Insomnia
Insomnia is a feeling of not being able to get enough sleep. It is usually related to finding it hard to get to sleep, waking up without having had enough sleep, or having unrefreshing sleep.
Who is affected?
People differ in their need for sleep, and everyone has the occasional night of disturbed sleep. Almost a quarter of the population frequently experience sleeping difficulties, and it becomes more common with increasing age. Over the age of 65, 29% of men and 37% of women are affected.
Sleep
The exact function of sleep is not fully understood, but the effects of lack of sleep suggest that its main function is to rest and repair the body. There are also psychological benefits. One phase of sleep is called rapid eye movement (REM) because the sleeper's eyes can be seen to move rapidly behind the lids. This is thought to be the time when dreams occur. People who don't sleep for long enough or who sleep very lightly, become deprived of REM sleep. They can become irritable and anxious and, in extreme sleep deprivation may even have hallucinations.
Symptoms
The symptoms of insomnia typically include:
difficulty getting to sleep (taking more than 45 minutes to get to sleep),
Difficulty staying asleep (frequent awakenings and difficulty getting back to sleep), early morning waking, feeling tired and unrefreshed in the morning.
Some people notice that the irritability that results from their insomnia has an effect on partners, families and work colleagues. Accident statistics have shown that daytime sleepiness can double the chance of having an accident while operating machinery or driving a car. There's also a link with physical illness. People with insomnia have an increased risk of dying from cancer, heart disease or stroke. Insomnia can be described as either transient, intermittent or chronic. Transient lasts only a few nights to a few weeks. Intermittent insomnia occurs occasionally but not every night. Chronic insomnia occurs most nights and lasts three or more weeks.
What causes it?
Typically, there is no single cause for insomnia but a number of factors are known to contribute.
Lifestyle - eating late at night, jet lag, hunger, alcohol, caffeine, stimulant drugs, including nicotine.
Environment – noise (eg partner snoring), uncomfortable bed or bedroom.
Physical health problems – sleep apnoea (abnormal breathing while asleep), asthma, tinnitus, pain, prostate problems that mean frequent trips to the toilet at night, and indigestion.
Psychological – including stress or grief.
Mental health problem such as depression or anxiety.
Medication – eg certain tablets for asthma and treatments for nasal congestion, vertigo and depression.
Rarely, insomnia occurs even when none of the above are present. This is known as 'primary' insomnia.
Treatment
There are a number of things that people affected by insomnia can do to help themselves. These are known as sleep hygiene measures.
Avoid taking cat-naps during the day.
Reduce the number of cups of coffee, tea or cola drinks you drink, especially later on in the day.
Only drink alcohol in moderation. It may bring on sleepiness, but will tend cause early waking.
Stop smoking – nightime breathing problems are more likely in smokers.
Take regular exercise, but avoid strenuous activity immediately before going to bed.
Try to get into a daily routine. Go to bed the same time each night and get up the same time each morning.
Avoid heavy or rich meals, especially in the few hours before bedtime.
Work out how many hours sleep you can manage with before daytime sleepiness becomes a problem. Becoming unnecessarily stressed over insomnia can lead to a vicious cycle.
If you can't sleep, get up and read in a dim light until you feel sleepy. Don't watch television or lie in bed thinking about how much sleep you are missing.
Other activities that can create a relaxed mood include taking a warm bath, having a milky drink, or listening to soothing music.
Mentally dealing with the day's unfinished business is also helpful. Writing down any worries to deal with the next day may help to clear them from the mind and prevent them re-surfacing in the early hours.
Psychological therapies
Hypnotherapists can teach simple relaxation techniques. They can also provide "talking therapy" (psychotherapy) which can help people come to terms with various life events - e.g. bereavement, marital problems etc. that may be triggers of insomnia. Specific sleep therapy includes cognitive behaviour therapy (CBT), which deals with misconceptions about sleep such as believing that frequent short naps during the day are good for you.
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