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INSOMNIA (Sleep Disorder)

General Information

DEFINITION--Sleep disturbance that includes difficulty in falling asleep, remaining asleep, intermittent wakefulness, early morning awakening or a combination of these. Insomnia affects all age groups but is more common in the elderly. Insomnia may be transient due to a life crisis or lifestyle change; or chronic, due to medical or psychological problems or drug intake.

BODY PARTS INVOLVED--Nervous.

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS

  • Restlessness when trying to fall asleep.
  • Brief sleep followed by wakefulness.
  • Normal sleep until very early in the morning (3 a.m. or 4 a.m.), then wakefulness (often with frightening thoughts).
  • Periods of sleeplessness, alternating with periods of excessive sleep or sleepiness at inconvenient times.

CAUSES

  • Depression. This is usually characterized by early-morning wakefulness.
  • Overactivity of the thyroid gland.
  • Anxiety caused by stress.
  • Sexual problems, such as impotence or lack of a sex partner.
  • Daytime napping.
  • Noisy environment (including a snoring partner).
  • Allergies and early-morning wheezing.
  • Heart or lung conditions that cause shortness of breath when lying down.
  • Painful disorders, such a fibromyositis or arthritis.
  • Urinary or gastrointestinal problems that require urination or bowel movements during the night.
  • Consumption of stimulants, such as caffeine.
  • Use of some medications, including dextroamphetamines, cortisone drugs or decongestants.
  • Erratic work hours.
  • New environment or location; jet lag after travel; lack of physical exercise.
  • Alcoholism; drug abuse, including overuse of sleep-inducing drugs; withdrawal from addictive substances.

RISK INCREASES WITH--Stress, obesity, smoking.

HOW TO PREVENT

    Establish a lifestyle that fosters healthy sleep patterns.


What To Expect

DIAGNOSTIC MEASURES--

  • Medical history and exam by a doctor.
  • Laboratory thyroid studies, EEG (See Glossary).
  • Tests in a sleep-study laboratory (sometimes).

APPROPRIATE HEALTH CARE

  • Self-care after diagnosis.
  • Doctor's treatment; psychotherapy or counseling, if the cause is psychological.

POSSIBLE COMPLICATIONS

  • Transient insomnia becomes chronic.
  • Increased daytime sleepiness that can affect all aspects of your life.

PROBABLE OUTCOME--Most persons can establish good sleep patterns if the underlying cause of insomnia is treated or eliminated.


How To Treat

GENERAL MEASURES--

  • Seek ways to minimize stress. Learn and practice relaxation techniques.
  • Don't use stimulants close to bedtime.
  • Treat any underlying or medical cause.
  • Relax in a warm bath before bedtime.
  • Don't turn your bedroom into an office or a den. Create a comfortable sleep setting.
  • Turn off your mind. Focus on peaceful and relaxing thoughts. Play soft music or relaxation tapes. Set a rigid sleep schedule.
  • Use mechanical aids such as ear plugs, eye shades or electric blanket.

MEDICATION--Your doctor may prescribe sleep-inducing drugs for a short time if:

  • Temporary insomnia is interfering with your daily activities.
  • You have a medical disorder that regularly disturbs sleep.
  • You need to establish regular sleep patterns. Long-term use of sleep inducers may be counter-productive or addictive.

ACTIVITY-- Exercise regularly to create healthy fatigue, but not within 2 hours of going to bed.

DIET--

  • No special diet, but don't eat within 3 hours of bedtime if indigestion has previously disturbed your sleep. Drinking warm milk before bedtime helps some. Limit caffeine consumption.

Call Your Doctor If

  • You have insomnia and self-help methods are ineffective.
  • New, unexplained symptoms develop.
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