Insomnia… an interesting problem

Did you know that insomnia affects 10 to 30% of the population?

Insomnia is a specific definition, per the International Classification of Sleep Disorders (ICSD3).  You must have all four of the following: difficulty falling asleep, difficulty staying asleep, early awakening, AND daytime impairment (fatigue/poor attention/ mood disturbance/daytime sleepiness).  It must occur at least three times per week or at least one month.  And, it needs to not be related to inadequate opportunity to sleep well.

Some conditions can predispose a person to insomnia:

1.Chronic medication conditions such as sleep apnea, cancer, itchy skin, diabetes or IMG_3631-1menopause, heartburn, dementia, pain, restless legs syndrome.

2. Medications:  antidepressants, blood pressure medication, appetite suppressants, over-the-counter allergy, cough and cold medications, and sedatives.

3.  Psychiatric conditions:  anxiety, depression and post-traumatic stress disorder.

4.  Substance abuse: alcohol, illicit drugs, and tobacco.

Here are suggestions for non-drug treatment of insomnia…

Sleep hygiene.  Use the bedroom for sleep and sex only!  Exercise regularly, although not within 4 hours of bedtime.  Limit caffeine, tobacco and alcohol intake.  Maintain a regular sleep-wake cycle weekdays and weekends.

Stimulus control.  Lie down to sleep only when feeling sleepy.  Avoid wakeful activities at bedtime such as TV watching or walking on the phone.  Leave the bed if unable to fall asleep within 20 minutes and return to bed when sleepy.

Sleep restriction.  Limit time in bed to the numbers of hours actually spent sleeping, although this should be not less than five hours.  Increase sleep time gradually as sleep efficiency improves.

Relaxation training.  Imagine a calm environment.  Focus on pleasant images.  Consider meditation, yoga, progressive muscle relaxation.  Try visual or auditory biofeedback to help reduce muscle tension.

Avoid daytime naps.

Keep a sleep diary.   sleep hygiene 2

 

Good news is you cannot die from a few nights of mediocre sleep.

Work on the above issues before seeing your doctor .

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About drlesliegreenberg

I have been practicing as a family physician for over 20 years--as both an educator of physicians and clinician. From infancy to the elderly, I perform obstetrics and general medicine. I love my career and am passionate about my field of knowledge and my patients. Follow me on Facebook at Leslie Md Greenberg Medical Disclaimer The content of this website is provided for general informational purposes only and is not intended as, nor should it be considered a substitute for, professional medical advice. Do not use the information on this website for diagnosing or treating any medical or health condition. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider.
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