Thursday, July 23, 2009

.::Sleepless in KL::.

Defining insomnia and looking at some of the reasons why many of us can’t sleep well.

I HAVE been riveted by the rumors surrounding Michael Jackson’s death and the possible causes. One reason, I read, is due to the fact he had been taking a lot of prescription medicines and the powerful unaesthetic, Diprivan, for chronic insomnia. I, too, suffer from chronic insomnia and am afraid of what might happen. Is chronic insomnia very common?

Insomnia is indeed a very common disorder, estimated to affect as much as 30 to 50% of the population. Most of us have experienced it at least once in a lifetime. People from all ages are affected, and women more than men.

However, chronic insomnia occurs in 10% of the population.

Insomnia means difficulty in initiating or maintaining sleep, or both. If you don’t get eight hours of sleep a day, it doesn’t mean you have insomnia! Different people require different durations of sleep.

Also important is the quality of sleep. You must wake up feeling refreshed, or you know you have not had enough sleep.

This is how insomnia is classified:

1. Transient insomnia – insomnia symptoms lasting less than a week

2. Short-term insomnia – symptoms lasting between one and three weeks

3. Chronic insomnia – symptoms lasting for more than three weeks

Women are affected more than men? Why? Is it because they are more easily stressed?

Men are also every bit as stressed as women, but anxiety does seem to affect the female population more. Nevertheless, pregnant women and women around menopause do frequently experience insomnia.

Other high risk groups likely to be affected by insomnia include frequent travellers who cross different time zones regularly, thus contributing to jet lag, older people, adolescents going through puberty, and young adults.

People who drink stimulants with caffeine in it, such as coffee or tea, are also at higher risk for insomnia. People who smoke and drink alcohol are also afflicted.

Lots of people with a disruptive bed partner (usually the male) who snores loudly and excessively or has restless leg syndrome are also frequently afflicted with insomnia.

What causes insomnia? I know that when I feel very stressed, I can’t sleep.

Transient and short-term insomnia are mostly caused by factors such as:

·Environmental – loud noises, unpleasant noises such as a neighbour’s TV, a neighbour’s dog barking, room temperature that is not optimal (too hot or too cold), and so on.

·Situational – stress caused by transient life situations (exams, death of a loved one, quarrels, divorce), an acute illness, jet lag, a change in shift work (such as if you are a nurse who now has to work nights instead of days).

·Drugs – high blood pressure medications, certain cold and asthma medications, medications used to treat depression or anxiety, withdrawal from alcohol, sedatives, drugs or stimulants.

Chronic insomnia is usually caused by a long-term underlying medical or psychiatric/psychological condition. The most common psychological/psychiatric disorders that can cause insomnia are anxiety, long-term stress, depression, mania, and schizophrenia.

The most common medical problems causing insomnia are anything that gives you chronic pain (rheumatoid arthritis, etc), chronic fatigue syndrome, heart disease, acid reflux, chronic obstructive pulmonary disease, obstructive sleep apnoea and nocturnal asthma (you are unable to breathe properly at night), Parkinson’s disease and Alzheimer’s disease, strokes and brain tumors.

What can I do? Is medication the only cure for insomnia?

Transient insomnia usually resolves when the underlying cause is removed, such as if you have jet lag, after a while, you will acclimatise to your new time zone. Or if you couldn’t sleep because your son is having his SPM and you are worried for him, you will be able to sleep again once he has passed his SPM with flying colours!

Insomnia treatment is always focused on finding the cause and eliminating it or suggesting a change in life behavioural patterns for it. Medicine should only be taken if all these measures don’t work.

Basic rules for getting a good night’s sleep include:

>Sleep only as much as you need. Don’t oversleep just because your wife needs eight hours of sleep while you only need six! The amount of hours you need will be determined by whether or not you feel rested.

>Exercise at least 20 minutes a day, but do it four to five hours before your bedtime.

>Don’t drink anything with caffeine later than the afternoon. Don’t smoke in the evening. Don’t go to bed hungry, take a light snack if you must.

>Don’t eat or drink too much near your bedtime.

>Sleep and wake at the same time every day.

>Don’t watch TV, eat, or read in bed. If you can’t sleep after 30 minutes, do something relaxing. Don’t force yourself to sleep.

>Don’t take afternoon naps. At night, make sure your room is dark and quiet.

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