General

INSOMNIA. CAUSES, SYMPTOMS AND TREATMENT

The condition of insomnia is defined by a perceived decline in sleep quality and difficulties sleeping, and first-day awakenings, or wake-ups in the middle of the night which result in a state of perpetual fatigue throughout the daytime. The majority of people suffering from insomnia suffer, throughout the day, several of issues related to lack of sleep, such as fatigue, difficulty concentration, mood swings and memory issues. While insomnia is a prevalent and widespread condition but it is usually not recognized and is not effectively treated.

Insomnia

Insomnia is a condition that is marked by an unsatisfactory, unrestful sleeping which can manifest as difficulties getting to sleep or frequent wake-ups during the night or early morning wake-ups. Insomnia can cause a drastic reduction in your quality of life. It’s frequently related to states of anxiety, and is usually caused by worries or specific periods of stress. In general, when sleep problems are present for short durations (from just a few days up to a couple of weeks) it is a sign of an acute sleep disorders. If the disorder is present for at least 3 months, we refer to insomnia.

It can also be a sign of different medical (e.g. hypertension, hypertension or heart problems) or psychotic (e.g. anxiety, depression as well as mood disorder) disorders. In certain cases insomnia can be one of the initial signs of developing a psychiatric illness which must be recognized and treated promptly. In other cases, sleeplessness is a result of poor behaviours (e.g. excessive caffeine consumption and excessive use of screen-based devices or spending too long in the bed) or cognitive issues (e.g. straining, or stressing about being unable to get to sleep).

However, insomnia isn’t just an issue that occurs at night. Poor sleep can cause a variety of issues that can also manifest in the daytime. The majority of people who are suffering from insomnia experience fatigue that is constant or, more often in older people the daytime insomnia. Also, it can be a sign of cognitive problems like a lack of focus, memory, and attention. Patients who are in a state of sleep also experience more emotional lability, or anger as well as depression and anxiety symptoms (Morin and co. (2015)).

Epidemiology

Sleep disorders are extremely frequent. There are estimates that suggest that around 30% to 35% of the population suffers from insomnia, however only 10-15% complain of everyday issues due to sleep disturbance. For young people, the most common sign is difficulty getting to sleep, while frequent awakenings in the night are more common among older and middle-aged individuals.

Insomnia is more prevalent among women than males and is more frequent among psychiatric patients than generally speaking. It can happen at any age , however the initial episode usually occurs at the end of adolescence or in early adulthood.

The number of hours rest are required?

The number of hours of sleep required to rest properly differ from person to person and can change with age. Infants require a lot more sleep hours beyond 24 hours than an adult, or an older person. A recent study conducted by the National Sleep Foundation (Hirshkowitz, 2015) issued recommendations in relation to the best amount of rest for different age groups. The study, which was conducted by a group of experts, reveals how the number of hours required decreases throughout a life time.

The recommended sleep times for infants include, for instance between 14-17 hours per day. There are a few possibilities of varying the standard of extending to an “acceptable” sleep period between 11 and 19 hours. Adults the recommended amount of sleep can vary in between seven and nine hours with an acceptable range of sleeping between 6 to 10 hours.

As you old age, these levels diminish as they age. When a person is over 65 years old, older the recommended hours can be reduced to 7-8, which is a reasonable interval of between 5 to 9 hours. The ideal time to sleep is influenced by personal factors. Age is among the factors that have the greatest impact.

Risk factors and causes of insomnia and risk factors.

Despite the rate of insomnia among all people, root causes of insomnia aren’t yet completely comprehended (Morin 2015). A combination of behavioral, genetic emotional, cognitive and emotional factors is believed to trigger the onset and perpetuation in the condition.

Genetic causes: research has revealed that around 30% of people suffering from insomnia have a parent with the same condition. This means that there is an inherent genetic predisposition which makes certain individuals more prone than others to develop insomnia.

Behavior-related factors include: certain behaviors and practices that can lead to the onset or perpetuation of sleepiness. This includes: being a frequent visitor sleeping, making inconsistent sleeping and wake cycles and naps throughout the day, or using video screens prior to falling asleep (e.g. computers, laptops or mobiles).

The emotional impact of experiences and anxieties may create and sustain insomnia. In most cases it is the result of an acute period of stress and can then become chronic. Insomnia can also be seen as one of the symptoms in several mental disorders. In certain cases, it could be a sign of an underlying psychiatric disorder (e.g. significant depression).

Cognitive aspects: Certain cognitive features can lead to sleepiness, such as the tendency to be apprehensive. Indeed, the need to be anxious often causes problems in sleeping. This can lead to more anxiety (e.g. worrying about being unable to sleep) and create an unending cycle of thought that can worsen the situation of insomnia.

The signs of insomnia

Insomnia is characterised by both symptoms during the night as well as during the day. The diagnosis is based on having these signs at least 3 nights per each week, for at most three months. Sleepiness symptoms at night include:

It is difficult to fall asleep

Nighttime awakenings that are frequent or long-lasting.

Early morning wake-ups

Inability to sleep in the evening can trigger various daytime symptoms that include:

Feeling tired and lacking energy.

Attention problems with concentration, attention and memory.

Disorders of the mood.

Troubles in school or at work due to a poor sleep.

Treatment for insomnia

The treatment of insomnia can require the use of pharmacological treatments, psychological therapies or the use of a variety of methods simultaneously. Based on the severity the condition and the severity manifestations, a variety of methods of treatment can be considered.

The treatment of insomnia in psychotherapy tends to focus on the behavioral and cognitive aspects that typically support the condition. The methods are used as a stand-alone treatment, but frequently in clinical settings they are integrated with other techniques (e.g. psychotherapy) and are incorporated into larger therapeutic avenues.

Treatment for insomnia. Treatments for behavioral disorders

The methods for treating insomnia through behavioral therapy include restraint of sleep, stimulation management, as well as relaxation techniques.

The goal of sleep restriction is to reduce the amount of time in bed at least the actual duration (even only a couple of hours). When it is established that the stimuli (lying in the bed) becomes more closely associated to the reaction (sleep) it is then possible to is gradually attempting to extend the time in bed in order extend the time spent sleeping.

 

The sleep restriction method is typically combined with stimuli control therapy. In this therapy, patients who is suffering from insomnia is provided with an array of “tasks”:

You should only get into bed when you are tired.

Make yourself comfortable whenever you’re unable to sleep.

Make use of the bedroom and bed solely for sleeping (not to read or watch TV)

Always rise in the morning.

Do not have naps during the daytime.

Another method of behavioral therapy to treat insomnia is to employ relaxation methods. The practice of relaxation techniques can be helpful in reducing the state of hyper-arousal, decreasing muscle tension and the frequency of thoughts that disturb sleeping. A lot of relaxation techniques initially require guidance from an expert however, as time and weeks pass you can use them in a way that is independent.

Treatment for insomnia. CBT-I

In the list of psychological treatments that are specific to insomnia, one specific type that is being used to treat insomnia includes CBT-I. It’s one of the psychotherapeutic approaches specifically targeted to insomnia, which focuses on the behavioral and cognitive aspects that contribute to the sleep disorder. CBT-I, as with other forms of cognitive behavior psychotherapy can be administered either in small groups or on a single occasion and has been demonstrated to be efficient in improving the quality of sleep and quantity.

The treatment focuses on the patients’ incorrect beliefs and thoughts about sleep, teaching methods to decrease rumination, particularly prior to sleep, and finally focusing on the behavioral factors which cause insomnia. The CBT-I program requires patients are also required to fill out an everyday “sleep diary” to monitor the time of their go to bed, how long it took them to sleep, the number of times they were awake during the night and so on..

Treatment for insomnia. Treatment with pharmaceuticals

Alongside psychological treatments There are a variety of alternative pharmacological treatments that can be used for treating insomnia. The decision about which drugs to choose is an issue of medical necessity and is essential to consult the advice of a doctor. In the different classes of medicines that are used to treat insomnia are:

The Benzodiazepines are symptomatic medicines that are used to enhance their hypnoinductive and muscular relaxant properties. They’re effective in treating insomnia, but they should only be utilized for only short durations of time because they can quickly cause dependence and tolerance. They can be abused drugs particularly when they are used without an prescription from a doctor. Learn more about addiction to benzodiazepine here.

Melatonin or Melatonin-Analysers: Melatonin supplements or melatonin-agonist medicines (such like Ramelteon) were proven that they are effective at treating insomnia especially in helping you fall asleep. Contrary to benzodiazepines these medications have a lower risk of misuse.

Antidepressants: certain antidepressant medications with sedative properties are prescribed to treat insomnia. Of these, the most frequently employed are amitriptyline and mirtazapine. The possibility of misuse of these drugs is very low.

Antipsychotics: antipsychotic medications are also used in the treatment of insomnia through making use of their sedative properties. Some of the most frequently used drugs are quetiapine (olanzapine), quetiapin the risperidone.

 

Next Post