For the novel by Stephen King, see Insomnia (novel); for the Norwegian movie and its American remake, see Insomnia (movie).

Insomnia is a sleep disorder characterised by an inability to sleep and/or to remain asleep for a reasonable period during the night. Sufferers typically complain of being unable to close their eyes for more than a few minutes at a time, or of 'tossing and turning' through the night.

If insomnia continues for more than a few nights running, it can become chronic and cause a sleep deficit that is extremely detrimental to the sufferer's well-being. Insomnia interrupts the natural sleep cycle, which can be hard to restore. Some insomniacs unwittingly perpetuate their complaint by napping in the late afternoon or early evening, leading to wakefulness at bedtime and more insomnia. Others push their bodies to the limits, until their sleep deficit causes severe physical and mental effects.

The most common forms of chronic insomnia are:

Sleep Apnea - This is when a sleeping person's breathing is interrupted, thus interrupting the normal sleep cycle. With the obstructive form of the condition, some part of the sleeper's respiratory tract loses muscle tone and partially collapses. People with obstructive sleep apnea often do not remember any of this, but they complain of excessive sleepiness during the day. Central sleep apnea is where the normal central nervous system stimulus to breathe is interrupted, and the individual must actually wake up to resume breathing. This form of apnea is often related to a cerebral vascular condition, congestive heart failure, and premature aging.

Restless Leg Syndrome (RLS) and Periodic Limb Movement (PLM) - The symptoms of RLS and PLM are often described as a tingling and creeping sensation in the legs which creates a powerful urge to move them. The individual continually moves in bed in an attempt to relieve these unpleasant sensations, resulting in restlessness and consequently lack of sleep. Fortunately for sufferers of the condition, current treatments for this disorder are effective in over 90% of those treated.

Phase Shift Disorder - this occurs when a person's biological clock no longer obeys the normal cycle of sleeping during the night and waking during the day. This is most often seen in people who travel through multiple time zones on a regular basis, as the time relative to the rising and falling of the sun no longer coincides with the body's internal concept of it, and is also seen in people who consistently work during the night. See also: circadian rhythm, jet lag.

Parasomnia - this includes a number of disorders of arousal or disruptive sleep events including nightmares, sleepwalking, violent behavior while sleeping, and REM behaviour disorder, in which a person moves their physical body in response to events within their dreams. These conditions can often be treated successfully through medical intervention or through the use of a sleep specialist.

Many people who feel they are suffering from insomnia may actually have a lower physical need for sleep than they believe they do. A normal part of the aging process is to sleep more lightly and for shorter periods of time, and some elderly people toss and turn in bed late at night or early in the morning when their body has no physical need for more rest, because they believe that they 'need' a certain amount of sleep to be rested.

Insomnia is a common side-effect of some medications, and it can also be caused by stress, emotional upheaval, physical or mental illness, dietary allergy and poor sleep hygiene. Insomnia is a major symptom of mania in people with bipolar disorder, and it can also be a sign of hyper-thyroidism, depression, or other ailments with stimulating effects.

Additionally, a rare genetic condition can cause a prion-based, permanent and eventually fatal form of insomnia called Fatal Familial Insomnia.


Treatment for insomnia

Many insomniacs rely on sleeping tablets and other sedatives to try to get some rest. Others use herbs such as valerian, chamomile, lavender, hops, and/or passion-flower.

Some traditional remedies for insomnia have included drinking warm milk before bedtime; taking a warm bath in the evening; exercising vigorously for half an hour in the afternoon; eating a large lunch and then having only a light evening meal at least three hours before bed; avoiding mentally stimulating activities in the evening hours; and paradoxically, making sure to get up early in the morning and to retire to bed at a reasonable hour.

Traditional Chinese medicine practitioners have been treating insomnia sufferers for thousands of years. A typical approach may utilize acupuncture, dietary and lifestyle analysis, herbology and other techniques, with the goal of rebalancing the body's energies to resolve the problem at a subtle level.

Although they may seem unscientific, many of these remedies are sufficient to break the insomnia cycle without the need for sedatives and sleeping tablets. Warm milk contains high levels of tryptophan, a natural sedative. Lavender oil and other relaxing essential oils may also be used to help induce a state of restfulness.

The most commonly used class of hypnotics prescribed for insomnia are the benzodiazepines. This includes drugs such as diazepam, lorazepam, nitrazepam and midazolam.

Removing probable causes of insomnia

Please note that the advice given below is not a substitute for a professional medical specialist's advice.

  • Sufferers of insomnia should avoid all caffeine. Caffeine is often a factor in insomnia, including insomnia in night-shift workers. Caffeine is found in coffee, tea, yerba mate (Ilex paraguaiensis), guarana, cocoa, kola nut (this includes all cola drinks); it is also found in "energy" sodas like Red Bull and similar, chocolate bars and other candy. Drink herbal teas or plain water instead of caffeine-containing liquids.
  • The bedroom environment should be conducive to sleep. Some people are very sensitive to light while others are sensitive to noise. The bedroom should be dark and quiet at night.
  • Practice good sleep hygiene. Do not use the bed for too many activities besides sleep. Using the bed for reading, writing, watching TV and other such non-sleep-related activities will lower your association of the bed with sleeping. Similarly, try to keep to a regular schedule of what time to go to bed and what time to wake up. Try not to sleep during the daytime.
  • Sleep apnea can be a cause of insomnia. While a visit to the doctor will help in the diagnosis or ruling out of sleep apnea, a definitive answer will have to come from a study at a sleep lab.
  • Sometimes lack of sleep is indicative of an emotional problem that's not being dealt with. If a person is not happy with their lifestyle, or they are putting off problems that should be dealt with, it can often result in sleeping trouble. Just as the human body has nutritional requirements, all people have social and environmental requirements. Sometimes more social activities can help.
  • Patients with depression may suffer from insomnia. A doctor can treat this, sometimes by changing or adding prescriptions.
  • In the Buddhist tradition, those suffering from insomnia or nightmares may be advised to practice meditation on loving-kindness, or metta. The practice of generating a feeling of love and goodwill toward all beings can have a soothing and calming effect on the mind and body. In the Mettā Sutta, The Buddha said that easeful sleep was one of the eleven benefits of this form of meditation.
  • Obscure allergies, such as dairy allergies, can sometimes cause sleeping disorders. Other symptoms may be very mild, such as slightly stuffed sinuses. A nutritionist can make helpful dietary and supplement recommendations.
  • If an alarm has been set, avoid looking at the clock during the night and cover the display if necessary. This prevents mental calculations of how much sleep has been lost so far and how little sleep can be obtained before the alarm will sound. Accepting that the amount of sleep obtained can only be determined upon waking, not while waiting to get to sleep, may also be beneficial.

A multifaceted approach

Most people who have cured their insomnia have done so by reviewing and experimenting with many different cures. Often, a combination of dietary and lifestyle changes is the most helpful approach. As with many similar health problems, a determined, across-the-board holistic approach to sleeping problems is the most effective solution.

External links

nl:Insomnia pl:Bezsenność ru:Бессонница sv:Smnlshet tr:İnsomnia


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