Insomnia

SUPPLEMENTAL KNOWLEDGE
Jhunie B. Wahayna

Most adults have experienced insomnia or sleeplessness at one time or another in their lives. Insomnia is a symptom, not a stand-alone diagnosis or a disease. By definition, insomnia is a difficulty initiating or maintaining sleep or both.

It may be due to inadequate quality or quantity of sleep. Insomnia is not defined by a specific number of hours of sleep that one gets, since individuals vary widely in their sleep needs and practices. Insomnia is generally classified based on the duration of the problem.

Generally, symptoms lasting less than one week are classified as transient insomnia, symptoms between one to three weeks are classified as short-term insomnia, and those longer than three weeks are classified as chronic insomnia.

Transient insomnia resolves when the underlying triggering cause is removed or corrected. Most people seek medical attention when their insomnia becomes more chronic. The main focus of treatment for insomnia should be directed towards finding the cause. Once a cause is identified, it is important to manage and control the underlying problem, as this alone may eliminate the insomnia.

The following therapies may be used in conjunction with the underlying medical or psychiatric cause. They are also the recommended therapies for some primary insomnia disorders. Non-pharmacological or non-medical therapies are sleep hygiene, relaxation therapy, stimulus control, and sleep restriction. These also referred to as cognitive behavioral therapies.

Sleep hygiene is one of the components of behavioral therapy for insomnia. Several simple steps can be taken to improve a patient's sleep quality and quantity. These steps include: Sleep as much as you need to feel rested, do not oversleep. Exercise regularly at least 20 minutes daily, ideally 4-5 hours before your bedtime. Avoid forcing yourself to sleep. Keep a regular sleep and awakening schedule.

Do not drink caffeinated beverages before going to bed (tea, coffee, soft drinks etc.). Avoid "night caps" (alcoholic drinks prior to going to bed). Do not smoke especially in the evening. Do not go to bed hungry. Adjust the environment in the room (lights, temperature, noise, etc.). Do not go to bed with your worries, try to resolve them before going to bed.

Relaxation therapy involves measures such as meditation and muscle relaxation or dimming the lights and playing soothing music prior to going to bed.

Stimulus control therapy also consists of a few simple steps that may help patients with chronic insomnia. Go to bed when you feel sleepy. Do not watch TV, read, eat, or worry in bed.

Your bed should be used only for sleep and sexual activity. If you do not fall asleep 30 minutes after going to bed, get up and go to another room and resume your relaxation techniques. Set your alarm clock to get up at a certain time each morning, even on weekends. Do not oversleep. Avoid taking long naps in the daytime.

Restricting your time in bed to sleep may improve quality of sleep. This therapy is called sleep restriction. It is achieved by averaging the time in bed that the patient spends sleeping. Rigid bedtime and rise time are set, and patient is forced to get up even if they feel sleepy. This may help the patient sleep better the next night because of sleep deprivation for the previous night. Sleep restriction has been helpful in some cases.

Other simple measures that can be helpful to treat insomnia are as follows: Avoid large meals and excessive fluids before bedtime. Control your environment- light, noise, and elevated room temperature can disrupt sleep. Avoid stressful tasks before going to bed may be beneficial.

Avoid doing work in the bedroom that should be done somewhere else. For example, do not work or operate your business out of your bedroom, avoid watching TV, reading books, and eating in your bed. Likewise, manage your stress level by not thinking too much of your problems before going to bed will help a lot.