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Insomnia is a common problem — it is reported to affect up to 49% of adults every year. Of these adults, 15-35% feel that their problem is serious. More than 10% report insomnia lasting greater than two weeks with approximately 14% reporting insomnia as a frequent problem.
Signs that you may be suffering from insomnia include:
- Difficulty falling asleep
- Difficulty staying asleep
- A non-restful sleep, for example — awakening feeling tired
The population that is most often affected by sleeping problems includes women, the aged, persons who snore and those suffering from psychological problems such as anxiety and depression. The consequences of insomnia can be numerous and include poor daytime function, a sense of loss of well being, impaired memory function and decreased job performance. Sleeplessness and wandering/sleep walking at night is reported as a leading reason for elderly individuals to be admitted to nursing homes.
Medical problems are many times associated with insomnia. Some of these include depression, anxiety, alcohol abuse and chronic pain suffering, as with arthritis.
There is no simple, objective test to diagnose insomnia. For a physician to effectively evaluate your sleep problem you should keep a detailed diary of your sleep patterns over a period of time. This diary should include the amount of time spent in bed, the amount of time sleeping, time of nocturnal wakening, as well as medications, alcohol and caffeine intake. Sometimes information gathered from a partner can be useful too. A partner can record your behavior while you sleep, including leg movements, interrupted breathing and snoring.
To improve the sleep pattern most specialists emphasize the importance of sticking to a regular schedule, with specific sleeping and wakening times. Most will limit the number of hours spent in bed to only those hours in which you are sleeping. They also emphasize the use of bright light when wakening. If you are unable to sleep — leave the bedroom within 20 minutes, and return only when you are sleepy. Napping should be eliminated entirely, except in the elderly. Daytime activities should include an exercise program, but try not to exercise in the evening and avoid frustrating or stressful activities prior to bedtime. A cool temperature in the bedroom is important along with a quiet atmosphere. The use of white noise, or a sound machine and a comfortable sleeping environment can also be important in getting a night of restful sleep.
Medications can be prescribed by your physician if behavior modifications fail to produce successful results. Medications are particularly useful and effective for brief episodes of insomnia including periods of bereavement or stressful situations such a loss of job or jet lag. The short-term management of insomnia can be treated without concern of serious side effects from medications, but used with caution in the elderly. Sometimes a referral to a sleep specialist is necessary for those reporting obstructive or disruptive sleep symptoms including, severe snoring or periods where there is a lack of breathing, which can signal the presence of a more severe problem.
The diagnosis and management of insomnia can be accomplished using a combination of methods — including education, modified behavior, environmental changes and/or medication. It is common problem in the general population and can have consequences if it goes untreated.
Dr. David McCarty joined the staff of Longmont Clinic in November 1985.
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