Insomnia- Causes, Symptoms, Complications, Diagnosis, Treatment, and Prevention
Insomnia can be defined as difficulty getting to sleep, staying asleep, waking up too early without being able to go back to sleep, or as a combination of the three. For a person to be diagnosed with insomnia, they must have difficulty sleeping at least 3 times a week, even when they are in good sleeping conditions. These difficulties must also have a negative impact on your daily life, for example, if you feel tired or if you find yourself or find yourself dozing during the day.
It is not possible to define whether you have insomnia based on your number of hours of sleep, as it varies for each person. It is also normal to sleep less and less as you get older. Thus, if you sleep less than when you were younger, it does not necessarily mean that you have insomnia. Insomnia is a more common condition for women, seniors, shift workers and people with medical conditions and mental disorders.
Insomnia usually has an underlying cause, such as:
· air travel, especially in the west-east direction (jet lag);
· nicotine, caffeine, and alcohol;
· lack of activity during the day;
· pain caused by arthritis or other health problems;
· poor sleep habits
· anxiety or depression
· conditions such as gastroesophageal reflux, prostatic hypertrophy, Parkinson's disease, Alzheimer's disease or stroke;
· exercise just before going to bed;
· environmental nuisances such as noise, light and inadequate temperature;
· mental conditions such as anxiety or depression
· medications such as decongestants, stimulants (e.g. methylphenidate) and some antidepressants;
· sleep disorders such as apnea;
· work-related stress, family life, the occurrence of a death or illness in the family or relatives, or financial difficulties;
· other sleep disorders such as sleep apnea syndrome or restless legs syndrome;
· watch television or other types of screen late at night;
Short-term insomnia (insomnia lasting less than 3 months) is usually caused by temporary stressors such as changes in the sleeping environment (e.g. noise, light, temperature etc.), a stressful event (e.g. death or confinement of a family member, dismissal, surgery, divorce, etc.), travel, etc. Insomnia usually goes away after the stress trigger has been eliminated. Persistent insomnia, which lasts at least 3 months, is usually caused by factors such as a medical condition, medication, and mental disorders. Finally, insomnia can also appear on its own.
Symptoms and Complications
Insomnia can be manifested by the following symptoms:
· a hard sleep;
· intermittent sleep;
· an early morning alarm clock;
· a feeling of tiredness on waking, despite having slept a sufficient number of hours;
· tiredness and drowsiness during the day;
· irritability or anxiety;
· headaches ;
· difficulty in concentrating during the day;
A person who does not sleep for several days in a row can have symptoms such as hallucinations, but this is a fortunately rare situation. However, insomnia can often lead to a lack of concentration, memory loss and fatigue with a negative impact on personal relationships as well as job performance and academic performance. It can also increase the risk of accidents. People with insomnia are also more likely to suffer from depression or anxiety.
Being worried about not being able to sleep properly can often aggravate insomnia. It is important to seek treatment so that you do not get trapped in this vicious circle.
In order to make a diagnosis, your doctor will ask you how you sleep and whether you go to bed at the same time every day. He might ask you to keep a diary in which you would record information about your sleep for a week or two. You will need to tell them if you are taking any medications (including herbal remedies and over-the-counter medications) and if you smoke or consume coffee and alcohol. If in your life there are sources of stress that could affect your sleep, it would be good to tell him.
By giving you a general medical examination and noting your medical history, your doctor will be able to know if you have any health problems such as depression, anxiety or arthritis, which can cause insomnia or contribute. In addition, he may prescribe blood tests that would highlight underlying medical problems.
Some patients may be referred to a clinic specializing in sleep disorders, which offers an exam such as Polysomnography to support the diagnosis of insomnia. It consists of recording, by means of electrodes placed on the body of the sleeping person, the various phases of sleep, from stage I (light sleep) to stage IV (deep sleep) as well as REM sleep (associated with dreams). Polysomnography also helps diagnose sleep apnea.
Treatment and Prevention
The treatment of insomnia can include several components: treatment of the condition that caused it, improvement of sleep hygiene, behavior modification and medication. If insomnia has been caused by a condition such as arthritis or depression, it should be treated first and foremost because it will probably improve insomnia.
Sleep hygiene involves simple steps that you can put into practice to increase your chances of a good night's sleep. For example, you could modify certain behaviors. As part of your treatment plan, your doctor may recommend the following sleep hygiene or behavior measures:
· adjust your bedtime by deciding to regularly follow practices that will help you fall asleep;
· avoid sleeping in bed or lying in bed, or spending long periods in a horizontal position or taking naps during the day; these activities generally reduce the quality of sleep the following night;
· book the bedroom for sleep and intimate activities;
· refrain from consuming beverages with caffeine (e.g. coffee, tea) after lunch;
· try not to think about work or stressful problems before going to bed; read a bit, if this activity helps you relax;
· think of positive things, it will save you from worrying about your sleep;
· lie down and wake up at the same time every day, even on weekends;
· lie on your back and put a pillow under your knees if you suffer from back pain;
· make sure the bedroom is dark, quiet and not too hot; a white noise generating device may mask traffic noises or noise from the snoring partner;
· drink a glass of hot milk or take a hot bath before bed;
· Avoid heavy, spicy or very sweet foods between 4 and 6 hours before going to bed; instead, try eating light and low carb snack (e.g. crackers and hot milk);
· exercise during the day; if physical activity in the evening prevents you from sleeping, then practice it earlier;
· try to reduce your consumption of cigarettes and alcohol, especially at night;
· avoid looking at the time; after setting the alarm, turn the clock radio so that you cannot see the dial;
· If you cannot fall asleep after 20 minutes in bed, get up and do an activity that relaxes you. Try to fall asleep again once you feel sleep winning you.
· Put your phone away when it's time to go to bed
· Try to practice relaxation techniques.
Cognitive behavioral therapy to treat insomnia is also a possibility and incorporates many of the suggestions suggested above.
Your doctor may prescribe medication for sleep, especially if your insomnia is caused by significant stress (e.g., loss of a loved one) or if non-drug methods have not been helpful. These medications can help you in the short term (i.e. for a few weeks) and are to be used on an ad hoc basis and not every night. However, they will not cure insomnia and could even aggravate it if you make prolonged use of it. In fact, when the treatment is stopped, insomnia can reappear, even more, marked than before.
Benzodiazepines (e.g., temazepam, triazolam, lorazepam, diazepam) are often prescribed for insomnia. There are several, but some have been studied more than others. In order to prescribe the benzodiazepine that is best for you, your doctor will consider your age, other conditions and the side effects of benzodiazepines. Some people may become physically addicted to benzodiazepines and have withdrawal symptoms when they stop using them.
Many of the sleeping pills can also cause tolerance (a decrease in the effect over time). This is why doctors do not like to prescribe them for long periods of time except in the event of failure with other treatments or in the absence of benzodiazepine tolerance. Their use should never be combined with alcohol. Zopiclone and zolpidem, which are not part of the benzodiazepine family, are other drugs that are sometimes used in the treatment of insomnia.
If your doctor has prescribed a medicine to help you sleep, it is important that you also use non-drug methods.
If you have an irregular work schedule that disrupts your sleep pattern, the best way to mitigate the effects is to expose yourself directly to the light in the morning. It has been found that this method is much more effective at restoring biological clocks on time than taking melatonin, a widely publicized supplement. Indeed, natural light causes the brain to produce melatonin, a posteriori when one finds oneself plunged into darkness.
The L-tryptophan is another supplement that may be effective against insomnia, but its effects are not as predictable as those of other drugs.
Finally, there are also over-the-counter medications that contain diphenhydramine. However, these should not be used without first discussing with a health care professional. If you think you have trouble sleeping, it would be best to consult your doctor for a thorough evaluation.