Insomnia -Causes and Treatment

Scientist have new information for insomnia treatments, as well as, other types of sleep disorders. Any diagnosis of insomnia obviously comes from a clinical interview witha patient, another family member is helpful, and the patient diary documenting the problem is helpful. Some patients are referred to as sleep Center for some tests, or other possible reasons for the sleeping disturbance. Insomnia is a common sleep disorder that affects up to one third of adults in Western countries, has a high prevalence in women versus men, and is often associated with a psychiatric disorder.

Disturbances of your natural circadian rhythm are a problem for some people. The key feature of circadian rhythm disorders is a continuous or occasional disruption of sleep patterns.

Some of the possible causes of circadian rhythm disorder:

• Consider jet lag in time zone changes
• Shift work when you work rotating shifts
• Delayed sleep phase syndrome (DSPS):  people tend to fall asleep and wake up late to go to work or school
• Advanced sleep phase syndrome:  people tend to fall asleep early in the evening and wake up earlier than desired in the morning
• Non 24-hour sleep wake disorder:  This is a condition in which an individual has a normal sleep pattern but lives in a 25-hour day. The person has inconsistent insomnia which occurs at different times each night and they sometimes fall asleep earlier and wake earlier, of they fall asleep later and wake up later.

Parasomnias are disruptive sleep-related disorders that can occur during arousals from rapid eye movement (REM) sleep or arousal from non-rapid eye movement (NREM) sleep. Parasomnias:

• are characterized by undesirable physical or verbal behaviors, such as walking or talking during sleep
• occur in association with sleep, specific stages of sleep or sleep-wake transitions
• can be divided into two groups—primary parasomnias and secondary parasomnias.

Nightmares – The person is usually awakened from REM (rapid eye movement) sleep with feelings of terror, fear and anxiety. Nightmares can be caused by many factors including illness, anxiety, the loss of a loved one, or negative reactions to a medication.

Sleep terrors, night terrors – A person experiencing a sleep terror awakened in a terrified state but while they appear awake they are confused and not able to communicate for about 15 minutes. At this point they can usually go back to sleep and won’t remember the dream in the morning

Sleepwalking usually occurs during non-REM sleep in the early evening. Again this is seen primarily in children 6-12 and can run in families.

REM Sleep behavior disorder (RBD) -People with rapid eye movement (REM) sleep behavior disorder act out dramatic and/or violent dreams during REM sleep. Usually, RBD occurs in men aged 50 and older.

Insomnia is a subjective disorder and is usually long term. Circadian rhythm disorders are sleep disorders in which there is a mismatch between circadian rhythms and the required sleep-wake cycle. Parasomnias are unusual episodes or behaviors occurring during sleep. It is important to treat insomnia because the condition causes decreased quality of life; is associated with impaired functioning in many areas; and leads to increased risk for depression, anxiety, and possibly cardiovascular disorders.

The goal of treatment is to lessen anguish and improve daytime function. Choice of treatment modality is patient guided and is based on the particular pattern of problem, such as sleep-onset insomnia or sleep maintenance, as well as on the evidence supporting use of specific treatments. There are several types of prescriptions available that your doctor can prescribe.

Prolonged-release melatonin improves sleep-onset latency and quality of life in patients older than 55 years. Antidepressants for insomnia should be considered when there is a coexistent mood disorder. Antihistamines have a limited role in psychiatric and primary care practice for the management of insomnia. For the treatment of circadian rhythm disorders, melatonin is effective in jet lag disorder. For parasomnias, drug treatment should be based on frequency and severity of events. Psychological treatments are effective for nightmares.

Sleep apnea and restless leg syndrome are two other sleep problems but I will write about those in another hub.

1. Take a hot bath or shower to relax before bed.
2. Try reading something instead of watching a violent show on TV.
3. Drink a cup of hot non-caffeinated tea, but avoid late night snacks.
4. Keep your room as dark as possible as any light can interfere with your production of melatonin.
   
5. Set a regular bedtime, but reasonably early as our best sleep is typically between 11:00 PM and 1 AM.
6. Wear socks to bed as this is the area of poorest circulation in your body; cool feet can wake you up.
7. Don't have the clock too close to the bed where you stare at it during the night as you only become more aware of your lack of sleep.
8. Drink less fluids toward night as this will keep you from waking up to go to the bathroom.
9. Meditation and prayer are very good to help you relax right before bed.
10. Some people find it helpful to wear an eye mask for sleep.
11. Use white noise or a sleep noise machine which will often help.
12. These are just a few suggestions which may help. Of course, eating healthy and regular exercise are always helpful for a healthy life.

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The copyright to this article is owned by Pamela Oglesby. Permission to republish this article in print or online must be granted by the author in writing.