Sleep problems - insomnia

Insomnia is a symptom, not a disease. It means having trouble with how much or how well you sleep. This may be caused by difficulties in either falling or staying asleep. Self-reported sleeping problems, dissatisfaction with sleep quality and daytime tiredness are the only defining characteristics of insomnia because it is such an individual experience. Long-term chronic insomnia needs professional support from a sleep disorder clinic.

The concept of ‘a good sleep’ differs widely from person to person. While the average night’s sleep for an adult is around seven or eight hours, some people only need four, while others like up to 10 hours or more. What seems like insomnia to one person might be considered a good sleep by another.

A common complaint
Over one-third of people experience insomnia from time to time, but only around five per cent need treatment for the condition. Transient or short-term insomnia is typically caused by such things as stressful episodes, jet lag, change in sleeping environments, some acute medical illnesses and stimulant medications. Normal sleeping habits return once the acute event is over.

If a person has experienced sleeping difficulties for a month or more, this is called persistent or chronic insomnia. There are many causes of persistent insomnia. These include:

• Secondary insomnia – due to a range of medical and psychiatric problems and the chronic use of drugs and alcohol.
• Primary sleep disorders – include circadian rhythm disorders, central sleep apnoea-insomnia syndrome, inadequate sleep syndromes and periodic limb movement or restless legs syndromes.
• Idiopathic insomnia – sleeplessness without a known cause, formerly called childhood onset insomnia.

• Don’t nap during the day.
• Cut down on smoking and drinking.
• Avoid tea, coffee and other caffeinated drinks before bed.
• Don’t exercise strenuously before bedtime.
• Do something to relax, such as meditate or have a warm bath.
• Only go to bed if you feel sleepy.
• Go to bed later.
• Stop reading, worrying or watching television in bed and limit your activities in the bedroom to sleeping and sex.
• If you can’t sleep, get up, go to another room and do something else until you feel sleepy again.
• Get up at the same time every morning regardless of how much sleep you have had.
• Avoid ‘judging’ your sleep on a day-to-day basis.

• A sleep diary, to help pinpoint the pattern of insomnia
• A program of mild sleep deprivation
• Medication to help set up a new sleeping routine
• Exposure to bright light in the morning
• Behavioural therapy.

• Your doctor
• Sleep disorder clinic

• Insomnia is a symptom not a disease. The cause (or causes) of insomnia needs to be identified and corrected.
• Insomnia means having trouble with how well or how much you sleep.
• People keep themselves awake by worrying about going to sleep.
• Long-term chronic insomnia needs professional support and a lot of patience.

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