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Insomnia
ICD-10 F51.0, G47.0
ICD-9 780.5
OMIM {{{OMIM}}}
DiseasesDB {{{DiseasesDB}}}
MedlinePlus {{{MedlinePlus}}}
eMedicine {{{eMedicineSubj}}}/{{{eMedicineTopic}}}
MeSH {{{MeshNumber}}}

Insomnia is characterized by an inability to sleep and/or to remain asleep for a reasonable period. Many believe that insomnia is a sleep disorder, but it is not. It is a symptom, as insomniacs typically complain of being unable to close their eyes or 'rest their mind' for more than a few minutes at a time. As opposed to being a sleep disorder, insomnia is most often caused by sleep disorders, though they are not the only causes. Other causes include fear, stress, anxiety, medications, herbs and caffeine. An overactive mind or physical pain may also be the cause of the problem. According to the U.S. Department of Health and Human Services, approximately 60 million Americans each year suffer from insomnia. Insomnia tends to increase with age and affects about 40 percent of women and 30 percent of men [1]. Whatever the case, it is important to find the underlying cause of the insomnia if it is to be cured.

Types of insomniaEdit

There are roughly three different types of insomnia. Insomnia may be classified as transient, acute (short-term), and chronic. Insomnia lasting from one night to a few weeks is referred to as transient. This is generally the case for most people, as one often suffers from jet lag or short-term anxiety. If this form of insomnia continues to occur from time to time, the insomnia is classified to be intermittent. Acute insomnia is the inability to consistently sleep well for a period of three weeks to six months. However, after this time, the person does not experience insomniatic episodes. Insomnia is considered to be chronic, the most serious, if it persists almost nightly for at least a month.

Common causes of insomniaEdit

A person can have primary or secondary insomnia. Primary insomnia is sleeplessness that is not attributable to a medical or environmental cause. Secondary insomnia means that a person is having sleep problems because of something else, such as a health condition, an example of which would be generalized anxiety disorder.

Some of the most common causes of insomnia are:

  • Sleep Apnea is a condition that occurs when a sleeping person's breathing is interrupted, thus interrupting the normal sleep cycle. With the obstructive form of the condition, some part of the sleeper's respiratory tract loses muscle tone and partially collapses. People with obstructive sleep apnea often do not remember any of this, but they complain of excessive sleepiness during the day. Central sleep apnea interrupts the normal breathing stimulus of the central nervous system, and the individual must actually wake up to resume breathing. This form of apnea is often related to a cerebral vascular condition, congestive heart failure, and premature aging.
  • Restless Legs Syndrome (RLS) and Periodic Limb Movement (PLM) involve symptoms often described as a tingling and creeping sensation in the legs, which creates a powerful urge to move them. The individual continuously moves in bed in an attempt to relieve these unpleasant sensations, resulting in restlessness and lack of sleep. Fortunately for sufferers of this condition, current treatments for this disorder are effective in over 90% of those treated.
  • Jet Lag is seen in people that travel through multiple time zones on a regular basis, as the time relative to the rising and falling of the sun no longer coincides with the body's internal concept of it, and is also seen in people who consistently work night shifts. See also: circadian rhythm.
  • Parasomnia includes a number of disorders of arousal or disruptive sleep events including nightmares, sleepwalking, violent behavior while sleeping, and REM behavior disorder, in which a person moves his/her physical body in response to events within his/her dreams. These conditions can often be treated successfully through medical intervention or through the use of a sleep specialist.
  • Gastroesophageal Reflux Disease causes repeated awakenings during the night due to unpleasant sensations resulting from stomach acid flowing upward into the throat while asleep.

A common misperception is that the amount of sleep one requires decreases as he/she ages. The ability to sleep for long periods, rather than the need for sleep, appears to be lost as people get older. Some elderly insomniacs toss and turn in bed and occasionally fall off the bed at night, diminishing the amount of sleep they receive. [2]

Insomnia is a common side-effect of some medications, and it can also be caused by stress, emotional upheaval, physical or mental illness, dietary allergy and poor sleep hygiene. Insomnia is a major symptom of mania in people with bipolar disorder, and it can also be a sign of hyper-thyroidism, depression, or other ailments with stimulating effects.

In addition, a rare genetic condition can cause a prion-based, permanent and eventually fatal form of insomnia called Fatal Familial Insomnia.

Treatment for insomniaEdit

Psychological treatmentEdit

Physical treatmentsEdit

Many insomniacs rely on sleeping tablets and other sedatives to try to get some rest. Others use herbs such as valerian, chamomile, lavender, hops, and/or passion-flower.

Some traditional remedies for insomnia have included drinking warm milk before bedtime; taking a warm bath in the evening; exercising vigorously for half an hour in the afternoon; eating a large lunch and then having only a light evening meal at least three hours before bed; avoiding mentally stimulating activities in the evening hours; and paradoxically, making sure to get up early in the morning and to retire to bed at a reasonable hour. Traditional Chinese medicine]] practitioners have been treating insomnia sufferers for thousands of years. A typical approach may utilize acupuncture, dietary and lifestyle analysis, herbology and other techniques, with the goal to resolve the problem at a subtle level.

Although they may seem unscientific, many of these remedies are sufficient to break the insomnia cycle without the need for sedatives and sleeping tablets[How to reference and link to summary or text]. Warm milk contains high levels of tryptophan, a natural sedative. Using aromatherapy, including Lavender oil and other relaxing essential oils, may also help induce a state of restfulness.

The most commonly used class of hypnotics prescribed for insomnia are the benzodiazepines. This includes drugs such as diazepam, lorazepam, nitrazepam and midazolam.

The more relaxed you are the greater the likelihood of getting a good night's sleep. Relaxation techniques such as meditation have been proven to help sleep. They take stress from the mind and body which leads to a deeper more restful sleep.

Alleviating insomniaEdit

Please note that the advice given below is not a substitute for a professional medical specialist's advice.

The emphasis is on good sleep hygeine

  • Sufferers of insomnia should avoid all caffeine. Caffeine is often a factor in insomnia, including insomnia in night-shift workers. Caffeine is found in coffee, tea, yerba mate (Ilex paraguaiensis), guarana, cocoa (although cocoa does not contain any caffeine, it contains another stimulant, theobromine), Kola nut (this includes all cola drinks); it is also found in "energy" sodas like Red Bull and similar, chocolate bars and other candy. Drink herbal teas or plain water instead of caffeine-containing liquids.
  • The bedroom environment should be conducive to sleep. Some people are very sensitive to light while others are sensitive to noise. The bedroom should be dark and quiet at night.
  • Try to avoid thinking of worries, fears and perhaps phobias. Such concerns are likely to prevent the mind from resting and may be exaggerated. It is a good idea to write down any particular worries that are bothering you, keeping a diary or noting down your emotions and thoughts can be very cathartic and any particular worries can be revisited and dealt with at a more appropriate time.
  • Write down plans for the next day, so you can go to sleep without fear of forgetting anything important.
  • Calm, relaxing music can help as it gives you something neutral to focus on and some are reported to relax you by tuning your brain in to certain rhythms, allowing you to fall into a deeper sleep.
  • Avoid use of the computer and television immediately before sleeping, as they stimulate the visual cortex.
  • Practice good sleep hygiene. Do not use the bed for too many activities besides sleep. Using the bed for reading, writing, watching TV and other such non-sleep-related activities will lower your association of the bed with sleeping. Similarly, try to keep to a regular schedule of what time to go to bed and what time to wake up. Try not to sleep during the daytime.
  • Sleep apnea can be a cause of insomnia. While a visit to the doctor will help in the diagnosis or ruling out of sleep apnea, a definitive answer will have to come from a study at a sleep lab.
  • Sometimes lack of sleep is indicative of an emotional problem that's not being dealt with. If a person is not happy with their lifestyle, or they are putting off problems that should be dealt with, it can often result in sleeping trouble. Just as the human body has nutritional requirements, all people have social and environmental requirements. Sometimes more social activities can help.
  • Patients with depression may suffer from insomnia. A doctor can treat this, sometimes by changing or adding prescriptions.
  • In the Buddhist tradition, people suffering from insomnia or nightmares may be advised to meditate on "loving-kindness", or metta. This practice of generating a feeling of love and goodwill can have a soothing and calming effect on the mind and body[1]. This seems to stem partly from the creation of relaxing positive thoughts and feelings, and partly from the pacification of negative ones. In the Mettā Sutta, Siddhartha Gautama, "The Buddha" tells the gathered monks that easeful sleep is one benefit of this form of meditation.
  • Exercise taken earlier in the day may help by reducing stress and promoting tiredness.
  • Obscure allergies, such as dairy allergies, can sometimes cause sleeping disorders. Other symptoms may be very mild, such as slightly stuffed sinuses. A nutritionist can make helpful dietary and supplement recommendations.
  • If an alarm has been set, avoid looking at the clock during the night and cover the display if necessary. This prevents mental calculations of how much sleep has been lost so far and how little sleep can be obtained before the alarm will sound. Accepting that the amount of sleep obtained can only be determined upon waking, not while waiting to get to sleep, may also be beneficial.

A multifaceted approachEdit

Most people who have cured their insomnia have done so by reviewing and experimenting with many different cures. Often, a combination of dietary and lifestyle changes is the most helpful approach. As with many similar health problems, a determined, across-the-board holistic approach to sleeping problems is the most effective solution.

Statistics for insomniaEdit

According to the U.S. Department of Health and Human Services, approximately 60 million Americans suffer from insomnia each year, which is the highest among the developed nations. [1]. Insomnia tends to increase with age and affects about 40 percent of women and 30 percent of men [2]. The average American gets 7 hours of sleep, instead of the 8 to 10 hours recommended by doctors

ReferencesEdit

  1. http://www.ninds.nih.gov/disorders/brain_basics/understanding_sleep.htm
  2. http://www.womenshealth.gov/faq/insomnia.htm
  1. ^  Lutz, A., Greischar, L.L., Rawlings, N.B., Ricard, M., and Davidson, R.(2004). Long-term meditators self-induce high-amplitude gamma synchrony during mental practice. Proc. Natl. Acad. Sci. USA 101,16369–16373. [3]
  2. Lower Back Pain
  3. Lower Back Pain Right Side

See alsoEdit

ReferencesEdit



External linksEdit

Sleep Deprivation Effect on Human Performance: A Meta-Analysis Approach[1]</br> The Effects of Sleep Deprivation on Information-Integration Categorization Performance [2]</br> Sleep and Performance Research Center [3]

References & BibliographyEdit

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