Insomnia or Sleeplessness

Insomnia is a term that describes a disturbance of the normal sleep pattern.

Each person needs a different amount of sleep to function well during the day. The average amount of sleep required by most people is 6 to 8 hours per night. Most people establish a pattern that is normal for them in their early adult life. It is normal to sleep less with old age e.g. many people in their 70's sleep less than six hours per night. Feeling refreshed after a night's sleep and not feeling sleepy during the day is a good indicator that you are getting the right amount of sleep. A person with Insomnia will have persistent difficulty falling or staying asleep, leading to impairment of daytime functioning.

• Difficulties with sleep can appear in a variety of ways:
• Difficulty getting to sleep (sleep onset insomnia) - most common in young people.
• Waking in the night - most common in older people.
• Waking early in the morning - the least common type of sleep disturbance.
• Not feeling refreshed after sleep, which can lead to fatigue, irritability and poor concentration.
• Waking when you have been disturbed from sleep by pain or noise.

Insomnia can last for days, months or even years and can be split into three categories:
• Transient insomnia lasts for 2-3 days.
• Short-term insomnia lasts for more than a few days, but less than three weeks.
• Chronic insomnia can be defined as insomnia most nights for three weeks or longer.

CLASSIFICATION OF INSOMNIA
Insomnia can also be classified as primary or secondary Insomnia. In addition, Insomnia that results from a specific sleep disorder, such as sleep apnoea, circadian disturbances, or sleep movement disorders including restless legs syndrome or periodic limb-movement disorder, are categorised separately. Primary Insomnia is a condition in which sleep disturbances last for at least one month, and have no physical or medical cause. Secondary Insomnia is a condition caused by a physical condition or clinical depression.

EFFECTS OF INSOMNIA
Clinical studies indicate that restriction of sleep results in a variety of effects, including high blood pressure, adverse effects on the nervous system, impairment of blood sugar control, and increased inflammation in the body. These studies suggest that sleep should not be considered a luxury, but an important component of a healthy lifestyle.

CAUSE
Insomnia can occur for no apparent reason, however, there are a number of possible causes.
• Worry about sleep can cause you to feel anxious or irritated which results in a cycle of sleeplessness.
• Temporary problems such as stress, a work or family problem, jet lag, a change of routine, sleeping away from home can cause Insomnia, which usually improves in time.
• Anxiety or depression are common causes of Insomnia.
• Sleep apnoea causes the large airways to narrow or collapse during sleep. This not only causes snoring, but also reduces the amount of oxygen that gets to the lungs. This causes you to wake up to breathe properly. You may wake up many times each night, which may result in daytime tiredness.
• Medical problems causing pain, breathlessness, leg cramps, indigestion, cough, itch, hot flushes etc can cause Insomnia. Dementia and mental health problems are also causes of Insomnia.
• Stimulants can interfere with sleep. These include alcohol, caffeine and nicotine.
• Street drugs such as ecstasy, cocaine, cannabis and amphetamines can affect sleep.
• Prescribed drugs such as diuretics, some antidepressants, steroids, beta-blockers, some slimming tablets, painkillers containing caffeine, and some cold remedies containing pseudoephedrine can interfere with sleep. If you suddenly stop taking regular sleeping tablets or other sedative drugs, 'rebound' insomnia can occur.

TREATMENT OPTIONS
As with all medical conditions it is advisable to consult your GP for an accurate diagnosis and treatment. Your Doctor will ascertain the underlying cause of your Insomnia, which will determine the treatment. For example, if depression is the cause then this condition will be treated.

Non-drug treatments for Insomnia are usually recommended initially. These involve counselling, lifestyle advice and education about healthy sleep practices. If your Insomnia is unresponsive to this treatment then your doctor may prescribe sleeping medication.

DIET HINTS
Have a healthy diet and avoid stimulants such as caffeine found in tea, coffee and some cola drinks. Alcohol can also disturb normal sleep patterns. Avoid a heavy/large meal just before bedtime. A light snack may be helpful.

VITAMINS/MINERALS/HERBS
• Calcium may have a calming effect as can relax the nervous system.
• Magnesium may help the muscles to relax as can relax the nervous system.
• Valerian, passionflower and Chamomile can all be useful in the treatment of insomnia as these herbs help to relax the nervous system.

AROMATHERAPY
The listed essential oils are suggested for the temporary relief of Insomnia. The most specific oils are shown in capitals.
Aniseed, Benzoin, BLUE CHAMOMILE, CHAMOMILE, LAVENDER, MARJORAM, NEROLI, Orange, Petitgrain
These oils may be added to massage oil, put in a bath or burned in a vaporiser.

PHARMACIST'S ADVICE
Ask your MedAux Pharmacist for advice.
1. Follow the Diet Hints and see the Insomnia Hints, Sleep and Ageing and Restless Legs Syndrome topics.
2. Avoid or limit caffeine, which is a stimulant that can interfere with sleep.
3. Avoid drinking alcohol and smoking, as these are also stimulants.
4. Regular exercise promotes healthy sleep patterns. Avoid exercising 4 hours before bed.
5. Your Pharmacist may suggest some herbal tablets to help you rest. Examples of herbs with mild sedative properties include valerian and chamomile. Ask your Pharmacist for suggestions.
6. If feelings of sadness or anxiety are causing you to lose sleep, ask your Pharmacist for advice. Talking to someone may help. Do not hesitate to ask your Doctor to refer you to a counsellor if your worries are affecting your sleep.
7. Create a relaxing environment to sleep in e.g. make sure you have a comfortable bed and pillow. Evaporating some lavender essential oil may promote relaxation and sleep.