Perhaps due to stress, heartburn, drinking too much caffeine or alcohol, most people have occasional sleepless nights.  Insomnia is a lack of sleep that occurs on a regular or frequent basis, often for no apparent reason.

What is considered enough sleep varies from person to person. 7 ½ hours is about average, some say 8, but some do well with four or five.  Still others need nine to ten hours a night.

Insomnia can affect your mood and energy levels, but also your health, because sleep helps bolster your immune system, that which prevents you from falling ill from so many causes.  Fatigue, at any age, leads to decreased mental alertness and concentration.  Of course lack of sleep caused by insomnia is linked to accidents on the road and on the job.

The problem may be temporary or chronic.  But you don’t have to live with it.  Some simple changes in your daily routine and habits may result in better sleep.

SIGNS AND SYMPTOMS

•    Inability to get enough sleep at night; i.e. what’s normally enough for you.
•    Difficulty falling asleep at night
•    Waking up during the night
•    Waking up too early
•    Waking up feeling tired, even after a full night’s sleep
•    Daytime fatigue or sleepiness
•    Daytime irritability

CAUSES OF INSOMNIA

Common ones include:

Stress.  Don’t we all know about this!? But there are also concerns about work, school, health, family, relationships, that keep your mind too active; you’re unable to relax.  Excessive boredom, such as after retirement or during a long illness, may create stress and keep you awake.

Anxiety.  Whether everyday ones or severe anxiety disorders, your mind may be kept too alert to fall asleep.

Depression.  Actually this may cause you to sleep too little or too much.  Chemical imbalances in the brain contribute, but worries that accompany depression may prevent you from relaxing enough to fall asleep when your want to.

Stimulants.  Prescription drugs, including antidepressants, high blood pressure medication and corticosteroids, like Prednisolone, may interfere with sleep.  Over-the-counter (OTC) medications, including some for pain, decongestants, and weight loss products, contain caffeine and other stimulants.  Antihistamines may initially make you groggy, but can worsen urinary problems, making you get up more during the night.

Change in your environment or work schedule.  Many of you who work weird shifts know the effect that this can have on your sleep.  Your circadian rhythm is disrupted.  This acts as your internal clock which guides your sleep-wake cycle, and even metabolism and body temperature.

Long-term use of sleep medications.  Some sleeping pills may be habit-forming (addictive).  If you need to take them for longer than four weeks, (doctor’s generally don’t recommend any longer that this), take them no more than two to four times a week.  Over time, they become less effective.

Medical conditions that cause pain.  Arthritis, condition affecting your physical nerves, and fibromyalgia, are among these.

Behavioral insomnia.  When you worry excessively about failure to sleep, and try too hard to sleep, this occurs.  Being away from your usual sleep environment or not trying to sleep, such as watching TV or reading, may help persons with this condition.

Eating too much too late in the evening.  You will feel uncomfortable when lying down and have trouble to sleep.  In addition, the resultant heartburn may keep you awake.

Inherited condition.  Imagine even insomnia can be inherited.  In this case, don’t over- excite yourself, especially in the evening.  Husbands, wives, I know that’s difficult, but you do need your sleep for your health.

Insomnia becomes more prevalent with age.  As you get older, changes can occur which affect your sleep.  You may experience:

•    A change in sleep patterns.  After age 50, sleep becomes less restful. You sleep more lightly and are therefore more likely to wake up.  With age, your internal clock speeds up.  You get tired earlier in the evening and as a result wake up earlier in the morning.

•    A change in activity.  Activity helps promote a good night’s sleep, so if you’re less physically or socially active, sleep may be a problem.  If you have more free time and use it to drink coffee or alcohol, or take a daily nap, sleep may not come too easily at night.

•    A change in health.  Arthritis, back problems, depression, anxiety, stress (as mentioned), prostate enlargement with urinary problems, the hot flashes that accompany menopause, all can keep you from sleep.

Children and teenagers have sleep problems too.  Many have the same causes as adults, but in addition, there is sleepwalking, night terrors, or teeth grinding (bruxism).  Some children just don’t respect their inherent clocks. When it is 11:00, it may feel like 8:00 to them, because of their, in essence, delayed clocks.

SEEK MEDICAL ADVICE

If insomnia has severely interfered with your daytime functioning for a month or longer, see your doctor

ANY COMPLICATIONS

Sleep is as important to your health as a healthy diet and regular exercise.  Whatever the reason for it, insomnia can impact you mentally and physically.

Chronic insomniacs are more likely to develop psychiatric problems like depression and anxiety disorders.  Notice these can be causes and consequences of insomnia.  Sleep deprivation may increase the severity of diseases like hypertension and diabetes.

Don’t forget we talked about accidents.

WHAT TREATMENTS ARE THERE?

Self-help measures, such as avoiding daytime naps, or eating too much too late, may help.

Prescription sleeping pills may help but there are different problems associated with them, so don’t expect them to be prescribed for too long.  Even OTC drugs have adverse effects, so you may want to talk to the doctor about them, to hear his thoughts on particular ones.

SOME WAYS TO COPE

Briefly:

•    Stick to a schedule
•    Limit your time in bed, to prevent shallow unrestful sleep.  For two weeks, try to cut the time you spend in bed by one hour to see if it helps you sleep.
•    Avoid trying too hard to sleep
•    Exercise and stay active
•    Avoid or limit caffeine and nicotine.  No alcohol
•    Check your medications
•    Don’t put up with pain
•    Find ways to relax
•    Minimize sleep interruption. Close your bedroom door, or create subtle background noise, such as a fan, to drown out other noises.  Keep your bedroom temperature comfortable, cooler than daytime.  Drink less before bed to stay away from the toilet often.

See you next week.