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How is insomnia defined?
Insomnia is a symptom or syndrome rather than a disease that results in decreased quantity or quality of sleep. It is characterized by difficulty falling asleep, staying asleep or simply having “unrefreshing” sleep. It is a very common problem, more so in women than men.
Insomnia can be of transient, short, or chronic duration. For many people, insomnia is related to an underlying problem such as situational stress, anxiety, grief or depression, or to a medical problem such as sleep apnea or restless legs syndrome. Circadian rhythm disorders related to shift work or jet lag also contribute to insomnia. People with insomnia can experience daytime fatigue or sleepiness, inability to concentrate, irritability, anxiety, depression, or forgetfulness.
If you suffer from insomnia, you should consult your doctor, as there may be an underlying disorder causing your problem.
What do sleep experts recommend for insomnia?
- Go to bed and wake up at the same time every day, including weekends.
- Establish a relaxing bedtime routine: take a bath, read a book or do something calming before bed.
- Make sure your sleep environment is dark, quiet, cool and comfortable.
- Avoid or limit your use of stimulants like caffeine (coffee, tea, sodas, chocolate), decongestants or tobacco before bed.
- Avoid or limit your intake of alcohol before going to sleep. Alcohol’s depressant effect helps people fall asleep, but not to stay asleep.
- Exercise regularly, but avoid exercise within a few hours before going to bed.
- Learn to reduce or manage the stress in your life.
- Avoid daytime naps.
- Use the bed only for sleep and sex; keep the bedroom free from distractions like television, computers and work. Remember that the multispectral light of TV stimulates the central nervous system.
- Avoid going to sleep hungry, but also avoid eating just before bedtime, as this not only adversely effects sleep, but can also cause gastro esophageal reflux disease (GERD).
- Get out of bed if you can’t fall asleep within 15–20 minutes. Read under a dim lamp until you are drowsy. Only spend time in bed when you are actually sleepy or sleeping.
- Don’t watch the clock—it can cause anxiety about sleep.
- Keep a journal or sleep log to record both good and poor nights’ sleep. This can help you recognize patterns and expose activities that trigger sleeplessness.
What treatments are available?
Medications that currently are available by prescription are known to improve sleep by reducing the amount of time it takes to fall asleep, increasing sleep duration, and/or reducing the number of awakenings during sleep. There are several types of prescription sleeping pills, such as the benzodiazepines like temazepam (Restoril). There are also the newer medications such as zolpidem (Ambien®), zaleplon (Sonata®), and eszopiclone (Lunesta®).
Over-the-counter medications that are available for the treatment of insomnia are mainly sedating antihistamines, such as diphenhydramine (Benadryl®).
What new treatments are being studied?
Baptist Health Center for Clinical Research has performed clinical trials on medication for those individuals who have difficulty staying asleep, and suffer from frequent awakenings in the night.