men are not immune from insomnia. Sleep efficiency deteriorates equally in men and women as they get older.
Risk Factors in Elderly Adults: As people grow older, sleep patterns change. Elderly adults tend to wake up frequently during the night, wake up earlier, and report waking up feeling unrefreshed. There is no gold standard for the normal number of hours of sleep an elderly person needs.
Although age itself does not appear to be a risk factor for insomnia, a number of factors may interfere with sleep as one gets older:
Elderly people are more likely to be sedentary than younger adults. Medical conditions that cause pain or nighttime distress are common in the elderly and pose a high risk for insomnia. They include arthritis, gastrointestinal distress, frequent urination, lung disease, and heart conditions. Neurologic diseases in the elderly, such as restless legs syndrome, Parkinson’s, Alzheimer’s, and other forms of dementia can cause nighttime disorientation, confused wandering, and delirium. Older people often take a number of prescription drugs whose side effects include insomnia. The elderly are prone to grief, depression, and anxiety, emotional factors that can cause sleeplessness.
Lack of sleep at night can lead to excessive sleepiness during the day. Consequences of poor sleep include daytime sleepiness, excessive fatigue, anxiety, impaired mental function, increased risk of falls, and decreased quality of life.
Shift Workers: Shift workers are at considerable risk for insomnia. Over half of shift workers report one or more symptoms of insomnia at least a few nights a week. Workers over age 50 and those whose shifts are always changing are particularly susceptible to insomnia, although night-shift workers also have a high rate of sleeplessness. Night shift workers are at risk for falling asleep on the job at least once a week, implying that their internal clocks do not adjust to unusual work times. (They are also at much higher risk than other workers for automobile accidents due to their drowsiness and may also have a higher risk for health problems in general.)
The diagnosis of insomnia is made by a physician based on the patient’s reported signs and symptoms. The doctor relies on the person’s report of a problem falling or remaining asleep. It can be useful for the patient to keep a daily record for two weeks of sleep patterns, food intake, use of alcohol, medications, exercise, and any other information recommended by the physician. If the patient has a bed partner, information can be obtained about whether the patient snores or is restless during sleep. This, together with a medical history and physical examination, can help confirm the doctor’s assessment.
Determining the causes or the severity of insomnia is less straightforward. A wide variety of healthcare professionals can recognize and treat insomnia, but when a patient with chronic insomnia does not respond to treatment, or the condition is not adequately explained by the patient’s physical, emotional, or mental circumstances, then more extensive testing by a specialist in sleep disorders may be warranted. Causes of insomnia are identified by looking closely at a person’s sleep patterns, habits around bedtime, use of drugs, use of cigarettes and alcohol, physical activity, and medical history. This evaluation along with a few common blood tests usually provides all the information the doctor needs. However, if the insomnia continues for more than 6 months and does not improve with treatment, a person may be referred to a sleep laboratory. The person’s brain waves, heart rate, and breathing may be monitored while they sleep. This test, called polysomnography, can help a doctor determine whether a specific sleep disorder (such as periodic limb movements or sleep apnea) is causing the insomnia.
Medicine and medications:
Although so much research has gone into sleep medications and lots of big pharma companies have many products in the market today, most experts say that you should not get too dependant on sleeping pills. Even though sleeping pills do put you to sleep, many frequent users say that they do not refresh the mind like natural sleep does. Plus long term usage of these pills may lead to certain side effects such as amnesia and sleepwalking. So it is always a good idea to try some of the natural therapies first.
However, in many cases, insomnia is caused by another disease or psychological problem. In this case, medical or psychological help may be useful. The most commonly used class of hypnotics prescribed for insomnia are the benzodiazepines. These are minor sedatives and include drugs such as temazepam, diazepam, lorazepam, nitrazepam and midazolam. These medications can be addictive; especially after taking them over long periods of time. Non-benzodiazepine prescription drugs, including the Ambien and Lunesta, are quickly replacing benzodiazepines as a first-line treatment for insomnia, as these drugs show little to no possibility of addiction or dependence. Some antidepressants such as mirtazapine, trazodone and doxepin have a sedative effect, and are prescribed off label to treat insomnia. Low doses of atypical antipsychotics such as quetiapine (Seroquel) are also prescribed for their sedative effect.
Benzodiazepines, such as quazepam (Doral), diazepam (such as Valium), and lorazepam (Ativan): These medicines help you fall asleep or stay asleep.
Antidepressants that have a calming or sedative effect. These can be used to help you sleep.
Antihistamines: Typically used for allergies, these can provide short-term relief of sleeplessness.
Nonprescription medicines for sleep: These can help, but they also can cause side effects, such as drowsiness the next day. Over time, sleeping pills may not work as well as they did when you first started using them.
DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.