-Insomnia-

This couple of month I had sleeping disorder problem. When I ask my friend, she said that it’s call Insomnia. Then, I try to find out about Insomnia. I hope this information can be helpful for others who also have the same problem as me.

Insomnia Causes

Insomnia may be caused by a host of different reasons. These causes may be divided into situational factors, medical or psychiatric conditions, or primary sleep problems. Insomnia could also be classified by the duration of the symptoms into transient, short-term, or chronic. Transient insomnia generally last less than seven days; short-term insomnia usually lasts for about one to three weeks, and chronic insomnia lasts for more than three weeks.

Many of the causes of transient and short-term insomnia are similar and they include:

* Jet lag

* Changes in shift work

* Excessive or unpleasant noise

* Uncomfortable room temperature (too hot or too cold)

* Stressful situations in life (exam preparation, loss of a loved one, unemployment, divorce, or separation)

* Presence of an acute medical or surgical illness or hospitalization

* Withdrawal from drug, alcohol, sedative, or stimulant medications

* Insomnia related to high altitude (mountains)

Chronic or long-term insomnia

The majority of causes of chronic or long-term insomnia are usually linked to an underlying psychiatric or physiologic (medical) condition.

Psychological related insomnia

The most common psychological problems that may lead to insomnia include:

* anxiety,

* stress,

* schizophrenia,

* mania (bipolar disorder), and

* depression.

In fact, insomnia may be an indicator of depression. Many people will have insomnia during the acute phases of a mental illness.

Physiological related insomnia

Physiological causes span from circadian rhythm disorders (disturbance of the biological clock), sleep-wake imbalance, to a variety of medical conditions. The following are the most common medical conditions that trigger insomnia:

* Chronic pain syndromes

* Chronic fatigue syndrome

* Congestive heart failure

* Night time angina (chest pain) from heart disease

* Acid reflux disease (GERD)

* Chronic obstructive pulmonary disease (COPD)

* Nocturnal asthma (asthma with night time breathing symptoms)

* Obstructive sleep apnea

* Degenerative diseases, such as Parkinson's disease and Alzheimer's disease (Often insomnia is the deciding factor for nursing home placement.)

* Brain tumors, strokes, or trauma to the brain

complication of insomnia

Non-medical treatment and behavioral therapy

Non-pharmacologic or non-medical therapies are sleep hygiene, relaxation therapy, stimulus control, and sleep restriction. These also referred to as cognitive behavioral therapies.

Sleep hygiene

Sleep hygiene is one of the components of behavioral therapy for insomnia. Several simple steps can be taken to improve a patient's sleep quality and quantity. These steps include:

* Sleep as much as you need to feel rested; do not oversleep.

* Exercise regularly at least 20 minutes daily, ideally 4-5 hours before your bedtime.

* Avoid forcing yourself to sleep.

* Keep a regular sleep and awakening schedule.

* Do not drink caffeinated beverages later than the afternoon (tea, coffee, soft drinks etc.) Avoid "night caps," (alcoholic drinks prior to going to bed).

* Do not smoke, especially in the evening.

* Do not go to bed hungry.

* Adjust the environment in the room (lights, temperature, noise, etc.)

* Do not go to bed with your worries; try to resolve them before going to bed.

Relaxation therapy

Relaxation therapy involves measures such as meditation and muscle relaxation or dimming the lights and playing soothing music prior to going to bed.

Stimulus control

Stimulus control therapy also consists of a few simple steps that may help patients with chronic insomnia.

* Go to bed when you feel sleepy.

* Do not watch TV, read, eat, or worry in bed. Your bed should be used only for sleep and sexual activity.

* If you do not fall asleep 30 minutes after going to bed, get up and go to another room and resume your relaxation techniques.

* Set your alarm clock to get up at a certain time each morning, even on weekends. Do not oversleep.

* Avoid taking long naps in the daytime.

Sleep restriction

Restricting your time in bed only to sleep may improve your quality of sleep. This therapy is called sleep restriction. It is achieved by averaging the time in bed that the patient spends only sleeping. Rigid bedtime and rise time are set, and patient is forced to get up even if they feel sleepy. This may help the patient sleep better the next night because of the sleep deprivation for the previous night. Sleep restriction has been helpful in some cases.

Other simple measures that can be helpful to treat insomnia include:

* Avoid large meals and excessive fluids before bedtime

* Control your environment.

o Light, noise, and elevated room temperature can disrupt sleep. Shift workers and night workers especially must address these factors. Dimming the lights in the bedroom, relaxation, limiting the noise, and avoiding stressful tasks before going to bed may be beneficial. (Refer to sleep hygiene and relaxation therapy above.)

o Avoid doing work in the bedroom that should be done somewhere else. For example, do not work or operate your business out of your bedroom and avoid watching TV, reading books, and eating in your bed.

A person's body's circadian rhythm (biological clock) is particularly sensitive to light. Parents who need to sleep during the day may have to make child care arrangements to allow them to sleep.

Medications and Medical Therapies

There are numerous possible medications to treat insomnia. Generally, it is advised that they should not be used as the only therapy and that treatment is more successful if combined with non-medical therapies. In a study, it was noted that when sedatives were combined with behavioral therapy, more patients were likely to wean off the sedatives than if sedatives were used alone.

* Benzodiazepine sedatives: six of these sedative drugs have been used to treat insomnia. There are reports of subjective improvement of quality and quantity of sleep when using these medications. These include temazepam (Restoril), flurazepam (Dalmane), triazolam (Halcion), estazolam (ProSom, Eurodin), lorazepam (Ativan), and clonazepam (Klonopin).

* Nonbenzodiazepine sedatives: These include eszopiclone (Lunesta), zaleplon (Sonata), and zolpidem (Ambien).

* Melatonin: Melatonin is secreted by the pineal gland, a pea-sized structure at the center of your brain. Melatonin is produced during the dark hours of the day-night cycle (circadian rhythm). Melatonin levels in the body are low during daylight hours. The pineal gland responds to darkness by increasing melatonin levels in the body. This process is thought to be integral to maintaining circadian rhythm. At night, melatonin is produced to help your body regulate your sleep-wake cycles. The amount of melatonin produced by your body seems to decrease as you get older. Melatonin may be beneficial in patients with circadian rhythm problems.

* Ramelteon (Rozerem) is a prescription drug that stimulates melatonin receptors. Ramelteon promotes the onset of sleep and helps normalize circadian rhythm disorders. Ramelteon is approved by the Food and Drug Administration (FDA) for treatment of insomnia characterized by difficulty falling asleep.

* Some antidepressants [for example, amitriptyline (Elavil, Endep) and trazodone (Desyrel)] have been used for the treatment of insomnia in patients with co-existing depression because of some sedative properties. Generally, they may not be helpful for insomnia in people without depression.

* Antihistamines with sedative properties [for example, diphenhydramine (Benadryl) or doxylamine] have also been used in treating insomnia as they may induce drowsiness, but they do not improve sleep and should not be used to treat chronic insomnia.

* Valeriana officinalis (Valerian) is a popular herbal medication used in the United States for treating insomnia, however, to date there are no convincing studies to show any real benefit in patients with chronic insomnia.

Others problems that also related to sleep disorder are :

• sleep apnea
  
• restless legs syndrome (RLS) and periodic limb movements in sleep (PLMS)
• narcolepsy
• snoring