Every day at a regular time, you have the need to sleep; you cannot prevent it from happening. It is not a hazard; this occurs due to very complex internal (hormonal) and external (environment) mechanisms. Functions of sleep in your life are multiple. It reduces or prevents mental and physical fatigue. A good night sleep is one of the best ways to achieve a good mental balance. Sleep provides you energy that no medication in the world can do. In addition, normal sleep patterns can prevent stress, depression, and help you have a healthy immune system. However, having a good sleep is not always the case for some people; they have insomnia.
Insomnia is the difficulty of falling and/or achieving the usual duration of sleep. Since duration of sleep tends to vary from one person to another, to estimate existence of insomnia, your current sleep duration must be shorter than your sleep habit in normal environment or circumstances. However, no matter what your sleep habit is, you need about eight hours of sleep each night.
In fact, insomnia is a common problem is the US. Approximately 64 million Americans suffer from sleep disorder each year. Although this disorder can affect sex, studies have shown that insomnia is more common in women than in men.
Insomnia Causes and Risk Factors
Insomnia can be transient, acute or chronic.
Transient insomnia – this form of insomnia usually lasts 2 to 3 days, rarely 3 weeks. It is most often associated with minor circumstances such as falling in love and non clinical stress.
Acute insomnia – usually lasts less than month, a few days to several weeks. It is linked to environmental, social or physical circumstances: emotional stress, professional problems, pain, etc.
Chronic insomnia – this sleep disorder is often linked to psychological and physiological factors. This may includes anxiety, depression, clinical stress, frequent nighttime awakenings due to certain diseases (Nocturia for instance), financial crisis, serious psychiatric problems, melancholy, mental confusion, dementia, etc. Certain disease such as cancer can cause chronic insomnia.
Some other common causes of insomnia include:
• Changes in life, giving birth, illness of a close relative
• Digestive disorders such as heartburn or acid reflux
• Sleep apnea
• Diseases: arthritis, fibromyalgia, restless leg syndrome, etc.
• Chronic cough
• Extreme need to have sex
• Circadian rhythm disturbance
• Several hours of sleep during the day
• Hormone change such as those that precede menstruation and those during menopause
• Difficulty of breathing during sleep due to nasal congestion or being overweight
• Persistent need to urinate during the night due to nocturia
• Consumption of psychoactive substances such as coffee, nicotine, alcohol, drugs
• Taking certain drugs such as anti-inflammatory drugs, antidepressants drugs and those used in the treatment of angina pectoris, and asthma
• Emotional disturbances such as divorce, death, betrayal, etc…
• Environmental disturbance noise, light, snoring, uncomfortable mattress, uncomfortable room temperature, etc.
Unlike many other diseases, you do not need a physician to tell you have insomnia; its symptoms are easily recognized, waking up early and difficulty to fall and/or stay asleep at night. Insomnia can lead to:
- Daytime fatigue or sleepiness
- Daytime irritability
- Memory disorders
- Head ache
- Decreased concentration and focus.
How Is Insomnia Diagnosed?
Usually, diagnosis of insomnia is based on its symptoms. Your doctor may ask you questions about your medical condition, environment, and medication you are taking. You may be also asked for how long you have been suffering from the insomnia and factors that can be linked to it, pain, polyuria, snore, etc.
Your doctor may also question you about current events in your life that can lead to sleep disorder, personal relationships, problems at work, financial crisis. If the interrogation is not sufficient to determine the cause of your insomnia, you will be recommended a multi-parametric test called polysomnography.
Polysomnography (PSG) – performed to identify sleep disorder, polysomnography is a medical procedure during which a medical device registers, during your sleep, physiological changes in your body: respiratory rate, heart rate, electroencephalography (EEG), electromyogram of the muscles of your arms or legs, etc. This exam is used in case of sleep apnea syndromes (obstructive sleep apnea, central sleep apnea), median stalk syndrome, and parasomnia (disorders that intrude into your sleep process and create disruptive sleep-related events).
Insomnia can be treated by practicing simple measures: go to bed only when you have the need for sleep, exercise regularly, do not eat large meal right before you g to bed, turn off the light in your bedroom, listen to a soft music, try to relax your mind, take a shower about one hour before you to bed. In addition, you need to:
- Avoid taking sleeping pills; they tend to worsen your sleep problem
- Avoid doing challenging physical or intellectual activities before going to bed
- Use computer at least one hour before bedtime
- Turn your phone off before you go to bed
- Not drink lot of fluid before you go to bed
- Not drinking alcohol to help you fall sleep; it does not treat insomnia, and can become addiction
- Try to relax If you feel stressed or depressed
- Not drink coffee or alcohol hours before you go to bed
- Not smoke before you go to bed.
Medications – Certain medications such as hypnotics, anxiolytics, and antidepressants drugs can help you; however, their effects are short and excessive use can lead to addiction (you need them to feel good) or dependency (you can no longer sleep without them). In addition, they can cause drowsiness in the morning.
Some of the medications commonly used in the US in the treatment of insomnia include zolpidem (Ambien), eszopiclone (Lunesta), zaleplon (Sonata), ramelteon (Rozerem), benzodiazepines (Valium, Ativan, Librium, midazolam, etc.).
Common side effects of those drugs include physical dependence, allergic reaction, swollen face, blurred vision, aggression or feeling agitated confusion, diarrhea, nausea, vomiting, headache, muscle pain, forgetfulness, etc.
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