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Insomnia
























































Insomnia

Insomnia is a common sleep disorder.

The childhood sleep habits may impact the sleep behaviors as adults.

The more they strive to enforce sleep, the more anxious they become, which makes it more challenging to sleep.

Variations in sleep hygiene are the best treatment for falling and staying asleep.

Insomnia can cause daytime drowsiness and a lack of energy to perform daily activities.


Definition

Insomnia is a common sleep disorder occurring in various age groups. People may have trouble falling asleep, staying asleep, or both. Consequently, they may get little or poor-quality sleep and feel less refreshed when the insomniac wake up.



Classification

Insomnia may have three types:


A. Short-term Insomnia

This type of insomnia lasts for less than three months. The major causes of this insomnia are anxiety, psychological issues, and environmental variations.


B. Chronic Insomnia

The insomnia can last for more than three months and occurs at least thrice a week.


C. Other Insomnia

Insomnia becomes complicated if it does not fit into the above two classifications. For instance, one may have insomnia symptoms lasting more than there months but occurring less than thrice a week.



Epidemiology

Chronic insomnia lasts a month or longer, impacting women more often than men. The insomniac can get it at any ages age, but senior adults are more likely to get insomnia. There are many causes of insomnia. However, the most common risks are stress, emotional distress (divorce or death of a spouse), income issues, and work overload. Likewise, insomnia can also occur if the insomniac have jetlag due to long-distance traveling. Furthermore, if insomniacs are going through an inactive lifecycle, they can have sleep troubles. An US-based study concludes that black Americans take longer to fall asleep and have more sleep-related breathing issues than whites do.



Nonetheless, most cases of chronic insomnia are secondary. It implies that insomnia might occur due to the symptoms or side effects of some other problems. These issues include certain medical conditions, medicines, and other sleep disorders. Moreover, the consumption of caffeine, tobacco, and alcohol may also cause insomnia in adults.



Causes

I. Poor sleep or lifestyle habits

Poor sleep or lifestyle habits may cause insomnia or make it worse, including:



Going to bed at a different times each night

Daytime napping

Poor sleeping conditions, such as too much noise or light.

Spending too much time in bed without sleeping

Working in evenings or night shifts due to overload or job nature

Not getting time to do adequate exercise

Watching TV, using the laptop or a smartphone while in bed

II. Medication and other Hazardous Substances

The consumption of medication and some harmful substances may also affect sleep. These substances include:



Alcohol or other drugs

Heavy smoking

Drinking too much caffeine throughout the day or in the evening

Getting used to certain types of intoxicating medicines

Regular use of some cold medicines and diet pills

Other medicines, herbs, or supplements

III. Physical, Social, and Psychological Health Issues

These issues can adversely affect insomniacs' sleep patterns. Some of the mental issues include the following:



Bipolar disorder

Depressive or sad feelings can cause people to seek medical help

Short-term or chronic stress and anxiety due to insomnia make it harder to fall asleep

IV. Health Issues

Some health-related issues may also lead to problems in sleeping and insomnia:



Pregnancy

Physical pain or discomfort

Waking up at night to use the bathroom is common in men with enlarged prostate.

Sleep Apnea

With aging, sleep patterns may vary, and many people find that aging causes insomniacs to have a harder time falling asleep. Therefore, they wake up more often.


Symptoms

The most common complaints or symptoms in people with insomnia are:



Trouble falling asleep on most nights

Feeling exhausted or falling asleep during the day

Not feeling refreshed after waking up

Waking up several times during sleep


The thought of getting enough sleep sometimes consumes people with insomnia. But the more insomniacs strive to sleep, the more frustrated and upset they get. As a result, it becomes harder for insomniacs to fall asleep. Lack of restful sleep can create the following issues:



It can make insomniacs tired and unfocused, hampering their routine activities.

It can put insomniacs at risk for automobile accidents. Therefore, pulling over and taking a break is better if insomniacs feel drowsy while driving.


Diagnosis

Study insomniacs' medical history.

Health professional may ask insomniacs for details about their sleeping habits and sleep history.

The health professional may take a physical exam to rule out other medical problems that might cause insomnia.

Doctor may recommend a sleep study, which quantifies how well insomniacs sleep and how their body responds to sleep issues.


Treatment

Talk Therapy

Various methods of talk therapy, such as Cognitive Behavioral Therapy for Insomnia (CBT-I) , may help insomniacs gain control over anxiety or depression. CBT is an integrated form of cognitive and behavioral therapy. Clinical practice has proven that it is an effective treatment method for short-term and long-term insomnia. Moreover, it is more effective than single-component therapy, more durable than medication, and suitable for people of all ages. Thus, CBT-I is an effective first-line treatment for chronic insomnia. Regarding cognition, insomniacs should adjust the attitudes toward insomnia. They should not pay too much attention to sleep, force themselves to fall asleep, or blame insomnia for everything. As for behaviors, one should intervene against insomnia through professional relaxation training and sleep-aid behaviors. The following describes some common behaviors adjustment:



Do not go to bed until insomniacs are feeling sleepy.

Chang the bedtime habits. The bed is for sleeping. Reduce the time spent in bed. Do not do things like eating, watching TV or using smartphones and other things that have nothing to do with sleep in bed.

Create a regular exercise routine for at least thirty minutes on most days. Do not nap for more than half an hour or avoid naps during the day or in the evening.

Sleep Hygiene

It would help to consider lifestyle and sleep habits that may impact insomniacs' sleep. This process is usually known as Sleep Hygiene. Moreover, transforming insomniacs' sleep habits may improve or solve their insomnia issues.



Develop a sleep routine, and try to wake up at the same time every day.

Maintain a regular diet; do not go to bed on a full or empty stomach, and avoid eating heavy meals at least two hours before sleeping.

Avoid tea, coffee, alcohol, and smoking before bedtime.

Avoid activity that increases the insomniac's heart rate for three to four hours before bed.

Find calming, relaxing activities before bedtime, such as reading or bathing.

Ensure that the insomniac's sleep area is quiet, dark, and at a temperature that s/he insomniac like.

Move to another room if the insomniac cannot fall asleep within 30 minutes and perform a quiet activity until s/he feels sleepy.

Sleep Requirements

Not getting eight hours of sleep every night, does not imply that the insomniac's health is at risk. Different people have diverse sleep requirements. For instance, some do fine on six hours of sleep a night. Others only do well if person they get ten to eleven hours of sleep. Treatment often begins by reviewing any medicines or health problems that may cause or worsen insomnia, such as:



Enlarged prostate gland, causing men to wake up at night.

Pain or discomfort from muscle, joint, or nerve disorders, such as arthritis and Parkinson's.

Other medical conditions include acid reflux, allergies, and thyroid problems.

Mental health disorders, such as depression and anxiety.

Medicines

Some insomniacs may require medicines to help with sleep for a short period. But in the long run, changing the insomniac's lifestyle and sleep habits is the best treatment for issues with falling and staying asleep.



Most Over-The-Counter (OTC) sleeping pills contain antihistamines--usually prescribed for treating allergies. Insomniacs' body quickly becomes used to them.

Insomniacs' health provider can prescribe sleep medicines called hypnotics to help reduce the time insomniacs fall asleep. However, most of these can become habit-forming.

Medicines used to treat anxiety or depression can also help with sleep.


Intervention

In daily life, insomniacs should maintain good sleep habits, exercise properly, relax their mind, and should not pay too much attention to sleep issues. Insomniacs should avoid smoking, alcohol, tea, coffee, and other sleep-related medications. The following factors can help insomniacs prevent insomnia:


Social Support

Family members can help insomniacs specify bad sleep habits and maintain a regular work and rest schedule.

Try to create a comfortable sleeping atmosphere in the bedroom and maintain a moderate luminance and temperature.

Care for the insomniac and avoid negative emotions like anxiety or depression.

During the treatment, family members should help one maintain a sleep diary for the doctor's treatments.

Behavior Management

Healthy sleep habits can help the insomniac improve sleep quality, maintain long-term efficacy, and avoid the recurrence of insomnia. Here are some suggestions for behavioral management:



Maintain physical exercise daily to improve fitness;

Do not overeat, and avoid indigestible foods before sleeping.

Relax the mind and the body, and practice belly breathing and muscle relaxation exercises before bed.

If insomniacs still cannot fall asleep twenty minutes after going to bed, do not force themselves to lie in bed. Get up, move around briefly for a while, and then go back to sleep when sleepy.

Monitoring Diary

During the treatment of insomnia, healthcare professionals usually conduct an efficacy assessment once a month. Their evaluation determines whether insomnia symptoms have improved or disappeared and whether the routine life has returned to normal. Later, they conduct a comprehensive assessment in six months, including a sleep diary and assessment scales. Six months after treatment discontinuation, they perform a final assessment to monitor the recurrence of insomnia.


Prevention

Prevention of insomnia is primarily to avoid triggering factors. They include avoiding excessive stress, creating a comfortable sleep environment, correcting poor sleep habits, etc. Appropriate exercise can also help improve sleep. If insomnia occurs due to mental disorders or other diseases, the doctors should actively treat the primary disease to avoid persistent insomnia.



Prognosis

Insomnia can cause daytime drowsiness and a lack of energy. It also can make insomniacs feel anxious, depressed, or irritable. They may have trouble focusing on tasks, learning, and recalling. Insomnia also can cause other serious issues. For instance, it could make insomniacs feel drowsy while driving. As a result, it could cause them to get into a car accident. Insomniacs can restore normal sleep and wake refreshed through psychotherapy, physical therapy, and medication.



For those with short-term insomnia, it is imperative to eliminate the insomnia causes to prevent the transition from acute to chronic insomnia. After a month of treatment, the insomniac should see the doctor again to evaluate the treatment effects. The doctors usually observe whether insomnia symptoms have improved or disappeared.



The high-risk period for recurrence of insomnia is six months after treatment discontinuation. People with insomnia are more likely to experience insomnia again than ordinary folks. Therefore, the insomniac should maintain good sleeping habits to prevent the condition from reoccurring.


Complications

Long-term chronic insomnia may lead to physical diseases such as obesity, diabetes, hypertension, cardiovascular disease, and mental disorders such as anxiety and depression.


Sources:- shuteye

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Preet Kaur
Preet Kaur
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