Insomnia

By Margarita Nahapetyan

Sleep is a normal physiological process that restores us physically, emotionally and intellectually. People who are not able to get a certain amount of sleep are less able to handle stress emotionally and physically.

Most adults have experienced insomnia at one time in their lives. Insomnia is one of the most common medical complaints that includes having trouble falling or staying asleep. In the morning people with insomnia usually are left weak, feel whacked and unable to normally function during the day. Insomnia can undermine not only ones energy level and mood, but also affect health, work performance and quality of life.

It is recommended that adults sleep at least 7 or 8 hours per night in order to maintain good health and good looks. But since people differ widely in their sleep needs, insomnia is not defined by a specific number of hours of sleep that one gets. An estimated 30 to 50 per cent of the general population are affected by insomnia, and 10 per cent have a long-term, or chronic insomnia.

Insomnia affects all age groups. Among adults, women are affected much more often with insomnia than men. Insomnia becomes more prevalent with age. As you get older, changes can occur that may affect your sleep. You may experience a change in sleep patterns, a change in activity, a change in health, the use of medications might have increased, restless leg syndrome and few others. Sleep problems may be a concern for children and teenagers as well. Most of kids and teenagers simply do not like going to sleep or resist a regular bedtime hour because their internal clocks are more delayed. They want to go to bed later and, therefore, sleep later in the morning.

Insomnia may be caused by lots of different reasons. These causes may be divided into situational factors, medical or psychiatric conditions, or primary sleep problems. Insomnia could also be classified by the duration of the symptoms into transient, short-term, or chronic. Symptoms of transient insomnia generally last less than one week, symptoms between one to three weeks are classified as short-term insomnia, and chronic insomnia lasts for more than three weeks.

Many of the causes of transient and short-term insomnia are very similar and they include changes in work shift, excessive or disturbing noise, stressful life situations (e.g. divorce, death), withdrawal from drug or alcohol dependence, jet lag, etc. Coffee, tea, cola and other caffeine-containing drinks are also well-known stimulants. Drinking coffee in the late afternoon can keep a person from falling asleep at night. Nicotine in tobacco products is another stimulant that can trigger insomnia. People often use alcohol to help them fall asleep, as a nightcap. However, it is a poor choice. Alcohol in most cases disrupts sleep and creates a sense of non-refreshed sleep in the morning.

The majority of causes of chronic or long-term insomnia are usually linked to an underlying psychiatric or physiologic (medical) condition.The most common psychological problems that may lead to insomnia include anxiety, stress, bipolar disorder, depression, and schizophrenia. Actually, insomnia may be an indicator of depression. Many people will have insomnia during the acute phases of a mental illness.

Physiological causes range from circadian rhythm disorders (biological clock disturbance), sleep-wake imbalance, to a variety of medical conditions. The most common medical conditions that cause insomnia are chronic pain syndromes, congestive heart failure, night time chest pain from heart disease, asthma with night time breathing difficulties, chronic fatigue syndrome, Parkinson's and Alzheimer's diseases, Brain tumors and strokes.

The main focus of treatment for insomnia should start with determining the cause. Once a cause is being established, it is important to manage and control the current problem, as this alone may eliminate the insomnia. Treating the symptoms of insomnia without addressing the main cause is successful in rare cases.

For dealing with a short-turn insomnia it is a good idea to start sending signals to your mind and body that it should get ready for sleep. Useful aids include soothing music, using oils such as lavender, a warm bath, a glass of milk, meditation and soft lighting in the bedroom. However, all the lights should be turned off when you go to sleep.

For treating psycho-physiological insomnia doctors recommend not to spend more time in bed than the hours needed to sleep. This therapy is called sleep restriction. Nor reading neither watching TV in bed for more than 15 minutes is advised by professionals. Also, it is recommended to reduce smoking, alcohol and caffeine consumption during the day, and specifically cutting the consumption at least three hours before bedtime. Strict bedtime and rise time should be set in order to be forced to get up in the morning even if one feels sleepy. This may help the patient sleep better the next night because of the sleep deprivation for the previous night. Sleep restriction has been helpful in many cases.

In general, treatment of insomnia includes both medical and non-medical aspects. If the condition persists and nothing can be done about it, it is always better to consult a doctor who will assign treatment for individual patient based on the potential cause. Studies have shown that combining medical and non-medical treatments typically is more successful in treating insomnia than either one alone.