What is it?
Insomnia is a condition in which one finds it difficult to initiate sleep, or wakes up severally during sleep and doesn’t get enough hours of sleep to make them feel refreshed. It can last for just a few days or weeks (acute insomnia), or for most nights in the week for at least three months (chronic insomnia)
Insomnia can occur due to a medical or mental health condition such as depression or anxiety. It can also be due to constant body pain from any condition. Sleep problems are more common in people aged over 65. This may be because of changes in their body clock. However, people generally need less sleep to get them refreshed as they get older.
What are the symptoms?
There are three main types of sleep problem:
• Difficulty falling asleep (the commonest)
• Difficulty staying asleep (commoner in the elderly)
• Early morning awakening with inability to fall back to sleep.
What treatments work?
There are non-drug treatments and drug treatments for insomnia. The former may work better in the long run, with probably no side effects. Sleeping pills can help, though with some side effects. But if the insomnia has a specific cause, they are better treated instead.
There are quite a number of things one can do on their own to improve the quality of sleep. They are referred to as good sleep hygiene. These include:
• regular exercise away from bedtime
• avoiding large meals and large quantities of fluids close to bedtime
• avoiding tobacco and drinks that contain caffeine towards bedtime
• going to bed only when you feel sleepy
• using the bedroom only for sleeping
• keeping your bedroom as cool and as quiet as possible
• not trying to force yourself to sleep. If you can’t sleep after about 15 or 20 minutes, go to another room. Try reading with a fairly dim light. But don’t watch television or use a computer or tablet as this gives off bright light that can keep you awake.
• trying to get up at the same time every morning
• avoiding daytime naps.
Having some sessions of a talking treatment called cognitive behaviour therapy (CBT) is also likely to help improve the quality of sleep. It does this by addressing negative thoughts and encouraging positive ones for many different conditions.
If the insomnia is so distressing and have refused to get better even after the above treatments, then the doctor might prescribe sleeping pills. Sleeping pills are not suitable for pregnant women. They can cause drowsiness during the day after they are taken. Other side effects include dizziness, headaches, and a blocked nose. Taking the lowest effective dose is usually advised to reduce these side effects.
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