Insomnia

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You probably have insomnia if it is hard for you to fall asleep at night, if you often wake up during the night and cannot fall back asleep, if you wake up too early in the morning and cannot go back to sleep, or if you feel tired when you wake up. If you find that you are sleepy, fatigued, irritable or unable to concentrate or remember things during the daytime, you may have insomnia.

The insomnia is PRIMARY if it is the only problem you are having, and is not a symptom of any other disorder. It is SECONDARY if there are other health problems that keep you from sleeping well -- for example, arthritis, asthma, cancer, depression or heartburn -- or if the medicines and substances you use --aspirin, alcohol, etc -- are keeping you awake.

Your insomnia may be ACUTE, or short-term -- if it is only a problem for a few days or weeks -- or it may be CHRONIC or long-term -- if it lasts for a month or longer. Acute and chronic insomnia have different causes.

Some of the reasons you might have trouble sleeping for a short period in your life include stressful events, such as losing your job, changing your job, moving to a new place, getting divorced or experiencing the death or loss of some one you love. You may also experience acute insomnia if you are ill, emotionally or physically uncomfortable, extremely hot or cold, or trying to sleep in a place with too much light or noise. Medication for colds, allergies, asthma, depression, and high blood pressure can keep you awake; so can changes in your schedule that change the hours during which you usually sleep, such as jet lag or a change in your work hours from day shift to night shift.

Chronic insomnia, on the other hand, may be the result of other long-term health problems, such as depression, anxiety, chronic stress, or pain and discomfort that affects you every night.

Diagnosis

The battle against insomnia requires the patient to gather a good deal of information that will help determine the factors contributing to the lack of sleep. Your provider may use several diagnostic techniques in order to give you the most effective treatment.

When your provider takes a sleep history, she will ask about how many hours you sleep each night, how often and for how long you wake up during the night, and whether you take daytime naps or doze off involuntarily during the day. She might also inquire about other health issues. Are you experiencing stress or anxiety? Are you taking medicine that makes you drowsy during the day or keeps you awake at night?

Sleep Logs, also known as sleep diaries, describe a person's sleeping habits during a normal time, at home rather than on the road, and during regular work schedules rather than during crunch periods or occasional night shifts. They record bedtime, wake-up times, and nap times. They are an essential component in most of the treatment programs used at sleep clinics. A useful sleep diary helps you discover and understand how and why you sleep, or don't sleep by organizing important data about your sleep habits into a daily chart, and it should be used to record all the following information:

Times you went to sleep and woke up
Number of hours and minutes you slept
Quality of sleep --fitful or deep? Dreamless or broken apart by nightmares?
Times you were awake during the night
Quantity of caffeine or alcohol consumed, and the times you consumed them;
Other food and drinks consumed, and when
Emotions you experienced

Treatment:

Both acute and chronic insomnia respond to the same treatments. You can begin by using self-help techniques, such as meditation, listening to relaxing music, or taking warm baths in the evening. Late-afternoon caffeine is frequently a sleep-killer, and should be avoided. Vigorous physical exercise early in the day, on the other hand, helps to make you feel tired at night and is thus an excellent antidote to insomnia.

Sleep hygiene also helps combat insomnia. Wikipedia defines "sleep hygiene" as "controlling all behavioral and environmental factors that precede sleep and may interfere with sleep."

Some forms of sleep hygiene include timing one's eating and sleeping hours to make it more likely that drowsiness will come at the right time, or arranging sleeping quarters to be cool, dark, soothing and physically comfortable, Mark Rosekind, PhD, president and chief scientist of Alertness Solutions, a scientific consulting firm, has this advice for insomniacs: The reality is that when you don't get enough sleep, it's going to impair all aspects of what you do. You will be irritable and short-tempered... Most people have not evaluated their own sleep environment, even though they spend a third of their lives asleep...You need to control and create a sleep environment that is personally the most comfortable for you," says Rosekind. "You want your sleep surface and the accouterments, like pillows, blankets, etc., to be as comfortable as possible for you."

Drugs to Treat Insomnia

In some cases, doctors will prescribe drugs for the treatment of insomnia. All insomnia medications should be taken shortly before bed. Do not attempt to drive or perform other activities that require concentration after taking an insomnia medication, as the medication will make you sleepy. Medications should be used in combination with good sleep practices.