Insomnia: Encyclopedia - Insomnia

Insomnia

Insomnia is characterized by an inability to sleep and/or to remain asleep for a reasonable period. Most believe that insomnia is, itself, a sleep disorder, but it is not. It is a complaint, as insomniacs typically complain of being unable to close their eyes or 'rest their mind' for more than a few minutes at a time. As opposed to being a sleep disorder, insomnia is most often caused by sleep disorders, but they are not the only causes. Other causes include fear, stress, anxiety, medications, herbs and caffeine. An overactive mind or physical pain may also be the cause of the problem. According to the U.S. Department of Health and Human Services, approximately 60 million Americans each year suffer from insomnia. Insomnia tends to increase with age and affects about 40 percent of women and 30 percent of men [1]. Whatever the case, it is important to find the underlying cause of the insomnia if it is to be cured.

Insomnia - Types of insomnia

There are roughly three different types of insomnia. Insomnia may be classified as transient, acute (short-term), and chronic. Insomnia lasting from one night to a few weeks is referred to as transient. This is generally the case for most people, as one often suffers from jet lag or short-term anxiety. If this form of insomnia continues to occur from time to time, the insomnia is classified to be intermittent. Acute insomnia is the inability to consistently sleep well for a period of three weeks to six months. However, after this time, the person does not experience insomniatic episodes. Insomnia is considered to be chronic, the most serious, if it persists almost nightly for at least a month.

Insomnia - Common causes of insomnia

A person can have primary or secondary insomnia. Primary insomnia is sleeplessness that is not attributable to a medical or environmental cause. Secondary insomnia means that a person is having sleep problems because of something else, such as a health condition, such as generalized anxiety disorder.

The most common sleep disorders which cause insomnia are:

• Sleep Apnea - This is when a sleeping person's breathing is interrupted, thus interrupting the normal sleep cycle. With the obstructive form of the condition, some part of the sleeper's respiratory tract loses muscle tone and partially collapses. People with obstructive sleep apnea often do not remember any of this, but they complain of excessive sleepiness during the day. Central sleep apnea is where the normal central nervous system stimulus to breathe is interrupted, and the individual must actually wake up to resume breathing. This form of apnea is often related to a cerebral vascular condition, congestive heart failure, and premature aging.

• Restless Legs Syndrome (RLS) and Periodic Limb Movement (PLM) - The symptoms of RLS and PLM are often described as a tingling and creeping sensation in the legs which creates a powerful urge to move them. The individual continually moves in bed in an attempt to relieve these unpleasant sensations, resulting in restlessness and consequently lack of sleep. Fortunately for sufferers of the condition, current treatments for this disorder are effective in over 90% of those treated.

• Jet Lag - this is seen in people who travel through multiple time zones on a regular basis, as the time relative to the rising and falling of the sun no longer coincides with the body's internal concept of it, and is also seen in people who consistently work night shifts. See also: circadian rhythm.

• Parasomnia - this includes a number of disorders of arousal or disruptive sleep events including nightmares, sleepwalking, violent behavior while sleeping, and REM behaviour disorder, in which a person moves their physical body in response to events within their dreams. These conditions can often be treated successfully through medical intervention or through the use of a sleep specialist.

A common misperception is that the amount of sleep one requires decreases as they age. This is not necessarily the case. The ability to sleep for long periods, rather than the need for sleep, appears to be lost as people get older. Some elderly insomniacs toss and turn in bed and occasionally fall off the bed at night, diminishing the amount of sleep they receive. [2]

Insomnia is a common side-effect of some medications, and it can also be caused by stress, emotional upheaval, physical or mental illness, dietary allergy and poor sleep hygiene. Insomnia is a major symptom of mania in people with bipolar disorder, and it can also be a sign of hyper-thyroidism, depression, or other ailments with stimulating effects.

Additionally, a rare genetic condition can cause a prion-based, permanent and eventually fatal form of insomnia called Fatal Familial Insomnia.

Insomnia - Treatment for insomnia

Many insomniacs rely on sleeping tablets and other sedatives to try to get some rest. Others use herbs such as valerian, chamomile, lavender, hops, and/or passion-flower.

Some traditional remedies for insomnia have included drinking warm milk before bedtime; taking a warm bath in the evening; exercising vigorously for half an hour in the afternoon; eating a large lunch and then having only a light evening meal at least three hours before bed; avoiding mentally stimulating activities in the evening hours; and paradoxically, making sure to get up early in the morning and to retire to bed at a reasonable hour.

Traditional Chinese medicine practitioners have been treating insomnia sufferers for thousands of years. A typical approach may utilize acupuncture, dietary and lifestyle analysis, herbology and other techniques, with the goal to resolve the problem at a subtle level.

Although they may seem unscientific, many of these remedies are sufficient to break the insomnia cycle without the need for sedatives and sleeping tablets. Warm milk contains high levels of tryptophan, a natural sedative. Using aromatherapy, including Lavender oil and other relaxing essential oils, may also help induce a state of restfulness.

The most commonly used class of hypnotics prescribed for insomnia are the benzodiazepines. This includes drugs such as diazepam, lorazepam, nitrazepam and midazolam.

The more relaxed you are the greater the likelihood of getting a good night's sleep. Relaxation techniques such as meditation have been proven to help sleep. They take stress from the mind and body which leads to a deeper more restful sleep.

Please note that the advice given below is not a substitute for a professional medical specialist's advice.

• Sufferers of insomnia should avoid all caffeine. Caffeine is often a factor in insomnia, including insomnia in night-shift workers. Caffeine is found in coffee, tea, yerba mate (Ilex paraguaiensis), guarana, cocoa (although cocoa does not contain any caffeine, it contains another stimulant, theobromine), Kola nut (this includes all cola drinks); it is also found in "energy" sodas like Red Bull and similar, chocolate bars and other candy. Drink herbal teas or plain water instead of caffeine-containing liquids.

• The bedroom environment should be conducive to sleep. Some people are very sensitive to light while others are sensitive to noise. The bedroom should be dark and quiet at night.

• Try to avoid thinking of worries, fears and perhaps phobias. Such concerns are likely to prevent the mind from resting and may be exaggerated. It is a good idea to write down any particular worries that are bothering you, keeping a diary or noting down your emotions and thoughts can be very cathartic and any particular worries can be revisited and dealt with at a more appropriate time.

For phobias try to clear them from your mind and repeat positive thoughts or imagine calming scenes (relaxing by a beach, waterfall, a happy memory etc)

• Calm, relaxing music can help as it gives you something neutral to focus on and some are reported to relax you by tuning your brain in to certain rhythms, allowing you to fall into a deeper sleep.

• Practice good sleep hygiene. Do not use the bed for too many activities besides sleep. Using the bed for reading, writing, watching TV and other such non-sleep-related activities will lower your association of the bed with sleeping. Similarly, try to keep to a regular schedule of what time to go to bed and what time to wake up. Try not to sleep during the daytime.

• Sleep apnea can be a cause of insomnia. While a visit to the doctor will help in the diagnosis or ruling out of sleep apnea, a definitive answer will have to come from a study at a sleep lab.

• Sometimes lack of sleep is indicative of an emotional problem that's not being dealt with. If a person is not happy with their lifestyle, or they are putting off problems that should be dealt with, it can often result in sleeping trouble. Just as the human body has nutritional requirements, all people have social and environmental requirements. Sometimes more social activities can help.

• Patients with depression may suffer from insomnia. A doctor can treat this, sometimes by changing or adding prescriptions.

• Sexual activity before sleep can help some.

• Obscure allergies, such as dairy allergies, can sometimes cause sleeping disorders. Other symptoms may be very mild, such as slightly stuffed sinuses. A nutritionist can make helpful dietary and supplement recommendations.

• If an alarm has been set, avoid looking at the clock during the night and cover the display if necessary. This prevents mental calculations of how much sleep has been lost so far and how little sleep can be obtained before the alarm will sound. Accepting that the amount of sleep obtained can only be determined upon waking, not while waiting to get to sleep, may also be beneficial.

Insomnia - A multifaceted approach

Most people who have cured their insomnia have done so by reviewing and experimenting with many different cures. Often, a combination of dietary and lifestyle changes is the most helpful approach. As with many similar health problems, a determined, across-the-board holistic approach to sleeping problems is the most effective solution.

See also

• Sleep deprivation

Adapted from the Wikipedia article "Insomnia", http://en.wikipedia.org/wiki/Insomnia, used and available under the GNU Free Documentation License.