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is not intended to be medical advice. If you suspect that you have a sleep
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There are four major types of Insomnia.
- Difficulty falling asleep
- No problem falling asleep but difficulty staying asleep (many awakenings)
- Waking up too early
- Sleep State Misperception
much sleep does a person need?
|Enough to feel
alert during the day. Typically 7 to 9 hours (varies from person to person)
of good quality sleep.
Many things can cause insomnia. Insomnia is not a disorder it is a complaint. The goal is to find the underlying problem causing the complaint. Almost any sleep disorder can present themselves as insomnia including circadian disorders, sleep apnea, restless legs, and the list goes on. So ruling out a sleep disorder can be important. Medications, herbs and caffeine can cause insomnia. Most medications will report the possible side effect of insomnia and sleepiness. The same medication can cause both since we all react to medications differently. Life events can cause insomnia but it is usually temporary. Anxiety about falling asleep can also be responsible, however, if the anxiety is due to a long history of insomnia, the anxiety is probably not the problem and you need to find out what is the underlying cause. Once sleep is restored to normal the anxiety will usually go away. Physical problems such as pain can be the underlying cause. There is also the possibility of mental problems, and a good sleep doctor that works with insomnia can rule this in or out sometimes without an all night sleep study. This problem can be treated using many different techniques. (More information coming)
basic types of Insomnia
Transient insomnia - lasting for a few nights
insomnia - two or four weeks of poor sleep
insomnia - poor sleep that happens most nights and last a month or
and short-term insomnia
generally occur in people who are temporarily experiencing one or more
of the following:
change in the surrounding environment
problems such as those due to jet lag
medication side effects
Chronic insomnia is more complex and often
results from a combination of factors, including underlying physical or
mental disorders. One of the most common causes of chronic insomnia is
depression. Other underlying causes include arthritis, kidney disease,
heart failure, asthma, sleep apnea, restless legs syndrome, Parkinson's
disease, and hyperthyroidism. However, chronic insomnia may also be due
to behavioral factors, including the misuse of caffeine, alcohol, or other
substances; disrupted sleep/wake cycles as may occur with shift work or
other nighttime activity schedules; and chronic stress.
In addition, the following behaviors have been shown
to perpetuate insomnia in some people:
poor sleep hygiene
expecting to have
difficulty sleeping and worrying about it
amounts of caffeine
in the afternoon or evening
irregular or continually
disrupted sleep/wake schedule
is only one of the symptoms. Daytime symptoms include:
- Impaired concentration
- Impaired memory
transient and short-term insomnia
short-term insomnia may
not require treatment since episodes last only a few days at a time. For
example, if insomnia is due to a temporary change in the sleep/wake
schedule, as with jet lag, the person's biological clock will often
get back to normal on its own. However, for some people who experience daytime
sleepiness and impaired performance as a result of transient insomnia, the
use of short-acting sleeping pills may improve sleep and next-day alertness.
As with all drugs, there are potential side effects. The use of over-the-counter
sleep medicines is not usually recommended for the treatment of insomnia.
chronic insomnia consists of:
First, diagnosing and treating underlying medical or psychological problems.
Identifying behaviors that may worsen insomnia and stopping (or reducing) them.
Possibly using sleeping pills, although the long-term use of sleeping pills for chronic insomnia is controversial.
A patient taking any sleeping
pill should be under the supervision of a physician to closely evaluate
effectiveness and minimize side effects. In general, these drugs are prescribed
at the lowest dose and for the shortest
duration needed to relieve the sleep-related symptoms. For some of
these medicines, the dose must be gradually lowered as the medicine is discontinued
because, if stopped abruptly, it can cause insomnia to occur again for a
night or two.
Trying behavioral techniques to improve sleep, such
as relaxation therapy, sleep restriction therapy, reconditioning, and bright
Relaxation Therapy. There are specific and
effective techniques that can reduce or eliminate anxiety and body tension.
As a result, the person's mind is able to stop "racing," the muscles can
relax, and restful sleep can occur. It usually takes much practice to learn
these techniques and to achieve effective relaxation.
Sleep Restriction. Some people suffering from
insomnia spend too much time in bed unsuccessfully trying to sleep. 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.
Another treatment that may help some people with insomnia is to recondition
them to associate the bed and bedtime with sleep. For most people, this
means not using their beds for any activities other than sleep and sex (some
experts even say using the bed for sex call cause performance anxiety which
could lead to insomnia). As part of the reconditioning process, the person
is usually advised to go to bed only when sleepy. If unable to fall asleep,
the person is told to get up, stay up until sleepy, and then return to bed.
Throughout this process, the person should avoid naps and wake up and go
to bed at the same time each day. Eventually the person's body will be conditioned
to associate the bed and bedtime with sleep.
Bright Light. If you are having trouble
getting to sleep early enough at night it will help to wake up at
the same time every morning and try to get as much bright
light in the morning as possible. This will help reset the internal
clock to an earlier time at night for sleep. If you are having trouble
staying awake in the evening and waking up too early in the morning
then try to get bright light in the evening.
This will help rest the internal clock to go to sleep later and wake up
later. You may want to avoid early morning light using this method until
you have stabilized your sleeping pattern.
Sleep State Misperception
Many people will sleep most of the night and believe they didn't sleep at all. Sleep State Misperception can cause anxiety which increases the symptoms. All night sleep recordings show normal sleep, but the next morning the patient will report not sleeping. Seeing their sleep data and education can help with this problem.
If you feel you are not sleeping at all during the night but are not sleepy the next day you may have this complaint.
is effecting the quality of life, talking to your physician is advised.
The subject will not usually be brought up unless your bring it up. For
chromic insomnia a sleep specialist may be
Go to the Insomnia Homepage for additional information.
Books to read:
Go to Sandman's Book Store.. Most books that
focus on Insomnia are listed in the Insomnia Category.
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