Insomnia

Insomnia is the most common sleep disorder, which affects one in four people.

1. Transient Insomnia

This version of insomnia can last anything from a few days to a week, can be triggered by various factors (such as excess environmental noise, medications, and extreme temperatures – either hot or cold). One type of transient insomnia experienced by avid travellers is jet lag, in which travelling through time zones causes a temporary disruption of the body’s circadian rhythm.

3. Chronic Insomnia

This type of insomnia can have detrimental effects on a person’s health, quality of life, productivity, and safety, and can last anything from months to years at a time.

In many cases, insomnia may be a consequence of another underlying medical problem, as discussed below:

1. Mental Health Issues

Insomnia is a symptom of many mental health problems, which includes anxiety, depression and bipolar disorder.

2. Physical Health Issues

There are various physical health conditions that are associated with insomnia. These including musculoskeletal problems, cardiovascular disease, gastrointestinal and urinary problems, neurological problems, respiratory problems, immunological problems, and cancer.

3. Hormonal Imbalances

Levels of sex hormones in men & woman (i.e., oestrogen, progesterone, and testosterone) may have a significant impact on the person’s ability to sleep peacefully. This is especially true for women; the incidence of sleep disturbances in women rises to 40% three years after menopause. Studies have found that hormone replacement therapy to balance the declined hormone levels post in menopausal women can significantly improve sleep patterns.

4. Medications

Medication-induced insomnia can be caused by a wide variety of drugs. Some of these drugs include decongestants, monoamine oxidase inhibitors (MAOIs), selective serotonin reuptake inhibitors (SSRIs), corticosteroids, chemotherapeutic agents, calcium channel blockers, beta-agonists, and theophylline.

5. Stimulants

Stimulants (such as caffeine and nicotine) contribute to insomnia by making it harder for the brain to achieve the state of relaxation needed for sleep.
Nicotine use and nicotine withdrawal can contribute to insomnia. Even those undergoing nicotine replacement therapy (to quit smoking) experience the adverse effects of nicotine on sleep patterns.
While most people think of alcohol as a sedative, its consumption increases dopamine released levels within the brain, which has a stimulating effect. Chronic alcohol use is associated with insomnia, as is alcohol withdrawal.

6. Lifestyle

Shift work will also contribute to sleep disorder. Shift work sleep disorder is a type of insomnia which affects individuals that work non-standard work schedules (such as rotating shifts, on-call work, or permanent night shifts) trigger a disconnect between the body’s circadian rhythm and actual time.

1. Improving sleep hygiene

Consider implementing the following sleep hygiene measures for improved sleep quality
Minimize the amount of light, noise and changes in temperature in the bedroom.
Avoid eating large meals before bed, as indigestion can make falling asleep difficult.
Limit the amount of stimulants (such as consuming caffeine, nicotine, and alcohol) consumed during the day, especially close to bedtime. Try to completely avoid these for minimum 4-6hours before bedtime.
Avoid vigorous exercise during the two hours prior to sleep.
Avoid bedtime activities that are not related to sleep (such as watching Television, reading, or listening to the radio).
If worrying about falling asleep and the time, cover the alarm clock to avoid anxiety.

2.Sleep restriction to reset circadian rhythms

Sleep restriction therapy forces the individual to limit the amount of time spent in bed (including naps) to increase the biological need for sleep at night.

3. Cognitive-behavioural therapy

Cognitive-behavioral therapy (CBT) is used for treatments of chronic insomnia and helps people develop behaviours that are more conducive to sleep. It has been shown to be an effective treatment for both “primary insomnia” (insomnia not due to other diseases) and insomnia caused by other medical problems. Notably, CBT for treatments of chronic primary insomnia may be more effective than the medication zopiclone in older adults.

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