Are you one
of those people who either have trouble falling asleep at night OR wake up
throughout the night; often struggling to fall back to sleep? Most probably
this will sound common to a lot of you, with the ‘busy’ lives that we are
leading in today’s times.
For some people, it could just be a matter of a few
disturbances that occur throughout the week, resulting in acute insomnia; and
this can last for just a month. Our lifestyles have become extremely hectic and
our work patterns become far more demanding.
However,
most people fall under the other category, which is chronic insomnia- that
happens for over 1 month. Insomnia is not just about finding it difficult to
fall asleep; it actually has a lot to do with the ‘quality’ and ‘quantity’ of
our sleep. It is an inability for individuals to get restorative sleep,
eventually causing daytime sleepiness, drowsiness and fatigue.
Of course
this is accompanied by feelings of irritability, anxiety and even depression.
The end result being that our personal and even our professional lives get
adversely affected. It can even make day-to-day tasks difficult to execute such
as driving, etc.
Causes:
Although
insomnia can occur without any underlying cause, most often it can aggravate
other health problems such as psychiatric conditions, pulmonary disease and
many other conditions that may cause physical pain.
Some of the underlying conditions that cause
insomnia are: diabetes, cancer, Parkinson’s disease, Alzheimer’s Disease, gastro esophageal
reflux disease (GERD), hyperthyroidism, an
overactive thyroid, heart failure, chronic pain, sleep apnea, restless leg
syndrome, use of or withdrawal from alcohol and other sedatives such as
anti-anxiety and sleep drugs like benzodiazepines, mental disorders such as bipolar disorder, clinical depression, generalised anxiety disorder, post-traumatic stress disorder (PTSD), schizophrenia, obsessive compulsive disorder, ADHD and dementia.
Medications:
Now, this is the tricky part, because many people already suffer from some or
the other health problem and the medicine they take for that health problem may
create a side effect of insomnia. Medications such as epilepsy medications,
antidepressants, hormone replacement therapy, medication for high blood
pressure (hypertension), such as beta-blockers, non steroidal anti-inflammatory
drugs (NSAIDS), certain medications that are used for treating asthma such as
salmeterol, salbutamol and theophylline.
Psychiatric
problems such as mood disorders, depression, bipolar disorder, anxiety disorders
anti-anxiety sedatives, panic attacks, or even post-traumatic stress disorders;
all cause insomnia. Even psychotic disorders such as schizophrenia can cause
insomnia.
Insomnia is
also a side effect to many stimulants such as caffeine and alcohol, which can
disrupt the sleep cycle. Sleep therapist and a hypnotist,
Tanusha Banerjee says, "Remember how you survived on cups of coffees
during the nights when you crammed for your exam? Caffeine is a stimulant, and
it can make us alert by temporarily blocking certain sleep-inducing chemicals
in the brain. It also increases adrenaline production. So, avoid having
anything caffeine in the night time." That is also to mention tea,
cola and other caffeinated drinks which can keep you up in the night and
prevent you from sleeping.
It could
even run in the family. According to a 2008 study teens with parents who had
insomnia have an increased risk of using prescribed sleeping pills and having
mental problems.
It could
also be a result of the daily stresses that are experienced at work or even
relationships, or even environmental factors (such as having to work at night
shifts, having a new born baby, etc.). There are also biological factors that
play a role in causing insomnia as well too; these include heightened levels of
cortisol, reduced levels of estrogen and progesterone (typically common during
menopause). Its easy to try to ‘self-medicate’ one-self’ by consuming alcohol and
taking benzodiazepines.
So, what
about the diagnosis of insomnia? As per medical information, it has been found
that insomnia lasts for periods of time because of Symptoms or a history of
depression, anxiety, or psychosis, Any new or ongoing health problem, painful
injuries or health conditions, such as arthritis, coping with highly stressful
life events, such as divorce or death and taking any medicines taken- either
over-the-counter or prescription
HOW DO WE MANAGE THIS UNWELCOME NEIGHBOUR- INSOMNIA?
Good Sleep Hygiene:
It’s very
important to have good sleep hygiene; i.e. sleeping and waking up at the same
time everyday, including weekends.
It also
includes getting exercise on a daily basis, reducing alcohol intake, avoiding
daytime naps (ONE OF THE MAIN REASONS FOR INSOMNIA), avoiding caffeine and
smoking (and in general) in the evening and NOT going to sleep on an empty
stomach (i.e. hungry). To ensure good sleep, it's important
that you tire your body out," says sleep specialist Mohammad Hasin,
"Exercising four hours before your sleep time is advisable.
Another
method of treatment is Stimulus Control: This is a term used to describe
situations in which a behavior is triggered by the presence or absence of
some stimulus. Therefore we
associate the bed only with sleeping and for no other activity. It should not
be used as a place for watching TV or even reading or sending a text or talking
on the phone.
Sometimes it is necessaary
to make use of eye covers and plug ears in case there is bright lights and
noise in the surrounding area. It is VERY, VERY important to NOT FORCE sleep.
If you just cant sleep after twenty minutes of time, it is better to leave the
bed, do something and come back when ready.
Another technique of
treatment is known as behaviour therapy, which includes relaxation techniques
and cognitive behviour techniques. This therapy helps a person to manage the
problems and life stressors in their lives in a better manner.
However, despite all of
these techniques there are medication which can help such as melatonin
agonists, non-benzodiazpine sedatives and occassionally benzodiazepines.
However, with every medication there is always a side-effect and these too have
side effects.
Tips for a Good Night of Sleep:
1)
Create a Routine & Stick to it: Ensure
that you wake up at a fixed time (suppose 8 AM) and sleep at a fixed time (10
PM). As far as possible avoid the afternoon snoozes.
Make
sure your room is noise-free: Sleep in a room that is dark, with a comfortable
temperature and does not have any surrounding noise.
2)
Create a relaxing bedtime ritual: Have
a relaxing, warm bath 30 minutes before bedtime: This will refresh you and
create a mood to sleep. You can also listen to soft music or even use this time
to read a book.
Have
a glass of warm water/milk – whatever you prefer.
3)
Avoid having heavy meals at dinner time.
In
addition to all of this, some of the other cognitive and behavioural treatments
include:
1)
Sleep-restriction therapy: This is a
therapy that is used to restrict the amount of time that is actually spent in
bed versus the actual amount of time spent
asleep. The sleep time is gradually increased as and when the sleep improves.
2)
Relaxation training: This method is
also known as relation technique and is a method/process/activity/procedure to
help a person basically relax. In order to do this, he/she has to attain a
state of increased calmness or reduced levels of anxiety, pain, anger and
stress. It helps to reduce the number of intrusive thoughts that may be
interfering with the quality of sleep.
3)
Bio-feedback: It is a method by
which a person learns to control their body’s functions, such as say their
heart rate. In this method, the person gets connected to electrical sensors,
which help to receive information (feedback) about your body (bio).
Risk Factors: Who Should be on
the lookout?
Although,
everyone should pay attention to their health the risk of insomnia is higher
for certain people. These people include:
A
woman: Hormonal shifts that take place during the menstrual cycle and even in
menopause. During menopause, hot flashes and night sweats are common and
disrupt the sleep. In fact, insomnia is particularly common during pregnancy as
well.
You’ve
crossed the Age of 60: With changes in health and sleep patterns, so does the
chance of getting insomnia increase.
No
Fixed Schedule to Follow: A schedule brings about a sense of discipline in our
lives. Without one, it could just bring about a lot of chaos and disruptions to
our sleep-wake cycle.
A
Mental health disorder or physical health condition: Are you one of those suffering from anxiety
or depression or physical health problems such as obesity, gastrointestinal problems,
asthma, diabetes or heart disease?
In addition to
psychological and physical health problems there is the constant nagging of
your number one enemy, that being stress! "Stress doesn't only make us
feel awful emotionally," says Jay Winner, MD, author of Take the
Stress Out of Your Life and director of the stress management Program for Sansum Clinic in Santa Barbara, Calif.
"It can also
exacerbate just about any health condition you can think of." Its
important to remember that stress is not JUST a feeling or JUST IN YOUR HEAD!
According to Jay Winner, MD, author of Take the Stress Out of Your Life, It's
a built-in physiologic response to a threat. When you're stressed, your body
responds.
Your blood vessels
constrict. Your blood pressure and pulse rise. You breathe faster. Your bloodstream
is flooded with hormones such as cortisol and adrenaline. "When you're
chronically stressed, those physiologic changes, over time, can lead to health
problems,"
Its high time you STOP the sleepless nights, take
control of your life and daily habits and push INSOMNIA out the back door!
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