Sleep disorders (also referred to as Insomnia), represent the inability to fall asleep or stay asleep during normal sleep hours. As such, if insomnia is left untreated, the result is chronic (ongoing) sleep deprivation.
Insomnia can be of 3 types, depending on the particular time during the sleep cycle when the difficulty is experienced.
- Insomnia due to difficulty falling asleep
- Insomnia due to difficulty staying asleep
- A combination of the 2 types above
Why is this classification important? Simply because the treatment is different for each type of sleep disorder: If taking medication for insomnia, you must be aware that a different agent will be required for treatment of type 1 insomnia versus treatment of type 2 or type 3 insomnia.
- For type 1 insomnia, where the main problem is difficulty initiating sleep, a sleep aid with short duration of action will provide relief.
- For type 2 or type 3 insomnia, where staying asleep represents the main problem, a sleep aid with intermediate or longer duration of action is required.
- Most of the time, sleep disturbances are the consequence of daily stresses, excessive job
demands, or personal lifestyle choices.
Below are a few examples of lifestyle factors that may cause insomnia:
- Jobs involving shift work (especially frequent night shifts, or switching between day and night shifts), are notorious for deregulating the sleep cycle and causing manifestations of insomnia.
- Staying up late at night (especially watching tv) appears to be related to a higher incidence of insomnia. This affects not only adults, but also teenagers and children.
- Food consumed close to bedtime, in particular caffeinated beverages, may keep one wired and preclude a good night's sleep.
- Poor sleep hygiene, meaning an uncomfortable sleep environment, is a major cause of insomnia in all age groups. By uncomfortable sleep environment, we mean any environmental factor that prevents continuous sleep - for example noisy sleeping quarters, temperature that's either too high or too low for comfort, excessive lighting, repeated sleep interruptions due to any environmental cause (phone ringing, pager going off, baby crying, etc).
- Anxiety, stress, or preoccupation with one's personal issues are other common factors leading to sleep disorders.
- Apart from the above-mentioned situations (which fall in the realm of normal, if unpleasant, daily life events), there are cases when sleep disorders may be linked to certain medical problems, which need to be addressed in order for the sleep disturbance to resolve.
Examples of medical conditions that may cause insomnia include:
- hypercortisolism (or Cushing syndrome)
- anxiety or panic disorder
- withdrawal from alcohol or street drugs
- withdrawal after discontinuation of various sedative medications
- certain psychiatric disorders (especially manic or bipolar disorder)
- any medical condition associated with pain or discomfort
Therefore, if the onset of a sleep disorder is accompanied by other unusual signs and symptoms
(e.g., weight changes, mood changes, headaches, etc), a medical workup is warranted to
rule out potential medical problems.
- Sometimes, sleep disorders may be caused by medications administered for other
purposes, such as:
- cold and cough medication (decongestants)
- certain antidepressant drugs
- steroid drugs
- over-the-counter weight loss supplements
- prescription weight loss medication, etc
The symptoms of insomnia are essentially symptoms of chronic sleep deprivation, including:
- daytime drowsiness
- chronic fatigue
- short attention span
- difficulty concentrating
- decreased memory capacity
- impaired task performance
- dizziness or lightheadedness
- body aches and muscle pains
- interpersonal problems
- anxiety or depression
- increased susceptibility to infection
- weight gain or weight loss (with weight gain being more common - since quite frequently the individual is prone to overeating in order to compensate for excessive fatigue)
Please note that the list above is not exhaustive, and that not every person suffering from insomnia will exhibit all of the above manifestations. Symptoms vary on an individual basis, with some persons tolerating insomnia very poorly, while others can be only minimally impaired.
- Improving your sleep quality without the use of medications should be the first line of action. Follow the link above for a detailed discussion and recommendations on how to achieve a better quality of sleep.
- Reducing Stress in your daily life is another important aspect in combating insomnia. Several relaxation techniques are available and can be employed with good results. Follow the link below for a detailed discussion:
Ways to Reduce Stress
- Finally, if everything else fails, you may consider a sleep aid. Sleeping with medication is better than not sleeping at all, so it's advisable to educate yourself about your options. Of course, sleep aids
should be taken as a measure of last resort, for limited periods of time, and in moderation
(i.e., not exceeding the recommendations of the manufacturer).
The above being said, here are the main options available:
- Over the counter (OTC) Sleep Aids:
These can be purchased without a prescription at any drugstore and are
moderately effective as far as treating insomnia. For further details (including available options), follow the link above.
- Prescription Sleep Medication:
These are controlled substances, which carry certain risks as far as addiction,
impaired task performance, overdosing, etc. This type of medication must be taken under the supervision of a physician, and usually for limited periods of time. The main categories available include benzodiazepines (such as Valium, Restoril, Xanax, etc), and non-benzodiazepines (such as Ambien, Lunesta, and Rozerem).
For further details on the individual agents in each group, follow this link:
PRESCRIPTION SLEEP AIDS
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