The lack of sleep is termed as insomnia and is also known as sleeplessness.Sleep is a periodic state of rest for the body, which is important for its efficient functioning. It gives relief from tension and worries. The amount of sleep varies from individual to individual. Normally 7-8 hours of sleep every night is adequate and normal. Insomnia deprives the person with mental rest and interferes with the daily activities. It is the most common problem among the people of upper classes in urban areas. It is also common among the elderly people as the sleep requirements decreases with aging.
Insomnia is generally classified based on the duration of the problem. Not everyone agrees on one definition, but generally:
- symptoms lasting less than one week are classified as transient insomnia,
- symptoms between one to three weeks are classified as short-term insomnia, and
- those longer than three weeks are classified as chronic insomnia.
Insomnia Causes
Insomnia may be caused by a host 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. Transient insomnia generally last less than seven days; short-term insomnia usually lasts for about one to three weeks, and chronic insomnia lasts for more than three weeks.
Many of the causes of transient and short-term insomnia are similar and they include:
- Jet lag
- Changes in shift work
- Excessive or unpleasant noise
- Uncomfortable room temperature (too hot or too cold)
- Stressful situations in life (exam preparation, loss of a loved one, unemployment, divorce, or separation)
- Presence of an acute medical or surgical illness or hospitalization
- Withdrawal from drug, alcohol, sedative, or stimulant medications
- Insomnia related to high altitude (mountains)
Chronic or long-term insomnia
The majority of causes of chronic or long-term insomnia are usually linked to an underlying psychiatric or physiologic (medical) condition.
Psychological related insomnia
The most common psychological problems that may lead to insomnia include:
- anxiety,
- stress,
- schizophrenia,
- mania (bipolar disorder), and
- depression.
In fact, insomnia may be an indicator of depression. Many people will have insomnia during the acute phases of a mental illness.
Physiological related insomnia
Physiological causes span from circadian rhythm disorders (disturbance of the biological clock), sleep-wake imbalance, to a variety of medical conditions. The following are the most common medical conditions that trigger insomnia:
- Chronic pain syndromes
- Chronic fatigue syndrome
- Congestive heart failure
- Night time angina chest pain from heart disease
- Acid reflux disease (GERD)
- Chronic obstructive pulmonary disease (COPD)
- Nocturnal asthma (asthma with night time breathing symptoms)
- Obstructive sleep apnea
- Degenerative diseases, such as Parkinson's disease and Alzheimer's disease (Often insomnia is the deciding factor for nursing home placement.)
- Brain tumors, strokes, or trauma to the brain
High risk groups for insomnia
In addition to the above medical conditions, certain groups may be at higher risk for developing insomnia:
- travelers
- shift workers with frequent changing of shifts
- seniors
- adolescent or young adult students
- pregnant women, and
- menopausal women
Medication related insomnia
Certain medications have also been associated with insomnia. Among them are:
- Certain over-the-counter cold and asthma preparations.
- The prescription varieties of these medications may also contain stimulants and thus produce similar effects on sleep.
- Certain medications for high blood pressure have also been associated with poor sleep.
- Some medications used to treat depression, anxiety, and schizophrenia.
Other causes of insomnia
- Common stimulants associated with poor sleep include caffeine and nicotine. You should consider not only restricting caffeine and nicotine use in the hours immediately before bedtime but also limiting your total daily intake.
- People often use alcohol to help induce sleep, as a nightcap. However, it is a poor choice. Alcohol is associated with sleep disruption and creates a sense of nonrefreshed sleep in the morning.
- A disruptive bed partner with loud snoring or periodic leg movements also may impair your ability to get a good night's sleep.
Alternative medicine
Non-pharmacologic or non-medical therapies are sleep hygiene, relaxation therapy, stimulus control, and sleep restriction. These also referred to as cognitive behavioral therapies.
Sleep hygiene
Sleep hygiene is one of the components of behavioral therapy for insomnia. Several simple steps can be taken to improve a patient's sleep quality and quantity. These steps include:
* Sleep as much as you need to feel rested; do not oversleep.
* Exercise regularly at least 20 minutes daily, ideally 4-5 hours before your bedtime.
* Avoid forcing yourself to sleep.
* Keep a regular sleep and awakening schedule.
* Do not drink caffeinated beverages later than the afternoon (tea, coffee, soft drinks etc.) Avoid "night caps," (alcoholic drinks prior to going to bed).
* Do not smoke, especially in the evening.
* Do not go to bed hungry.
* Adjust the environment in the room (lights, temperature, noise, etc.)
* Do not go to bed with your worries; try to resolve them before going to bed.
Relaxation therapy
Relaxation therapy involves measures such as meditation and muscle relaxation or dimming the lights and playing soothing music prior to going to bed.
Stimulus control
Stimulus control therapy also consists of a few simple steps that may help patients with chronic insomnia.
* Go to bed when you feel sleepy.
* Do not watch TV, read, eat, or worry in bed. Your bed should be used only for sleep and sexual activity.
* If you do not fall asleep 30 minutes after going to bed, get up and go to another room and resume your relaxation techniques.
* Set your alarm clock to get up at a certain time each morning, even on weekends. Do not oversleep.
* Avoid taking long naps in the daytime.
Sleep restriction
Restricting your time in bed only to sleep may improve your quality of sleep. This therapy is called sleep restriction. It is achieved by averaging the time in bed that the patient spends only sleeping. Rigid bedtime and rise time are set, and patient is forced to get up even if they feel 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 some cases.
Other simple measures that can be helpful to treat insomnia include:
* Avoid large meals and excessive fluids before bedtime
* Control your environment.
o Light, noise, and elevated room temperature can disrupt sleep. Shift workers and night workers especially must address these factors. Dimming the lights in the bedroom, relaxation, limiting the noise, and avoiding stressful tasks before going to bed may be beneficial. (Refer to sleep hygiene and relaxation therapy above.)
o Avoid doing work in the bedroom that should be done somewhere else. For example, do not work or operate your business out of your bedroom and avoid watching TV, reading books, and eating in your bed.
A person's body's circadian rhythm (biological clock) is particularly sensitive to light. Parents who need to sleep during the day may have to make child care arrangements to allow them to sleep.
Tips to help you sleep
* Avoid or limit your use of caffeine (coffee, tea, sodas, chocolate), decongestants, alcohol and tobacco.
* Exercise more often, but don't exercise within a few hours before going to bed.
* Learn to reduce or manage the stress in your life.
* Don't lie in bed worrying about things. Set aside another time just for worrying. For example, spend 30 minutes after dinner writing down what's worrying you and what you can do about it.
* Try eating a light snack before going to bed, but don't eat too much right before bedtime. A glass of warm milk or some cheese and crackers may be all you need.
* Don't nap during the day if naps seem to make your insomnia worse.
Source : http://www.emedicinehealth.com, http://familydoctor.org
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