27 East Street, Ashburton, Newton Abbot, Devon, TQ13 7AQ
For more information about Sleep Therapy at the South Dartmoor Clinic please call 07957 605134 or email us at max@secchi.co.uk
Insomnia or sleeplessness is a common sleep disorder and is defined as the inability to fall asleep and/or stay asleep for normal amounts of time. Insomniacs often complain that their mind is racing and typical feel unrefreshed and often anxious after a night of attempted sleep.
Insomnia is a common condition affecting 30% of men and 40% of women. The incidence and severity of insomnia also seems to worsen with age.
Transient insomnia normally lasts from between one night and a few weeks. Transient insomnia is usually caused by a minor stressful event leading to anxiety or from jet lag. It is normally self limiting when the anxiety has passed or the “body clock” had re-established itself.
Acute insomnia is the inability to achieve consistent good sleep for between three weeks and six months.
Chronic Insomnia is poor sleep on most nights for at least a month. Chronic insomnia is the most serious form.
Poor sleep quality is when a person can’t achieve Stage 4 sleep or deep sleep characterised by delta waves. This can occur as a result of sleep apnea or major depression. There are, however, people who are unable to achieve stage 4 sleep due to brain lesions or damage who still lead perfectly normal lives and are unaffected by this lack of deep sleep.
Sleep apnea occurs when normal breathing is interrupted during sleep causing the person to awaken. Obstructive sleep apnea is when the sufferers respiratory tract loses muscle tone and partially collapses. People with obstructive sleep apnea often do not remember awakening or having difficulty breathing, but they complain of excessive sleepiness during the day. Central sleep apnea occurs due congestive heart failure or cerebral vascular conditions when the individual must actually awaken to resume breathing.
Major depression leads to alterations in the function of the hypothalamus and pituitary causing excessive release of cortisol which can lead to poor sleep quality.
Nocturnal polyuria or excessive nighttime urination can easily disturb sleep. Nocturnal polyuria can be related to kidney disease or it may be due to prostate enlargement (benign prostatic hyperplasia BHP) or hormonal influences. Excessive thirst or the use of diuretics can also cause these symptoms.
As stated above insomnia often is caused by another disease or psychological problem. It is therefore vital to exclude any possibility of a medical condition causing the insomnia and ensuring the correct treatment is prescribed.
Many insomniacs rely on sleeping tablets or other sedatives to treat their sleeplessness. Any sedative drugs may cause psychological dependence where the individual cannot accept that they can sleep without drugs. Certain classes of sedatives such as benzodiazepines drugs can also cause physical dependence which may lead to withdrawal symptoms.
The most commonly used class of tablets that induce sleep or hypnotics prescribed for insomnia are the benzodiazepines such as temazepam, lorazepam, flurazepam, diazepam, nitrazepam. These medications are addictive causing physical dependence quite quickly
Nonbenzodiazepine prescription drugs such as nonbenzodiazepines zolpidem (Stilnoct) and zopiclone (Zimovane) and may have less side effects than the older benzodiazepines; however, there are controversies over whether these non-benzodiazepine drugs are superior to benzodiazepines. These drugs appear to cause both psychological dependence and physical dependence, and can also cause the same memory and cognitive disturbances as the benzodiazepines along with morning sedation.
Some antidepressants have a sedative effect and are prescribed to treat insomnia. Unfortunately these drugs can lead to many side effects.
Melatonin has proved effective for some insomniacs in regulating the sleep/waking cycle, but lacks definitive data regarding efficacy in the treatment of insomnia. Some individuals are can’t tolerate melatonin leading to aggressive behaviour. It is unavailable to purchase in the UK.
The antihistamine diphenhydramine is widely used in nonprescription sleep aids with a 50 to 100mg recommended dose in the United Kingdom. While it is available over the counter, the effectiveness of these agents may decrease over time and the incidence of next-day sedation is higher than for most of the newer prescription drugs. Dependence does not seem to be an issue with this class of drugs.
Some insomniacs use herbs such as valerian, chamomile, lavender, hops, and passion-flower with mixed success.
Alcohol may have sedative properties but interferes with REM sleep and causes awakenings due to polyuria (frequent urination)> Hangovers are also common.
Insomnia may be a symptom of magnesium deficiency, or lower magnesium levels. A healthy diet containing magnesium, can help to improve sleep in individuals without an adequate intake of magnesium.
The South Dartmoor Clinic
27 East Street, Ashburton, Newton Abbot, TQ13 7AQ
For appointments or further information please call 07957 605134 or email us at max@secchi.co.uk.