What is Insomnia?

Many adults have suffered from symptoms of insomnia at one point in their life. As many as 30-40% of adults surveyed report symptoms of insomnia over the period of a year; however, less than 10% of people actually have chronic insomnia. Insomnia is a sleep disorder in which a person has difficulty falling asleep and/or maintaining sleep through out the night. Loss of sleep can be caused by multiple factors like stress, depression or life event changes. Insomnia is a very common sleep disorder that can be diagnosed and treated. Women and the elderly are the most common targets of this disorder. There are two types of insomnia, primary and secondary.

The causes of primary insomnia are environmental influences that a person may encounter and are not related to other health conditions. In contrast, secondary insomnia is related to other issues such as health conditions, chronic pain, medication or other substances one is consuming, like alcohol.

Causes of insomnia…

Insomnia can also be classified by the amount of time one is affected by it. Acute insomnia is a short-term ordeal, where difficulty sleeping is sporadic, or may last for only a few weeks. However, chronic insomnia is long-term. Chronic insomnia is distinguished by being unable to sleep for at least three nights per week, and can last for a month or longer.
The causes of acute insomnia are most often related to irregular conditions in a person’s day-to-day life experiences. Significant stress from life like loss of a loved one, loosing a job or divorce can cause trouble sleeping. Illness, physical strain or medications may disrupt a person’s sleep cycle for a period of time as well. Some medications for colds, allergies or depression can act as stimulants. If this is the case, speak with your health care provider to find an alternative that will not disrupt your sleep. Other environmental influences can cause sleep disruption as well, like light, noise or temperature. In today’s modern society, working “swing shifts”, a night shift or jet lag also commonly cause sleep cycle disruptions.

Chronic insomnia is related to other underlying conditions such as depression or anxiety, pain or discomfort during the night or chronic stress. If the trouble sleeping is related to a medical condition, it is imperative that the medical condition is addressed. Loss of sleep while ill may lead to decreased ability to recover from an illness. In addition, treating the medical condition causing ones insomnia will most often relieve the symptoms of insomnia.

Signs and Symptoms…

There are various signs and symptoms of insomnia. Commonly sufferers of insomnia report the inability to fall asleep, waking during the night, failure to return to sleep after waking or waking up too early in the morning. Unrefreshed rest resulting from a pattern of sleep difficulties may cause significant daytime sleepiness and general fatigue. These symptoms can lead to irritability, problems concentrating or memory problems. Insomnia is one of the leading causes of absenteeism from work and decreased productivity while at work. Fatigue and tiredness may leave a person feeling drained at the end of the day, which can also negatively influence their quality of life while at home.

Women specifically can suffer from insomnia due to fluctuating hormone levels at specific points in their life cycle. Sleeplessness may be caused by menopause, menstruation and pregnancy.

Steps to insure sleep…

A person can make several helpful choices to encourage a restful night of sleep. The first and most basic being listen to ones own “internal clock”. A person’s sleep-wake cycle is regulated by ones own Circadian Rhythm, which is a portion of the body’s “internal clock”. When a person begins a new sleep pattern, the body’s sleep clock is still on its original schedule and wants to sleep at its preprogrammed time. This is the most basic reason why a person still feels tired even though they are unable to sleep. If a person is having trouble sleeping, there are steps that can be taken to promote a restful night. Some basic sleep hygiene steps (steps to promote sleep) are:

* Sleep at the same time every night, including weekends. At the same time, ensure you are getting the proper amount of sleep that your body desires.
* Avoid caffeine, nicotine and alcohol. Caffeine and nicotine are stimulants that may keep you awake. Alcohol, although it can make a person feel sleepy, can also reduce sleep quality leaving one feeling unrested in the morning.
* Get regular exercise, studies show exercise may reduce stress. However, do not exercise with in 3-4 hours before bed.
* Avoid heavy meals before bedtime. However, if you are hungry, a light snack before bed may actually help you sleep.
* Make sure your bedroom and bed are comfortable. Keep your sleep environment dark, quiet and at a comfortable temperature, not too cool, not too warm. If light is a problem, try black out curtains or a sleep mask, if noise is a problem, try a white noise machine, a fan or ear plugs.
* Have a time to relax before bed. Reading a book or taking a bath may promote relaxation.
* Do not use the bedroom for anything other than sleep or sex :).
* If a person feels unable to sleep and does not feel drowsy, get up. Engage in something that is relaxing like reading or listening to music.
* While in bed if one finds their mind flooded with tomorrows “to do list”, make a list before bed. This way ones thoughts will not constantly replay what needs to be accomplished the next day.

Diagnosis…

Insomnia can be difficult to diagnose because of differentiations in individual sleep patterns and reported levels of fatigue. If you feel you suffer from insomnia, see your health care professional. The initial evaluation may include a physical exam and questions about your medical history. To determine the level of sleeplessness you are experiencing, your health care provider may ask you several questions, like how long the symptoms last, weather or not you snore, or if the symptoms occur every night. A health care professional may also ask a person to start a sleep diary so one can record the events as they happen. Currently there is also a short survey available to health care providers which is designed to evaluate the level of daytime sleepiness and sleep-wake patterns; this will assist in determining how severe ones insomnia may be. If a health care provider thinks it is necessary, they may refer one to a sleep disorder clinic for further diagnosis or treatment.

Treatment…

There are several different treatment options for insomnia. A person working with their health care provider can decide on what is the most appropriate course of action to take. The course of treatment will be based on what is keeping a person from experiencing the level of sleep their body specifically needs. A health care provider may suggest behavior modification, like creating an environment that is conducive to relaxation and sleeping. Another option may be to practice relaxation techniques such as yoga or meditation. Exercise during the day may also be recommended, as it does reduce stress and promotes a deeper level of sleep.
Sleep Hygiene Tips

As an alternate option, a health care provider may prescribe a medication. Currently there are several medications available for treatment of insomnia. These medications, called hypnotics, are prescribed when the cause of insomnia has been determined and other appropriate therapy options have been explored. A heath care provider will determine, based on your medical history, your current medical condition and your level of insomnia, if hypnotics are right for treatment. Hypnotics carry out their chemical task on specific sleep related areas of the brain. Hypnotics do induce sleep and some activate the ability to stay asleep through the night. There are side effects from hypnotics, as with any drug. Before starting a regimen of medication, talk to a health care provider about any side effects like morning headaches, sleepwalking or dependency.