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Insomnia - download this document in Microsoft Word format

-Trouble falling asleep or staying asleep-commonly termed insomnia-plagues one in three American adults. If you suffer from insomnia, it disturbs your waking hours as well as your sleeping hours, since you're likely to feel sleepy during the day and have trouble concentrating on tasks after a poor night's sleep.
-Insomnia afflicts people of all ages, most often just for a night or two, but sometimes for weeks, months, or even years.
-Understanding insomnia presents an interesting puzzle: It's clear that trouble sleeping at night can make you sleepy during the day, but why can't you fall asleep easily at bedtime or sleep through the night?
-Recent advances in understanding both the day and night components of insomnia are making it possible for healthcare providers to help most troubled sleepers.

Types of Insomnia-

Transient insomnia-Transient insomnia is an inability to sleep well over a period of a few nights. This type of insomnia is usually brought on by excitement or stress.
Short-term insomnia-Periods of ongoing stress at work or at home can result in two or three weeks of poor sleep.
Chronic insomnia-More than 35 million Americans complain of chronic insomnia-poor sleep every night or most nights.

What causes insomnia? What helps?
Insomnia is a symptom of another problem, much like a fever or a stomachache. It can be caused by any number of things.

Psychological factors
Vulnerability to insomnia: Some people seem more likely than others to experience insomnia during times of stress, just as some people might tend to have headaches or indigestion. Knowing that the problem may occur and that it will subside can be helpful in coping with bouts of poor sleep.
Persistent stress: Problems such as a troubled marriage, a chronically ill child, or an unrewarding career can often contribute to poor sleep. People with these problems can be helped by counseling to gain a new outlook on their continuing troubles and to exert more control.
Psychiatric problems: Insomnia-especially with awakenings earlier than desired-is one of the most common symptoms of depression. People with anxiety, schizophrenia, and other psychiatric disorders may also sleep poorly. Treatment of the underlying disorder, often including both medications and psychotherapy, can help improve sleep.

Use of stimulants: The use of caffeine near bedtime, even if it doesn't interfere with the onset of sleep, can trigger awakenings later in the night. Nicotine is also a stimulant, and smokers may take longer to fall asleep than non-smokers. Ingredients of many common drugs, including nonprescription drugs for weight loss, asthma, and colds, can interfere with sleep.

Use of alcohol: A nightcap, while it may help induce sleep, is likely to make sleep more fragile throughout the night.
Erratic hours: Shift workers (those who work nontraditional hours, such as nights or rotating shifts), along with those who maintain later hours on weekends than during the week, are likely to experience sleep problems. Maintaining regular hours can help program the body to sleep at certain times and to stay awake at others.
Interactive behavior: People whose lifestyles are very quiet or restricted may find it difficult to sleep at night because of their inactivity during the day.
Learned insomnia: People who sleep poorly during times of stress are likely to worry about not being able to function effectively during the day. They resolve to try harder to sleep at night, and unfortunately this determined effort makes them more alert and sets off a new round of worried thoughts

Activities in and around the bedroom-changing into night clothes, turning off the lights, pulling up the blankets-can serve as cues that encourage wakefulness. People who have trouble sleeping in their own beds may fall asleep quickly when they don't intend to-while reading the newspaper, watching TV, or driving for example. Even a few nights of poor sleep during a month can be all it takes to maintain this cycle of poor sleep and continuing concern about poor sleep. Treatment for this type of insomnia aims to improve sleep habits and defuse the accompanying anxiety.
Misuse or overuse of sleeping pills: If used every night, sleeping pills stop being effective after a few weeks. When their use is stopped suddenly, however, sleep can temporarily be worsened.

Environmental factors
Noise: Passing traffic, airplanes, television and other noises can disturb sleep even when they don't cause the sleeper to wake up. Light: Light comes through the eyelids even when the eyes are closed.

Physical illness
Breathing disorders: Certain disorders can cause repeated interruptions in breathing during sleep which can rouse a sleeper dozens or even hundreds of times a night. These pauses can be as short as 10 seconds and may not be remembered in the morning. Breathing-related sleep disruptions becomes more common with advancing age. Most cases are mild and don't require treatment, but it's generally wise to avoid sleeping pills, which can make breathing problems worse. Severe cases of sleep apnea often benefit from a treatment known as continuous positive airway pressure. This treatment keeps the breathing passages open with a steady stream of air delivered through a mask worn over the nose and mouth during sleep.

Periodic leg movement: Brief muscle contractions can cause leg jerks that last a second or two and occur roughly every 30 seconds (often for an hour or longer) several times a night. Treatment can include sleeping pills, pain relieving drugs, evening exercise, a warm bath, or a combination of these. Iron replacement can be helpful in people who have an iron deficiency, especially if they also experience restless legs.
Waking brain activity that persists during sleep: Sleep monitoring during the night demonstrates that some people who complain of light or nonrestorative sleep fail to sink fully into sleep.
Gastroesophageal reflux: The back-up of stomach contents into the esophagus (commonly known as heartburn), can awaken a person several times a night. Elevating the head of the bed on 6- to 8-inch blocks can help prevent reflux. Medication can also provide relief.
Pain: Disorders such as arthritis, angina, lower back pain, fibromyalgia, and headache may upset sleep and waking hours. Sometimes a Change in the positioning of pillows, the correct mattress, and pre-sleep behavior can make a difference.

When to seek help
-If your sleep has been disturbed for more than a month and interferes with the way tou feel or function during the day, see your healthcare provider, or ask for a referral to a sleep disorders specialist.

Can sleeping pills help?
Sleeping pills can help provide sounder sleep and can improve alertness the following day. This relief is only temporary, since sleeping pills are not a cure for insomnia. For some types of insomnia-such as that resulting from breathing disorders-sleeping pills can be dangerous. Insomnia needs to be properly diagnosed and treatment options discussed with a healthcare provider.

Sleeping pills can help with the following conditions:
-Jet lag
-Shift work schedule changes that affect sleep time
-Acute stress
-Predictable stresses
-Chronic insomnia
-Certain medical disorders






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