Insomnia Overview
Insomnia is considered as the inability to sleep or to sleep satisfactorily, Insomnia is the most common sleep disorder. It involves difficulty falling asleep and staying asleep. Almost everyone goes through bouts of sleeplessness from time to time. But if someone struggles to fall asleep or wakes up at night or early in the morning and finds it difficult to fall back asleep and this happens at least three times a week for a few months, that person is likely suffering from chronic insomnia.
According to the American Association of Sleep Medicine, occasional insomnia is experienced by more than a third of American adults, and chronic insomnia is known to plague more than one in 10. Insomnia can disturb your waking as well as your sleeping hours. It can get you to feel sleepy or fatigued during the day, affect your mood, and result in trouble focusing on tasks. Recent research into physical and psychological factors, lifestyle, and the environment is making it possible for the sleep doctors to help most troubled sleepers. Looking at both the daytime and the night time effects of insomnia can help you and your sleep doctor understand the causes of this condition and provide a basis for treating the disorder.
If a person has experienced sleeping difficulties for a month or more, this is called persistent or chronic insomnia. There are many causes of persistent insomnia. These include:
Primary sleep disorders – include circadian rhythm disorders, central sleep apnea-insomnia syndrome, inadequate sleep syndromes, and periodic limb movement or restless legs syndromes.
Secondary insomnia – due to a range of medical and psychiatric problems and the chronic use of drugs and alcohol.
Idiopathic insomnia – sleeplessness without a known cause, formerly called childhood-onset insomnia.
Insomnia Symptoms
Symptoms vary from restless or disturbed sleep to difficulty falling asleep, to a reduction in the usual time spent sleeping. In the extreme, it may involve the total inability to sleep for days at a time. Insomnia may cause daytime fatigue and reduced energy levels. People with insomnia may also experience weakened coping skills, difficulty paying attention, concentrating memory problems, and trouble to perform even routine tasks. But most of all, insomnia affects mood.
The chronic sleep disruption of insomnia appears to be a major trigger for depression and irritability especially in women. Women are especially sensitive to irregular sleeping habits because of the hormonal changes they experience during pregnancy and perimenopause. Studies indicate that about one in four women is currently experiencing insomnia symptoms. Insomnia can cause women to have more accidents, with falls being especially common, especially for the elderly. Women with insomnia are at increased risk for certain health problems, including diabetes and high blood pressure. Women are also more likely to suffer from depression, which is linked to sleeplessness.
Depression is a major cause of insomnia, and yet it can also result from insomnia. For some people, depressive symptoms will appear before the onset of sleeping problems, while others will notice insomnia symptoms first. Due to the similarity of symptoms, insomnia can be misdiagnosed as depression, and vice versa. The mood-sleep connection often plays out in a frustrating cycle for sufferers of either condition: Anxiety and rumination keep them up at night, and the lack of restorative sleep triggers a worse state of mind the next day.
Insomnia Treatment
Insomnia that has persisted for months or years needs professional support from a sleep doctor and a lot of patience from the patient. It might take some time to re-establish normal sleeping patterns. Stress is the primary cause of insomnia, but there are also physical conditions and other factors that can bring it on. A doctor should rule these out first. They include sleep apnea, overactive thyroid, certain medications, and gastrointestinal problems, such as gastroesophageal reflux. Lack of sufficient physical activity during the day can interfere with the body’s drive for sleep. Substance abuse can also be a major sleep disruptor.
Some of the techniques used by a sleep doctor may include, a sleep diary, to help pinpoint the pattern of insomnia, a program of mild sleep deprivation, medication to help set up a new sleeping routine, exposure to bright light in the morning, Behavioral therapy and Short-acting sleeping pills may improve sleep and next-day alertness
Current non-pharmacologic management of chronic insomnia suggests that stimulus control therapy helps patients with insomnia.
For stimulus control therapy the following instructions are given to reinforce the association between the bed with sleep:
1. Go to bed only when sleepy.
2. Get out of bed when unable to sleep after 20 minutes, go to another room, and return to bed only when sleepy.
3. Do not use the bed for anything except for sleep, with the exception of sexual activity.
4.Get up at the same time every morning irrespective of how much sleep was achieved during the night.
5. Do not nap during the day.
Other therapy options for insomnia that help patients are relaxation training and cognitive behavioral therapy for insomnia (CBT-I). Sleep restriction, paradoxical intention, and biofeedback therapies can also be used. Consultation with a sleep therapist is also available.