There are many organic causes of insomnia but most commonly it is caused by fear, stress, anxiety, medications, herbs or caffeine. An overactive mind or physical pain may also be the cause. Most experts claim that finding the underlying cause of insomnia means curing it. It is important to point out that sleep problems seem to run in families; approximately 35% of people with insomnia have a positive family history.
Incidence
Research has confirmed that approximately one third of American adults report that they have sleep problems. Nearly a half of the people with insomnia consider the difficulty to be serious. Not only does insomnia cause daytime drowsiness, it may impair quality of life in many other aspects.
Types of insomnia
There are different kinds of insomnia:
Sleep Onset Insomnia
It is a disorder in which the major sleep episode is delayed in relation to the desired clock time that results in difficulty in awakening at the desired time.
Idiopathic Insomnia
This is a serious form of insomnia which is characterized by a lifelong inability to obtain adequate sleep. Most experts believe that it could be caused by an abnormality of the neurological control of the sleep-wake system.
Psycho-physiological Insomnia
Physical symptoms of anxiety are often accompanied with insomnia and associated decreased functioning during wakefulness.
Childhood Insomnia
This is primarily a childhood disorder that is characterized by the inadequate enforcement of sleeping by a parent with resultant refusal to go to bed at the appropriate time.
Food Allergy Insomnia
This represents a disorder of initiating and maintaining sleep due to an allergic response to food allergens.
Environmental Sleep Disorder
This disorder is caused by a disturbing environmental factor.
Transient Insomnia
This represents a sleep disturbance temporally related to acute stress, conflict or environmental change.
Periodic Insomnia
This type of insomnia consists of a chronic steady pattern consisting of 1-2 hour daily delays in sleep onset.
Altitude Insomnia
This is an acute type of insomnia usually accompanied by headaches, loss of appetite, and fatigue, that occurs following ascent to high altitudes.
Hypnotic-Dependency Insomnia
This type of insomnia associated with tolerance to or withdrawal from hypnotic medications.
Stimulant-Dependent Sleep Disorder
This disorder is characterized by a reduction of sleepiness or suppression of sleep by central stimulants and resultant alterations in wakefulness following drug abstinence.
Alcohol-Dependent Insomnia
Characterized by the assisted initiation of sleep onset by the sustained ingestion of alcohol that is used for its hypnotic effect.
Chronic insomnia
Chronic insomnia is more complex and often results from a combination of factors, including underlying physical or mental disorders. Many experts are saying that chronic insomnia is a symptom of a deeper problem, not a disorder itself. One of the most common causes of chronic insomnia is depression. Other underlying causes include
- arthritis
- kidney disease
- heart failure
- asthma
- restless legs syndrome
- Parkinson's disease
- hyperthyroidism
- sleep apnea
- the misuse of caffeine, alcohol, or other substances
- disrupted sleep/wake cycles as may occur with night-shift work
- chronic stress
Diagnosis of insomnia
Insomnia may be difficult to diagnose because of its subjective nature.
Patients history
In most cases, a doctor may ask a patient some questions about his or her sleep patterns, such as how long do the symptoms last and whether they occur every night, do you snore, how well you function during the day, whether you take any medications and whether you have other health disorders could also be very important.
Night monitoring
A patient might need to spend a night at a sleep disorders center, where a team of people monitors and records a variety of body activities during the night, including brain waves, breathing, heartbeat, eye movements and body movements.
Treatment of chronic insomnia
Chronic insomnia treatment consists of:
• Diagnosing and treating underlying medical or psychological problems.
• Identifying behaviors that may worsen insomnia and stopping them.
• Possibly using sleeping pills, although the long-term use of sleeping pills for chronic insomnia is controversial.
• Trying behavioral techniques to improve sleep, such as relaxation therapy, sleep restriction therapy, reconditioning, and many other techniques.
Medications
Taking prescription sleeping pills, such as Zolpidem (Ambien®), Eszopiclone (Lunesta®), Zaleplon (Sonata®) or Ramelteon (Rozerem®) can be very helpful, especially for the first couple of weeks until there's less stress in patient’s life. Beside these sleeping pills the antidepressant called Trazodone (Desyrel®) also may help with insomnia. Doctors generally don't recommend prescription sleeping pills for the long term because they may cause side effects.
Relaxation Therapy
Beside medications, there are also specific and effective relaxation techniques that can reduce or eliminate anxiety and tension. The most important effect of these relaxation techniques is that the person's mind is able to stop calm down and the muscles can relax, and restful sleep can occur.
Sleep Restriction
Most of the insomnia patients spend too much time in bed unsuccessfully trying to sleep but they don’t know that they may benefit from a sleep restriction program that at first allows only a few hours of sleep during the night. Gradually the time is increased until a more normal night's sleep is achieved.
Reconditioning
A lot of people nowadays are using bed for various other activities such as reading or watching TV. This may lead to insomnia because their brain isn’t conditioned to asociate the bed with sleeping only. In this therapy the brain needs to be reconditioned to asociate bed and bedtime with sleeping.
Bright Light
This therapy is based on a concept that, if the patient is having trouble getting to sleep early enough at night, waking up at the same time every morning and trying to get as much bright light in the morning as possible may help. This should help reset the internal clock to an earlier time at night for sleep.
If the patient is having trouble staying awake in the evening and waking up too early in the morning then he should try to get some bright light in the evening in order to reset the internal clock to go to sleep later and wake up later.
Tips for managing Chronic Insomnia
Chronic insomnia means that you have had troubles sleeping for a month or more. It might be caused by stress, anxiety, depression, disease, pain, medications, sleep disorders or poor sleep habits.
The following tips may be helpful:
- Establish a regular schedule. Go to bed and get up the same time every day
- Don't drink coffee or other caffeine-based beverages after noon.
- Exercise regularly
- Refrain from smoking; nicotine is a stimulant.
- Use your bed only for sex and sleep
- Restrict your sleep by limiting the time you spend in bed to the actual amount of time that you sleep. If you lay in bed for eight hours and only sleep five, limit your time in bed to five hours. Gradually increase this number by 15 or 30-minute intervals.
- Get up at the same time every morning, no matter how poorly you slept
- Learn relaxation techniques, such as Yoga or meditation.
- Keep the bedroom dark, comfortable and quiet to minimize sleep interruptions
- Reset your body's clock
- Check your medications
- If some painful condition bothers you, make sure the pain reliever you take is effective enough to control your pain
- Avoid or limit noon or afternoon naps
Complementary and alternative medicine
Melatonin is a widely used supplement made to help people overcome insomnia, prevent jet lag, battle cancer, rejuvenate your sex life and slow aging.
However, most experts believe that using melatonin supplements isn't necessary because human body already produces it.
Sources & Links
- www.stanford.edu
- en.wikipedia.org/wiki/Chronic_insomnia
- www.chs.edu.sg
- www.mayoclinic.com/health/insomnia/DS00187
- Photo by shutterstock.com