What is insomnia?
Insomnia is a disorder associated with difficulty falling asleep and characterized be the lack of quality and quantity of sleep required for normal daily activities.
Insomnia can be acute (short-term) or chronic (ongoing). Acute insomnia is common and often is brought on by situations such as stress at work, family pressures, or a traumatic event. Acute insomnia lasts for days or weeks. Chronic insomnia lasts for a month or longer.
What causes insomnia?
Insomnia is usually a manifestation of another disease or condition, it requires understanding and finding causes of sleeping problems. The most common causes of insomnia:
- mental illness,
- disease of inner organs,
- intake of psychotropic drugs,
- alcohol, caffeine, nicotine
- toxic factors,
- hormonal changes,
- syndromes that occur during sleep (sleep apnea syndrome, sleep movement disorders),
- external environmental factors (noise, moisture, etc),
- shift work,
- jet lag,
- violation of sleep hygiene,
- eating too much late in the evening.
Read more: Fatigue - Chronic Fatigue Syndrome
Insomnia symptoms may include:
- Difficulty falling asleep at night
- Awakening during the night
- Awakening too early
- Not feeling well rested after a night’s sleep
- Daytime tiredness or sleepiness
- Irritability, depression or anxiety
- Difficulty paying attention, focusing on tasks or remembering
- Increased errors or accidents
- Tension headaches
- Distress in the stomach and intestines (gastrointestinal tract)
- Ongoing worries about sleep
People suffering from insomnia will often take 30 minutes or more to fall asleep and may get only six or fewer hours of sleep for three or more nights a week over a month or more.
Diagnosis is based on:
- assessment of individual characteristics of a person (an owl or a lark, sufficiency of short or long sleep), the genetic factor may play an important role;
- cultural factors (for example, the siesta is an afternoon nap in countries with hot climate) and occupation (shift work, jet lag);
- the results of psychological research;
- the results of polysomnography (this method involves the simultaneous record of multiple parameters, such as electroencephalography, electromyography, electrooculography – minimal set to assess sleep patterns).
You should change your sleep habits and find out causes of insomnia, it is helpful to restore sleep. If these measures are not effective, your doctor may recommend medications to help with relaxation and sleep.
Here you will learn how to improve your sleeping environment. Good sleep habits promote healthy sleep and daytime alertness. Behavior therapies are generally recommended as the first step of treatment for people suffering from insomnia. Typically they’re equally or more effective than sleep medications.
Behavior therapies include:
- Learning about good sleeping habits.This is known as “sleep hygiene”. Good sleep habits involve having a regular sleep, avoiding any activities before bed, and having an appropriate sleep environment.
- Cognitive behavioral therapy.This type of therapy helps you control or get rid of negative thoughts and worries that keep you awake. It may also involve minimizing false or worrisome beliefs about sleep, for example, the belief that one restless night will make you ill.
- Relaxation techniques.Progressive muscle relaxation, biofeedback, and breathing exercises are ways to get rid of anxiety at bedtime. These methods help you control your breathing, heart rate, muscle tension, and mood.
- Stimulus control helps to build an association between the bedroom and sleep by limiting the type of activities allowed in the bedroom. An example of stimulus control is going to bed only when you are sleepy, and getting out of bed if you’ve been awake for 20 minutes or more. This helps to break an unhealthy association between the bedroom and wakefulness.
- Light Therapy. Some sleep experts use exposure to light for people who tend to fall asleep too early at night or wake too early in the morning. This helps to adjust your internal clock. During times of the year when it’s light outside later in the evenings, going outside for 30 minutes or using a light from a medical-grade light box can help adjust your sleep patterns.
Taking sleeping pills may help you fall asleep. There are many different types of sleep aids for insomnia, including over-the-counter (non-prescription) and prescription medications. Doctors generally don’t recommend relying on sleeping pills for more than a few weeks, but several medications are approved for long-term use.
Sleep medicines include:
- Prescription sleep medicines, such as eszopiclone(Lunesta), ramelteon (Rozerem), zaleplon (Sonata), and zolpidem (Ambien). They are the first-choice medicines for short-term insomnia.
- Orexin receptor antagonists, such as suvorexant (Belsomra). These medicines block chemicals in the brain that keep you awake, helping to promote sleep.
- Benzodiazepines, such as diazepam(such as Valium), lorazepam (Ativan), and quazepam (Doral). These medicines help you fall asleep or stay asleep. You need a prescription for these medicines.
- Antidepressants that have a calming or sedative effect. These can be used to help you sleep. Often insomnia is a symptom of depression, antidepressants are effective to beat depression.
- Antihistamines. Typically used for allergies, these can provide short-term relief of sleeplessness.
- Nonprescription medicines for sleep. These can help, but they also can cause side effects, such as drowsiness the next day. Over time, sleeping pills may not work as well as they did when you first started using them.
However, you can always use home remedies or alternative medicine (such as yoga or meditation) in order to improve your sleep.
In addition, treatments mentioned below aren’t recommended for insomnia, because it’s unclear how effective they are and they can sometimes cause side effects:
- antidepressants (unless you also have depression)
- chloral hydrate
- herbal remedies, such as valerian extract
- complementary and alternative therapies, such as acupuncture, hypnotherapy, and reflexology