Insomnia

Insomnia is the condition characterized by interruption in regular sleep pattern. The sleep disturbance can be of the following ways:

Difficulty sleeping (sleep onset insomnia) – this type is found to mostly affect young people.

Night waking (frequent nocturnal awakening – elderly population are likely to suffer from this.

Waking early in the morning – it is the rarest type.

Sleep doesn’t leave one refreshed.

Insomnia may be present for a few days, or it may even extend to months and years. According to this insomnia is divided into:

Transient insomnia – present only for two-three days.
Short-term insomnia – present for a few days but not more than 3 weeks.
Chronic insomnia – present for greater than 3 weeks.

Symptoms

The symptoms vary in accordance to the type of sleep disturbance. The common symptoms include –

• A person lays awake for pretty elongated duration prior to sleeping.
• Several episodes of sleep disturbance amid the sleep.
• Waking up before time in morning and unable to continue sleep.
• Feeling exhausted even after normal sleep hours.
• Finding difficulty in performing day to day activities.
• Sleep deprivation resulting in irritability.

Causes

The causes can be divided into the following:
Physical: The physical factors responsible for this includes condition called ‘restless leg syndrome’, continued cough, back pain , arthritis and headaches, hot blush, an injury of head, disorders affecting gastrointestinal system, severe itching and Parkinson’s disease.

Physiological:

This includes all the interferences associated with the sleep environment. This comprise of loud noise, bright light, snoring by co – sleeper, partner walking around, jet lag, exercise or other strenuous activities prior to sleep.

Psychiatric:

If ever a mental illness like dementia, anxiety or depression is present, the person again may have sleep disturbances.

Pharmacological:

A person under treatment for a particular condition and having medicines that interfere with the normal sleep pattern is also likely to result in insomnia. The following drugs are likely to cause sleep deprivation – antidepressant medications, beta-blockers, nasal decongestants, thyroid hormones, appetite suppressants, corticosteroids etc.

Treatment

The first and foremost measure is to identify the underlying cause if any. The person has to be treated for that cause as insomnia might only be a symptom. The following general measures are found to be useful:

Counselling – in cases where insomnia is due to stressors or loss
Cognitive behavioural therapy – in case of behavioural problems
Problem-solving approaches – to make oneself confident and ease tension
Lifestyle advice – it involves restricting consumption of alcohol and caffeine just before sleep.

Sleeping tablets may be indicated if the person has severe manifestations, to treat insomnia that is short term and if all other measures are a total failure.

Benzodiazepines, Z medicines, hypnotics, melatonin etc are few medications that may be administered in this context.