Insomnia is difficulty in initiating or maintaining sleep, or both during night. It affects energy level, mood, health, work performance and quality of life. It is a symptom of a disease. Stress is most commonly triggers short-term or acute insomnia.
All age groups are affected by insomnia.The incidence increases with age.
• Transient insomnia: Symptoms lasts for less than one week.
• Short-term insomnia: Symptoms occurs for one to three weeks.
• Chronic insomnia: Symptoms lasts longer than three weeks.
Short term insomnia:
• Changes in shift work.
• Excessive noise.
• Stressful situations.
• Physical symptoms (pain, fever, breathing problems, nasal congestion, cough, diarrhea, etc.
• Withdrawal from drug, alcohol, sedative, or stimulant medications.
• Extreme temperatures.
Long term insomnia:
• It depends on physiologic or mental problem of patient.
• stress(mental, emotional, situational, etc)
• Chronic fatigue syndrome
• Congestive heart failure
• Chronic pain syndromes
• Acid reflux disease
• Obstructive sleep apnea
• Brain tumors, strokes, or trauma to the brain
• Night time angina
• Chronic obstructive pulmonary disease
• Nocturnal asthma
• Degenerative diseases, such as Parkinson’s disease and Alzheimer’s disease. Medication related insomnia:
• Medicines used to treat depression, anxiety, and schizophrenia.
• Medicines for high blood pressure
• Medicines for cold and asthma.
• Old age
• Adolescents or young adult students
• abuse drugs
• Despite being tired patient is unable to fall asleep.
• Frequent awakening during the night
• Un-refreshing sleep
• Daytime drowsiness, fatigue or irritability
• Depression or anxiety
• Difficulty concentrating during the day
• Tension headaches
• Gastrointestinal symptoms
Investigation of insomnia can be done by taking complete medical and psychiatric history of the patient.
Some diagnostic tests may be done for evaluation for insomnia. These include:
• Polysomnography: This test monitors heart rate, brain waves, movements, respirations, oxygen levels, and other parameters while the patient is in sleep.
• Actigraphy: An actigraph senses the person’s movements during sleep and wakefulness.
The cause of insomnia should be identified first.Chronic insomnia is cured if its medical or psychiatric causes are evaluated and treated properly.
Sleeping pills may help get to sleep. Antidepressant with a sedative effect is used in psychological causes.
Prognosis depends on the underlying cause of insomnia. Acute condition goes away on its own as the life-style is modified.
• Increased risk of accidents.
• Lowers the work performance.
• Psychiatric causes.
• Affects the quality of life.
• Sleeplessness, especially of plethoric children, from nervous excitement, from local congestion, from irritation in various parts.
• Flushed face, headache; anguish and restlessness.
• Starting on first falling asleep.
• Moaning and tossing about.
• Drowsy evenings, but no sleep follows, and feels in the morning as if he had not slept enough.
• For drunkards who are suffering from effects of stimulation.
• Intense prostration.
• Pain at the base of the brain, extending to nape of neck or spreading over shoulders.
• Crushing mental depression.
• Great restlessness the whole night.
• Insomnia from nervous irritation arising from bad or exciting news, from fright, from the anticipation of an unusual ordeal, from chronic spinal troubles, during pregnancy or after labor.
• Exhausting the vital force.
• Patient is quiet, dull and stupid.
• Sleeplessness from grief, fright, from suppressed mental suffering, in children after punishment, during dentition.
• Child wakes up from sleep with piercing cries and tremble all over.
• Tormenting sleeplessness after grief.
• Constant chilly sensations, wants to be wrapped up.
• Twitching in limbs and electric shocks through whole body.
• Sleep often interrupted by thirst and urging to urinate.
>• Sleeplessness from nervous exhaustion, as from severe acute diseases, from mental over-work with headache.
• Muscle relaxation.
• Making the room environment soothing before sleeping.
• Avoid TV, reading, eating, watching TV or worry in bed.
• Go to bed only on feeling sleepy.
• If you are unable to fall asleep within 30 minutes, resume relaxation therapy.
• Avoid naps during day.
• Follow rigid bedtime and rise time.
• Avoid oversleeping.
• Regular exercise for 4-5 hours before bedtime for at least 20 minutes
• Avoid alcohol and smoking before bedtime.
• Avoid sleeping hungry.
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