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Insomnia
What is insomnia?
What are the different types of insomnia and what causes
them?
How is insomnia diagnosed?
How is insomnia treated?
What habits promote a good night's sleep?
What is insomnia?
It is not unusual to have sleep troubles from time to time.
But, if you feel that you do not get enough sleep or
satisfying sleep, you may have insomnia, a sleep disorder.
People with insomnia have one or more of the
following:
· difficulty falling asleep;
· waking up often during the night and having trouble
going back to sleep;
· waking up too early in the morning;
· unrefreshing sleep.
Insomnia can cause problems during the day, such as
sleepiness, fatigue, difficulty concentrating, and
irritability. A person with insomnia may also have another
sleep disorder such as sleep apnea, narcolepsy, and
restless legs syndrome.
Insomnia is not defined by the number of hours you sleep
every night. The amount of sleep a person needs varies.
While most people need between 7 and 8 hours of sleep a
night, some people do well with less, and some need
more.
Insomnia tends to increase with age and affects about 40
percent of women and 30 percent of men.
What are the different types of insomnia and what causes
them?
A person can have primary or secondary insomnia. Primary
insomnia means that a person is having sleep problems that
are not directly associated with any other health condition
or problem. Secondary insomnia means that a person is
having sleep problems because of something else, such as a
health condition (like depression, heartburn, cancer,
asthma, arthritis), pain, medication they are taking, or a
substance they are using (like alcohol). Insomnia can vary
in how long it lasts and how often it occurs. Insomnia can
be short-term (called acute insomnia) or last a long time
(called chronic insomnia). It can also come and go (or be
intermittent), with periods of time when a person has no
sleep problems. Acute (short-term) insomnia can last from
one night to a few weeks. It is often caused by emotional
or physical discomfort, and can be related to a single
specific event. Causes of acute insomnia can include:
· significant life stress (job loss or change, death
of a loved one, moving);
· illness;
· environmental factors like noise, light, or extreme
temperatures (hot or cold) that interfere with sleep;
· things that throw off a normal sleep schedule (like
jet lag or switching from a day to night shift).
Chronic (long-term) insomnia is when a person has insomnia
at least 3 nights a week for 1 month or longer. It can be
caused by many things and often occurs along with other
health problems. Common causes of chronic insomnia are
depression, chronic stress, and pain or discomfort at
night.
If you think you have insomnia, talk to your health care
provider. An evaluation may include a physical exam, a
medical history, and a sleep history. You may be asked to
keep a sleep diary for a week or two, keeping track of your
sleep patterns and how you feel during the day. Your health
care provider may want to interview your bed partner about
the quantity and quality of your sleep. In some cases, you
may be referred to a sleep center for special tests.
How is insomnia treated?
Acute, or short-term insomnia may not require treatment.
But if your insomnia makes it hard to function during the
day because you are sleepy and tired, your health care
provider may prescribe sleeping pills for a limited time.
The rapid onset, short-acting medications now available
avoid many of the earlier problems with continuing effects
(like feeling drowsy or groggy) the following day. Some
medications may be less effective after several weeks of
nightly use, however, and long-term safety and
effectiveness has not yet been established. Side effects of
sleeping pills (and over-the-counter sleep medicines) can
be a problem, too. Mild insomnia often can be prevented or
cured by practicing good sleep habits (see below).
Treatment for chronic (long-term) insomnia includes first
treating any underlying conditions or health problems that
are causing the insomnia. If insomnia continues, your
health care provider may suggest behavioral therapy or
medication. Most medicines that are used for sleep have
side effects and must be used with caution. It is not
recommended to use over-the-counter sleeping pills for
insomnia. Behavioral approaches to treatment focus on
changing behaviors that may worsen insomnia and learning
new behaviors to promote sleep. Techniques such as
relaxation exercises, sleep restriction therapy, and
reconditioning may be useful.
What habits promote a good night's sleep?
Good sleep habits can help you get a good night's sleep.
For example:
· Try to go to sleep at the same time each night and
get up at the same time each morning. Try not to take naps
during the day because naps may make you less sleepy at
night.
· Avoid caffeine, nicotine, and alcohol late in the
day. Caffeine and nicotine are stimulants and can keep you
from falling asleep. Alcohol can cause waking in the night
and interferes with sleep quality.
· Get regular exercise. Try not to exercise close to
bedtime because it may stimulate you and make it hard to
fall asleep. Experts suggest not exercising for 3 hours
before the time you go to sleep.
· Don't eat a heavy meal late in the day. A light
snack before bedtime, however, may help you sleep.
· Make your sleeping place comfortable. Be sure that
it is dark, quiet, and not too warm or too cold. If light
is a problem, try a sleeping mask. If noise is a problem,
try earplugs, a fan, or a "white noise" machine to cover up
the sounds.
· Follow a routine to help relax and wind down before
sleep, such as reading a book, listening to music, or
taking a bath.
· Avoid using your bed for anything other than sleep
or sex.
· If you can't fall asleep and don't feel drowsy, get
up and read or do something that is not overly stimulating
until you feel sleepy.
· If you have trouble lying awake worrying about
things, try making a to-do list before you go to bed. This
may help you to "let go" of those worries overnight.
See your health care provider if you think that you have
insomnia or another sleep disorder.
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