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Difficulty in sleeping (Insomnia)-5 Common Questions and their Answers

What is insomnia?

Do you have a hard time falling asleep? Do you find it difficult to stay asleep, perhaps waking up frequently during the night? Are there times you wake up earlier than usual? Do you feel unrefreshed after sleeping? If your answer is ‘Yes’ to any or more of these questions, you may have a very common condition called insomnia.  So, if  you have difficulty in sleeping despite having the opportunity to do so. You may have insomnia.

Most people experience difficulty in sleeping once in a while. However, if this persists, additional problems  arise. Some individuals wake up feeling un-refreshed. Others become irritable, anxious and  easily tired. You may begin to lack the energy and desire to work or engage in fun activities. In some cases, difficulty in focusing on tasks and remembering things occurs. If unresolved, insomnia could significantly affect your  ability to meet your obligations at home, school  or workplace.

Unfortunately, when insomnia is accompanied by daytime sleepiness, accidents may occur.  In fact, persons with sleep problems have experienced falls, road traffic injuries and  occupational errors. However, persons that have insufficient sleep are more likely to report falling asleep during the day than those with insomnia. According to the American Academy of Sleep Medicine,  this is because ‘people with insomnia often underestimate the amount of sleep they get each night. They worry that their inability to sleep will affect their health and keep them from functioning well during the day. Often, however, they   are able to perform well   during the day despite feeling tired’.

How common is insomnia?

It is one of the most distressing medical problems worldwide.  Up to 50% of adults have experienced   insomnia in their lifetime.  However, it is only serious enough to cause daytime sleepiness or become chronic in 10% of adults. Older persons, women, persons with marital difficulties and the unemployed are more likely to have this condition than others. Gladly, difficulty in sleeping is short lived, resolving over a period of days or weeks in most individuals.

What causes insomnia?

Insomnia may be primary or secondary. In primary insomnia, the cause is unknown. Are you often emotionally upset or stressed up? Then you are more likely to experience primary insomnia.  It may also be due to changes in your home or work environment and schedule. For example, travelers and shift workers  often experience difficulty in sleeping because of changes in their sleep patterns and environment. Unfortunately, this form of   insomnia  may persist despite your return to previous work routine or environment.

Secondary insomnia occurs when specific medical conditions or medications lead to difficulty in sleeping. In up to 80% of cases, secondary causes account for insomnia.

What are the common causes of insomnia?

    • Mental health conditions such as  anxiety, depression and psychotic disorders
    • Lifestyle factors such as drinking, smoking or use of recreational drugs
    • Acute or chronic medical conditions e.g heart failure and dementia
    • Sleep disorders e.g restless legs syndromes
    • Pain
    • Poor sleep routine or environment

Medications such as steroids, antidepressants and beta blockers


Can it be treated?

Yes. Treatment options are available. However, a lot depends on the cause of the problem.

The doctors may need to obtain a detailed history of your sleeping pattern.  According to the American sleep association, common questions doctors ask include:

How long have you been experiencing  sleeping problems?

How often do you experience it? When do you fall asleep?

How long does it take you to fall back asleep when your sleep is disrupted?

Sleep hygiene  and lifestyle factors like drinking, exercise and dietary habits are some important issues the doctor may want to review with you.

Your doctor may also ask you to keep a sleep diary to track your sleep habits.

The treatment plan depends on the causes and specific problems you have.  Most doctors may prescribe sedatives (usually benzodiazepines) for short term relief. This is often limited to about 2 weeks because many of these drugs are addictive. Complications arise when sedatives are inappropriately prescribed. So be alert for the tendency to pop the pills without a doctor’s prescription.

In some instances, psychological therapy may be needed to resolve the problem. Sleep hygiene, stimulus control, cognitive therapy and relaxation training are effective common psychological treatments. You will need to discuss possible treatment options with your doctors.

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