Insomnia
is the perception or complaint of inadequate or poor-quality sleep because
of one or more of the following: (1) trouble falling asleep (initial
insomnia); (2) trouble remaining asleep through the night (middle insomnia);
(3) waking up too early (terminal insomnia); or (4) unrefreshing sleep.
All types of insomnia can lead to daytime drowsiness, poor concentration,
and the inability to feel refreshed and rested in the morning.
Insomnia
is not defined by the number of hours of sleep a person gets or how
long it takes to fall asleep. Individuals vary normally in their need
for, and their satisfaction with, sleep. Insomnia may cause problems
during the day, such as tiredness,
a lack of energy, difficulty concentrating, and irritability.
Insomnia
can be classified as transient (short term), intermittent (on and off),
and chronic (constant). Insomnia lasting from a single night to a few
weeks is referred to as transient. If episodes of transient insomnia
occur from time to time, the insomnia is said to be intermittent. Insomnia
is considered to be chronic if it occurs on most nights and lasts a
month or more.
How
much sleep do we need?
The
amount of sleep each person needs depends on many factors, including
age. Infants generally require about 16 hours a day, while teenagers
need about 9 hours on average. For most adults, 7 to 8 hours a night
appears to be the best amount of sleep, although some people may need
as few as 5 hours or as many as 10 hours of sleep each day. Women in
the first 3 months of pregnancy often need several more hours of sleep
than usual.
The
amount of sleep a person needs also increases if he or she has been
deprived of sleep in previous days. Getting too little sleep creates
a "sleep debt," which is much like being overdrawn at a bank. Eventually,
your body will demand that the debt be repaid. We don't seem to adapt
to getting less sleep than we need, while we may get used to a sleep-depriving
schedule, our judgment, reaction time, and other functions are still
impaired.
People
tend to sleep more lightly and for shorter time spans as they get older,
although they generally need about the same amount of sleep as they
needed in early adulthood. About half of all people over 65 have frequent
sleeping problems, such as insomnia, and deep sleep stages in many elderly
people often become very short or stop completely. This change may be
a normal part of aging, or it may result from medical problems that
are common in elderly people and from the medications and other treatments
for those problems.
What Does Deep Sleep
Do For Us?
Although
scientists are still trying to learn exactly why people need sleep,
animal studies show that sleep is necessary for survival. For example,
while rats normally live for two to three years, those deprived of REM
sleep survive only about 5 weeks on average, and rats deprived of all
sleep stages live only about 3 weeks. Sleep-deprived rats also develop
abnormally low body temperatures and sores on their tail and paws. The
sores may develop because the rats' immune systems become impaired.
Some studies suggest that sleep deprivation affects the immune system
in detrimental ways.
Symptoms of Insomnia
People
will be unable to carry out their daily responsibilities either because
they are too tired or because they have trouble concentrating due to
lack of restful sleep.
Insomnia
may cause a reduced energy level, irritability, lack of focus, attention
disorders, anhedonia, disorientation, dark circles under the eyes, posture
changes, and fatigue.
Causes
of Insomnia
There are
a number of possible causes of insomnia:
- Wake-sleep
pattern disturbances
- Grief
- Depression
or major depression
- Worry
- Jet lag
- Anxiety
or stress
- Exhilaration
or excitement
- Bed or
bedroom environment not conducive to sleep
- Nicotine,
alcohol, caffeine, food, or stimulants at bedtime
- Aging
- Excessive
sleep during the day
- Excessive
physical or intellectual stimulation at bedtime
- Overactive
thyroid
- Taking
a new drug
- Alcoholism
- Inadequate
bright-light exposure during waking hours
- Abruptly
stopping a medication
- Medications
or illicit drugs
- Withdrawal
of medications
- Interference
with sleep by various diseases
Transient
and intermittent insomnia generally occur in people who are temporarily
experiencing one or more of the following:
- Stress
- Environmental
noise
- Extreme
temperatures
- Change
in the surrounding environment
- Sleep/wake
schedule problems such as those due to jet lag
What are possible
treatments for insomnia?
Appropriate
sleep habits are important in the management of insomnia. In some instances,
changing sleep habits may correct the problem without the need for medications.
Good sleep habits should include:
- Regular
sleep times;
- Appropriate
lighting;
- A comfortable
bed and quiet room at a comfortable temperature;
- A bedroom
that is not used for work or other activities that are not related
to sleep;
- Avoidance
of stimulants (e.g. caffeine, tobacco), alcohol, and large meals close
to bedtime;
- Regular
exercise but not close to bedtime or late in the evening;
- Relaxation
techniques such as breathing exercises; and
- Avoidance
of naps during the day.
- Use of
an OTC sleeping pill or sleep
aid.
