|
|
 |
|||||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||||
| Chronic Insomnia : Insomnia that occurs most nights and lasts a month or more. The treatment of chronic insomnia consists of: First, the diagnosis and treatment of underlying medical or psychological problems. The identification of behaviors that may worsen insomnia and stopping (or reducing) them. A possible trial of 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. A trial of behavioral techniques to improve sleep, such as relaxation therapy, sleep restriction therapy, and reconditioning. 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. 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. 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. Types of Insomnia: Insomnia can be classified as transient (short term), intermittent (on and off), and chronic (constant). Insomnia lasting from a single night to a few weeks is referred to as transient. If episodes of transient insomnia occur from time to time, the insomnia is said to be intermittent. Insomnia is considered to be chronic if it occurs on most nights and lasts a month or more. Causes of Insomnia: Certain conditions seem to make individuals more likely to experience insomnia. Examples of these conditions include: advanced age (insomnia occurs more frequently in those over age 60); female gender; and a history of depression. If other conditions (such as stress, anxiety, a medical problem, or the use of certain medications) occur along with the above conditions, insomnia is more likely. There are many causes of insomnia. Transient and intermittent insomnia generally occur in people who are temporarily experiencing one or more of the following: stress, environmental noise, extreme temperatures, a change in the surrounding environment, sleep/wake schedule problems such as those due to jet lag, or 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. Certain Behaviors: Behaviors that perpetuate insomnia in some people include: expecting to have difficulty sleeping and worrying about it, ingesting excessive amounts of caffeine, drinking alcohol or smoking cigarettes before bedtime, excessive napping in the afternoon or evening, and irregular or continually disrupted sleep/wake schedules. These behaviors may prolong existing insomnia, and they can also be responsible for causing the sleeping problem in the first place. Stopping these behaviors may eliminate the insomnia altogether. Who Has Insomnia? Insomnia is found in males and females of all age groups, although it seems to be more common in females (especially after menopause) and in the elderly. The ability to sleep, rather than the need for sleep, appears to decrease with advancing age. Insomnia Sleep Aids : Insomnia means difficulty in falling or staying asleep, the absence of restful sleep, or poor quality of sleep. Insomnia is a symptom and not a disease. The most common causes of insomnia are medications, psychological conditions (e.g., depression, anxiety), environmental changes (e.g., travel, jet lag, or altitude changes), and stressful events. Insomnia can also be caused by faulty sleeping habits such as excessive daytime naps or caffeine consumption. Insomnia may be classified by how long the symptoms are present. Transient insomnia usually is due to situational changes such as travel and stressful events. It lasts for less than a week or until the stressful event is resolved. Short-term insomnia lasts for 1-3 weeks, and long-term insomnia (chronic insomnia) continues for more than 3 weeks. Chronic insomnia often results from depression or substance abuse. Transient insomnia may progress to short- term insomnia and without adequate treatment, short-term insomnia may become chronic insomnia. Appropriate sleep habits are important in the management of insomnia. In some instances, changing sleep habits may correct the problem without the need for medications. Good sleep habits should include: Regular sleep times; A comfortable bed and quiet room at a comfortable temperature; Appropriate lighting; Regular exercise but not close to bedtime or late in the evening; A bedroom that is not used for work or other activities that are not related to sleep; Avoidance of stimulants (e.g. caffeine, tobacco), alcohol, and large meals close to bedtime; Relaxation techniques such as breathing exercises; and Avoidance of naps during the day. Self-treatment of insomnia with over-the-counter (OTC) drugs is advisable only for transient or short-term insomnia. OTC sleep aids should only be used for a short period of time in conjunction with changes in sleeping habits. Chronic use of these drugs may result in dependence on the them. This creates a situation in which sleep is not possible unless the drug is used. Chronic insomnia should be evaluated by a physician. Insomnia: The perception or complaint of inadequate or poor-quality sleep because of one or more of the following: difficulty falling asleep; waking up frequently during the night with difficulty returning to sleep; waking up too early in the morning; or unrefreshing sleep. Insomnia is not defined by the number of hours of sleep a person gets or how long it takes to fall asleep. Individuals vary normally in their need for, and their satisfaction with, sleep. Insomnia may cause problems during the day, such as tiredness, a lack of energy, difficulty concentrating, and irritability. |
20th August 2008
