Insomnia is a poor quality sleep. This may mean a lack of sleep or difficulty staying asleep. Some have trouble falling asleep, or problems waking in the middle of the night or very early in the morning. It may be characterized as:
There are many causes.
Transient and intermittent insomnia generally occur in people who are temporarily experiencing one or more of the following:
Chronic insomnia sometimes results from the following conditions:
Chronic insomnia may also be due to behavioral factors, including:
In addition, the following behaviors have been shown to perpetuate insomnia in some people:
This results from a person not getting enough sleep due to life circumstances. The person may be working more than one job or working and going to school at the same time. As a result they do not get enough sleep every day, over a longer period of time. This may lead to daytime sleepiness. It can also lead to problems with focus and muscle aches and pains.
Factors that increase your chance of getting a disease or condition:
Symptoms include:
The doctor will ask about your symptoms and medical history. A physical exam will be done. You will also be asked about your job, eating habits, and drug and alcohol use. The doctor will also ask about your schedule and travel patterns. You may be asked to keep a sleep diary. This will include information about your naps, bedtime, and how often you awaken during the night.
Certain types of insomnia or severe daytime sleepiness may be observed in a sleep lab. You will spend the night in a special center. Your movements, breathing, and brain activity are monitored. This will allow your doctor to identify a treatable condition that is affecting your sleep.
A number of physical and mental disorders can disrupt sleep. Diagnosis and treatment of underlying illness, such as restless legs syndrome , may prevent insomnia.
Sleeping pills are available by prescription or over the counter. Some doctors advise against the long-term use of sleeping pills. They may cause dependence.
Proper prescription sleep medicine can be effective. They should not interfere with memory, work functioning, or daytime drowsiness.
Most over-the-counter sleep medications contain diphenhydramine (Benadryl). This antihistamine will help many people fall asleep more rapidly. It will probably improve sleep quality. Elderly persons may have a variety of adverse effects to this drug. They should discuss its use with their doctor.
Some people use the herb valerian to reduce insomnia. Others take melatonin . In the US, these products do not undergo the same testing as drugs. Their long-term impact, side effects, and possible interactions with other drugs or medical conditions are often unknown.
This may reduce or eliminate anxiety and body tension. therapy. This stops the mind from racing and allows the muscles to relax so that restful sleep can occur. It may include deep breathing, stopping thought, and using progressive relaxation.
A sleep restriction program at first allows only a few hours of sleep during the night. This is usually about five hours. Gradually, the time is increased until a more normal night's sleep is achieved.
Reconditioning helps people associate the bed and bedtime with sleep. This means not using the bed for activities other than sleep and sex. As part of the reconditioning process, the person is usually advised to go to bed only when sleepy.
To reduce your chance of having insomnia:
RESOURCES:
National Center on Sleep Disorders Research
http://www.nhlbi.nih.gov/
National Sleep Foundation
http://www.sleepfoundation.org/
CANADIAN RESOURCES:
The Canadian Sleep Society
http://www.css.to/
Better Sleep Council Canada
http://www.bettersleep.ca/
References:
American Academy of Sleep Medicine website. Available at http://www.aasmnet.org/PatientsPublic.aspx.
American Sleep Apnea Association website. Available at: http://www.sleepapnea.org/.
Insomnia. EBSCO Publishing Health Library, Natural and Alternative Treatments website. Available at: http://healthlibrary.epnet.com/GetContent.aspx?token=da29d243-e573-4601-8b42-77cd0ccb14b2chunkiid=21730. Accessed March 4, 2008.
National Center on Sleep Disorders Research website. Available at: http://www.nhlbi.nih.gov/about/ncsdr/index.htm.
National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/.
National Sleep Foundation website. Available at: http://www.sleepfoundation.org/.
Last reviewed February 2009 by Rimas Lukas, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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