Insomnia - Wikipedia. Insomnia, also known as sleeplessness, is a sleep disorder where people have trouble sleeping. It may result in an increased risk of motor vehicle collisions, as well as problems focusing and learning. Insomnia can be short term, lasting for days or weeks, or long term, lasting more than a month. A sleep study may be done to look for underlying sleep disorders. It can be caused by another disorder, by changes in the sleep environment, by the timing of sleep, severe depression, or by stress. Insomnia is present when there is difficulty initiating or maintaining sleep or when the sleep that is obtained is non- refreshing or of poor quality. These problems occur despite adequate opportunity and circumstances for sleep and they must result in problems with daytime function. It can be caused by another disorder, or it can be a primary disorder. People with high levels of stress hormones or shifts in the levels of cytokines are more likely than others to have chronic insomnia. They might include muscular weariness, hallucinations, and/or mental fatigue. Chronic insomnia can cause double vision. Delayed sleep phase disorder can be misdiagnosed as insomnia, as sleep onset is delayed to much later than normal while awakening spills over into daylight hours. Two- thirds of these patients wake up in the middle of the night, with more than half having trouble falling back to sleep after a middle- of- the- night awakening. Early morning awakening is often a characteristic of depression. Poor sleep quality is caused by the individual not reaching stage 3 or delta sleep which has restorative properties. People experiencing sleep state misperception often sleep for normal durations, yet overestimate the time taken to fall and remain asleep. Chronic circadian rhythm disorders are characterized by similar symptoms. Exercise- induced insomnia is common in athletes in the form of prolonged sleep onset latency. They also have an elevated metabolic rate, which does not occur in people who do not have insomnia but whose sleep is intentionally disrupted during a sleep study. Studies of brain metabolism using positron emission tomography (PET) scans indicate that people with insomnia have higher metabolic rates by night and by day. The city’s water crisis has given many people in Flint sleepless nights. Last night, the man who helped reveal the problem spent a sleepless night seeing. Why won't my baby sleep through the night? There are all sorts of reasons why your baby may be waking through the night. She may need a feed, she may want your. The question remains whether these changes are the causes or consequences of long- term insomnia. However, alcohol use to induce sleep can be a cause of insomnia. Long- term use of alcohol is associated with a decrease in NREM stage 3 and 4 sleep as well as suppression of REM sleep and REM sleep fragmentation. Frequent moving between sleep stages occurs, with awakenings due to headaches, the need to urinate, dehydration, and excessive sweating. Glutamine rebound also plays a role as when someone is drinking; alcohol inhibits glutamine, one of the body's natural stimulants. When the person stops drinking, the body tries to make up for lost time by producing more glutamine than it needs. The increase in glutamine levels stimulates the brain while the drinker is trying to sleep, keeping him/her from reaching the deepest levels of sleep. During withdrawal REM sleep is typically exaggerated as part of a rebound effect. While benzodiazepines can put people to sleep (i. NREM stage 1 and 2 sleep), while asleep, the drugs disrupt sleep architecture: decreasing sleep time, delaying time to REM sleep, and decreasing deep slow- wave sleep (the most restorative part of sleep for both energy and mood). Opioids can fragment sleep and decrease REM and stage 2 sleep. By producing analgesia and sedation, opioids may be appropriate in carefully selected patients with pain- associated insomnia. In this case, drugs related to calming mood disorders or anxiety, such as antidepressants, would regulate the cortisol levels and help prevent insomnia. Heya Mahous, Cube here! I realized I haven't made a proper post here since I took over art duties, so this seemed like a good time!! First off, if you're curious. Sleepless nights aren't a modern invention. But modern life is making them increasingly common. Instead of winding down and relaxing before bed, we're. How to help patients get a better night's sleep. Published in the July 2012 issue of Today’s Hospitalist. It may be the one proven therapy that. Sleepless in Seattle script at the Internet Movie Script Database.This could occur because of the lower levels of estrogen. Lower estrogen levels can cause hot flashes, change in stress reactions, or overall change in the sleep cycle, which all could contribute to insomnia. Estrogen treatment as well as estrogen- progesterone combination supplements as a hormone replacement therapy can help regulate menopausal women. The ability to sleep for long periods, rather than the need for sleep, appears to be lost as people get older. Some elderly insomniacs toss and turn in bed and occasionally fall off the bed at night, diminishing the amount of sleep they receive. Past medical history and a physical examination need to be done to eliminate other conditions that could be the cause of insomnia. After all other conditions are ruled out a comprehensive sleep history should be taken. The sleep history should include sleep habits, medications (prescription and non- prescription), alcohol consumption, nicotine and caffeine intake, co- morbid illnesses, and sleep environment. The diary should include time to bed, total sleep time, time to sleep onset, number of awakenings, use of medications, time of awakening and subjective feelings in the morning. Such a study will commonly involve assessment tools including a polysomnogram and the multiple sleep latency test. Specialists in sleep medicine are qualified to diagnose disorders within the, according to the ICSD, 8. Approximately half of all diagnosed insomnia is related to psychiatric disorders. The bedroom should be cool and dark, and the bed should only be used for sleep and sex. These are some of the points included in what doctors call . The beneficial effects, in contrast to those produced by medications, may last well beyond the stopping of therapy. However, many doctors do not recommend relying on prescription sleeping pills for long- term use. It is also important to identify and treat other medical conditions that may be contributing to insomnia, such as depression, breathing problems, and chronic pain. Hypnotic medication is only recommended for short- term use because dependence with rebound withdrawal effects upon discontinuation or tolerance can develop. The strategies include attention to sleep hygiene, stimulus control, behavioral interventions, sleep- restriction therapy, paradoxical intention, patient education and relaxation therapy. Behavioral therapy may include, learning healthy sleep habits to promote sleep relaxation, undergoing light therapy to help with worry- reduction strategies and regulating the circadian clock. As stimulus control therapy involves taking steps to control the sleep environment, it is sometimes referred interchangeably with the concept of sleep hygiene. Examples of such environmental modifications include using the bed for sleep or sex only, not for activities such as reading or watching television; waking up at the same time every morning, including on weekends; going to bed only when sleepy and when there is a high likelihood that sleep will occur; leaving the bed and beginning an activity in another location if sleep does not result in a reasonably brief period of time after getting into bed (commonly ~2. This technique involves maintaining a strict sleep- wake schedule, sleeping only at certain times of the day and for specific amounts of time to induce mild sleep deprivation. Complete treatment usually lasts up to 3 weeks and involves making oneself sleep for only a minimum amount of time that they are actually capable of on average, and then, if capable (i. Bright light therapy, which is often used to help early morning wakers reset their natural sleep cycle, can also be used with sleep restriction therapy to reinforce a new wake schedule. Although applying this technique with consistency is difficult, it can have a positive effect on insomnia in motivated patients. Paradoxical intention is a cognitive reframing technique where the insomniac, instead of attempting to fall asleep at night, makes every effort to stay awake (i. One theory that may explain the effectiveness of this method is that by not voluntarily making oneself go to sleep, it relieves the performance anxiety that arises from the need or requirement to fall asleep, which is meant to be a passive act. This technique has been shown to reduce sleep effort and performance anxiety and also lower subjective assessment of sleep- onset latency and overestimation of the sleep deficit (a quality found in many insomniacs). These behaviors are used as the basis of sleep interventions and are the primary focus of sleep education programs. The creation of a positive sleep environment may also be helpful in reducing the symptoms of insomnia. In order to create a positive sleep environment one should remove objects that can cause worry or distressful thoughts from view. Common misconceptions and expectations that can be modified include: (1) unrealistic sleep expectations (e. I need to have 8 hours of sleep each night), (2) misconceptions about insomnia causes (e. I have a chemical imbalance causing my insomnia), (3) amplifying the consequences of insomnia (e. I cannot do anything after a bad night's sleep), and (4) performance anxiety after trying for so long to have a good night's sleep by controlling the sleep process. Numerous studies have reported positive outcomes of combining cognitive behavioral therapy for insomnia treatment with treatments such as stimulus control and the relaxation therapies. Hypnotic medications are equally effective in the short- term treatment of insomnia but their effects wear off over time due to tolerance. The effects of CBT- I have sustained and lasting effects on treating insomnia long after therapy has been discontinued. The long lasting benefits of a course of CBT- I shows superiority over pharmacological hypnotic drugs. Even in the short term when compared to short- term hypnotic medication such as zolpidem (Ambien), CBT- I still shows significant superiority. Thus CBT- I is recommended as a first line treatment for insomnia. The Internet has already become a critical source of health- care and medical information.
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