Sleep Disorder - Insomnia

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General Information

DEFINITION - Sleep disturbance that includes difficulty in falling asleep, remaining asleep, intermittent wakefulness, early morning awakening or a combination of these. Insomnia affects all age groups but is more common in the elderly. Insomnia may be transient due to a life crisis or lifestyle change; or chronic, due to medical or psychological problems or drug intake.

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BODY PARTS INVOLVED - Nervous.

SEX OR AGE MOST AFFECTED - Both sexes; all ages.

SIGNS & SYMPTOMS

• Restlessness when trying to fall asleep.
• Brief sleep followed by wakefulness.
• Normal sleep until very early in the morning (3 a.m. or 4 a.m.), then wakefulness (often with frightening thoughts).
• Periods of sleeplessness, alternating with periods of excessive sleep or sleepiness at inconvenient times.

CAUSES

• Depression. This is usually characterized by early-morning wakefulness.
• Overactivity of the thyroid gland.
• Anxiety caused by stress.
• Sexual problems, such as impotence or lack of a sex partner.
• Daytime napping.
• Noisy environment (including a snoring partner).
• Allergies and early-morning wheezing.
• Heart or lung conditions that cause shortness of breath when lying down.
• Painful disorders, such a fibromyositis or arthritis.
• Urinary or gastrointestinal problems that require urination or bowel movements during the night.
• Consumption of stimulants, such as caffeine.
• Use of some medications, including dextroamphetamines, cortisone drugs or decongestants.
• Erratic work hours.
• New environment or location; jet lag after travel; lack of physical exercise.
• Alcoholism; drug abuse, including overuse of sleep-inducing drugs; withdrawal from addictive substances.

RISK INCREASES WITH - Stress, obesity, smoking.

HOW TO PREVENT

• Establish a lifestyle that fosters healthy sleep patterns.

What To Expect

DIAGNOSTIC MEASURES

• Medical history and exam by a doctor.
• Laboratory thyroid studies, EEG (See Glossary).
• Tests in a sleep-study laboratory (sometimes).

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment; psychotherapy or counseling, if the cause is psychological.

POSSIBLE COMPLICATIONS

• Transient insomnia becomes chronic.
• Increased daytime sleepiness that can affect all aspects of your life.

PROBABLE OUTCOME - Most persons can establish good sleep patterns if the underlying cause of insomnia is treated or eliminated.
How To Treat

GENERAL MEASURES

• Seek ways to minimize stress. Learn and practice relaxation techniques.
• Don't use stimulants close to bedtime.
• Treat any underlying or medical cause.
• Relax in a warm bath before bedtime.
• Don't turn your bedroom into an office or a den. Create a comfortable sleep setting.
• Turn off your mind. Focus on peaceful and relaxing thoughts. Play soft music or relaxation tapes. Set a rigid sleep schedule.
• Use mechanical aids such as ear plugs, eye shades or electric blanket.

MEDICATION - Your doctor may prescribe sleep-inducing drugs for a short time if:

• Temporary insomnia is interfering with your daily activities.
• You have a medical disorder that regularly disturbs sleep.
• You need to establish regular sleep patterns. Long-term use of sleep inducers may be counter-productive or addictive.

ACTIVITY - Exercise regularly to create healthy fatigue, but not within 2 hours of going to bed.

DIET

• No special diet, but don't eat within 3 hours of bedtime if indigestion has previously disturbed your sleep. Drinking warm milk before bedtime helps some. Limit caffeine consumption.

Call Your Doctor If

• You have insomnia and self-help methods are ineffective.
• New, unexplained symptoms develop.

From the Complete Guide to Symptoms, Illness & Surgery by H. Winter Griffith, M.D. © 1995 The Putnam Berkley Group, Inc.; electronic rights by Medical Data Exchange.