| |
|
|
| |
a-z physical
health : insomnia
|
|
| |
|
|
| |
|
|
| |
|
|
| |
|
|
| |
Insomnia is a common sleep complaint
that occurs when you have one or more of these problems: |
|
| |
| • |
You have a hard
time initiating sleep. |
| • |
You struggle to maintain
sleep, waking up frequently during the night. |
| • |
You tend to wake up too
early and are unable to go back to sleep. |
| • |
Your sleep is nonrestorative
or of a poor quality. |
|
|
| |
|
|
| |
These symptoms of insomnia can
be caused by a variety of biological, psychological and social
factors. They most often result in an inadequate amount of sleep,
even though the sufferer has the opportunity to get a full night
of sleep. Insomnia is different from sleep deprivation, which
occurs when an individual does not have the opportunity to get
a full night of sleep. A small percentage of people who have
trouble sleeping are actually short sleepers who can function
normally on only five hours of sleep or less. |
|
| |
|
|
| |
Types |
|
| |
Insomnia is considered a disorder
only when it causes a significant amount of distress or anxiety,
or when it results in daytime impairment. |
|
| |
| • |
Adjustment insomnia:
This is also called acute insomnia or short-term insomnia.
It is usually caused by a source of stress and tends to
last for only a few days or weeks. |
| • |
Behavioral insomnia of childhood:
Two primary types of insomnia affect children. Sleep-onset
association type occurs when a child associates falling
asleep with an action (being held or rocked), object (bottle)
or setting (parents’ bed), and is unable to fall
asleep if separated from that association. Limit-setting
type occurs when a child stalls and refuses to go to sleep
in the absence of strictly enforced bedtime limits |
| • |
Idiopathic insomnia: An
insomnia that begins in childhood and is lifelong, it
cannot be explained by other causes. |
| • |
Inadequate sleep hygiene:
This form of insomnia is caused by bad sleep habits that
keep you awake or bring disorder to your sleep schedule.
|
| • |
Insomnia due to drug or substance,
medical condition, or mental disorder: Symptoms of insomnia
often result from one of these causes. Insomnia is associated
more often with a psychiatric disorder, such as depression,
than with any other medical condition. |
| • |
Paradoxical insomnia: A complaint
of severe insomnia occurs even though there is no objective
evidence of a sleep disturbance. |
| • |
Psychophysiological insomnia:
A complaint of insomnia occurs along with an excessive
amount of anxiety and worry regarding sleep and sleeplessness.
|
|
|
| |
|
|
| |
Risk
groups |
|
| |
| • |
A high rate
of insomnia is seen in middle-aged and older adults. Although
your individual sleep need does not change as you age,
physical problems can make it more difficult to sleep
well. |
| • |
Women are more likely than
men to develop insomnia. |
| • |
People who have a medical
or psychiatric illness, including depression, are at risk
for insomnia. |
| • |
People who use medications
may experience insomnia as a side-effect. |
|
|
| |
|
|
| |
In addition, the following behaviours
have been shown to perpetuate insomnia in some people: |
|
| |
| • |
Expecting to
have difficulty sleping and worrying wbout it. |
| • |
Ingesting excessive amounts
of caffeine. |
| • |
Drinking alchohol before
bedtime. |
| • |
Irregular or continually
disrupted sleep/wake schedules. |
| • |
Excessive napping in the
afternoon or evening. |
|
|
| |
|
|
| |
Effects |
|
| |
| • |
Fatigue |
| • |
Moodiness |
| • |
Irritability or anger |
| • |
Daytime sleepiness |
| • |
Anxiety about sleep |
| • |
Lack of concentration |
| • |
Poor memory |
| • |
Lack of motivation or energy |
| • |
Headaches or tension |
| • |
Upset stomach |
| • |
Mistakes/Accidents at work
or while driving |
|
|
| |
|
|
| |
Severe daytime sleepiness typically
is an effect of sleep deprivation and is less common with insomnia.
People with insomnia often underestimate the amount of sleep
they get each night. They worry that their inability to sleep
will affect their health and keep them from functioning well
during the day. Often, however, they are able to perform well
during the day despite feeling tired. |
|
| |
|
|
| |
Treatments
|
|
| |
Cognitive behavioral therapy (CBT):
CBT can have beneficial effects that last well beyond the end
of treatment. It involves combinations of the following therapies:
|
|
| |
| • |
Cognitive therapy:
Changing attitudes and beliefs that hinder your sleep
|
| • |
Relaxation training: Relaxing
your mind and body |
| • |
Sleep hygiene training: Correcting
bad habits that contribute to poor sleep |
| • |
Sleep restriction: Severely
limiting and then gradually increasing your time in bed
|
| • |
Stimulus control: Going
to bed only when sleepy, waking at the same time daily,
leaving the bed when unable to sleep, avoiding naps, using
the bed only for sleep and sex |
|
|
| |
Over-the-counter products: Most
of these sleep aids contain antihistamine. They can help you
sleep better, but they also may cause severe daytime sleepiness.
Other products, including herbal supplements, have little evidence
to support their effectiveness. |
|
| |
|
|
| |
Prescription sleeping pills: Prescription
hypnotics can improve sleep when supervised by a physician.
The traditional sleeping pills are benzodiazepine receptor agonists,
which are typically prescribed for only short-term use. Newer
sleeping pills are nonbenzodiazepines, which may pose fewer
risks and may be effective for longer-term use. |
|
| |
|
|
| |
American Academy of Sleep Medicine |
|
| |
|
|
| |
|
|
