Definition: Insomnia is the inability to get restorative sleep.
Symptoms: Trouble falling asleep, waking up throughout the night, and difficulty returning to sleep. Occurs at least 3 times a week.
Types:
Acute insomnia: lasts less than a month.
Chronic insomnia: lasts more than a month.
Effects: Impacts both the quantity and quality of sleep, leading to daytime sleepiness, fatigue, irritability, anxiety, depression, and can cause professional and personal problems.
Causes
Can occur without an underlying cause.
Medical Conditions: Pulmonary diseases, psychiatric conditions, pain-related conditions.
Substance Use: Stimulants like caffeine, depressants like alcohol.
Daily Stresses: Work, relationships, night shifts, having a newborn baby.
Biological Factors
Elevated levels of cortisol (stress hormone).
Increased sensitivity to cortisol.
Reduced levels of estrogen and progesterone, especially during menopause.
Self-medication Risks
Alcohol: Physical and psychological changes, dependence, worsened sleep-wake cycle.
Benzodiazepines: High abuse potential, dependence, potential worsening of insomnia.
Treatment Methods
Sleep Hygiene:
Consistent sleep and wake times.
Regular exercise (not before bed).
Reduce alcohol intake.
Avoid daytime naps.
Avoid caffeine and smoking in the evening.
Do not go to bed hungry.
Stimulus Control:
Use the bed only for sleep.
Remove bright lights and minimize noise.
Use eye covers and earplugs if necessary.
Leave the bed if unable to sleep after 20 minutes and return when ready to sleep.
Behavior Therapy:
Relaxation techniques.
Cognitive Behavior Therapy (CBT).
Medications (short-term use):
Melatonin agonists.
Non-benzodiazepine sedatives.
Occasionally benzodiazepines.
Recap
Insomnia: Inability to achieve restorative sleep causing daytime sleepiness and fatigue.
Management includes good sleep hygiene, stimulus control, behavior therapy, and short-term medications.
Conclusion
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