Insomnia

According to several medical dictionaries, the definition of insomnia is “the perception or complaint of inadequate or poor-quality sleep because of one or more of the following:

• Difficulty falling asleep
• Waking up frequently during the night with difficulty returning to sleep
• Waking up too early in the morning
• Unrefreshing sleep

Some factors can make individuals more likely to experience insomnia, such as a history of depression, being female or advanced age. Researchers believe insomnia occurs most frequently in people over the age of 60.

Types of Insomnia

There are three main types of insomnia, transient (short term), intermittent (off and on) and chronic (constant). Transient and intermittent insomnia commonly occur in individuals who are experiencing:

• Stress
• Jet lag
• Side effects of medications or some other temporary cause.

There are other variations of insomnia however, including Psychophysiologic (also called “Learned”) Insomnia. This form of insomnia is characterized by severe difficulty falling asleep and staying asleep. Many people go to bed worrying about insomnia because of previous episodes, and this thinking produces an adverse association between the bedroom and sleep.

If you have trouble sleeping, it is very important to determine whether an underlying disease or condition is causing the problem. Sometimes insomnia is caused by pain, digestive problems or a sleep disorder. Insomnia may also signal depression or anxiety. Often times, insomnia exacerbates the underlying condition by leaving the patient fatigued and less able to cope and think clearly.

Chronic insomnia, however, is more complex and often is a result of many factors contributing to this inability to sleep well.

One of the most common causes of chronic insomnia is depression even though there may be underlying issues such as arthritis, sleep apnea or other afflictions. Behavioral factors may also play a role in insomnia such as the misuse of alcohol or drugs, shift work (working a night shift or in specific industries which affect the internal clock). Ongoing stress is certainly an issue because worrying at night can deter sleep significantly.

Insomnia in Women

Fluctuations in female hormones play a major role in insomnia in women throughout the course of their lifetimes. Insomnia caused by hormonal imbalances in women is usually transient, lasting for varying periods of time. Different stages in female reproductive life can be directly correlated to onset and duration of insomnia.

• Menstruation: Progesterone promotes sleep, and levels of this hormone decrease during menstruation, causing insomnia. (When these hormone levels rise during ovulation, women may become sleepier than usual.)
• Pregnancy: The effects of changes in progesterone levels in the first and last trimester can disrupt normal sleep patterns.
• Menopause: Insomnia can be a major problem in the first phases of menopause because hormones fluctuate intensely. Insomnia during this period may be due to different factors that occur. In some women, hot flashes, sweating, and a sense of anxiety can awaken women suddenly and frequently at night during the first months of menopause. In such women, hormone replacement therapy may be beneficial. Insomnia may also be perpetuated by psychological distress provoked by this life passage. In most cases, insomnia is temporary. Cases of chronic insomnia in women after 50 are more likely to be due to other causes.

• For transient and intermittent insomnia, sleeping pills may be helpful, as well as relaxation and meditation methods.
• If the cause of the insomnia is another sleep disorder or a psychological ailment, then treatment for the primary cause will help reduce the symptoms of insomnia.

Sleep aids, or hypnotics, with a prescription or over the counter may also help insomnia symptoms. Sleep aids contain anti-histamines and may have side effects such as daytime drowsiness and forgetfulness. Side effects are determined by age and the dose and half-life of the drug. A physician’s opinion should be weighed heavily in determining whether to take sleep aids.

Getting Some Rest

Half of all people who have suffered from insomnia blame the problem on stress or worry. In the case of stress-induced insomnia, the degree to which sleep is disturbed depends on the severity and duration of the stressful situation. Sometimes it may be an emotional disturbance such as the loss of a loved one, loss of a job, marital or relationship problems or a tragic occurrence. Anticipation of events such as weddings, vacations, or holidays can also disturb sleep and make it difficult to fall asleep or remain asleep.

• Keep a sleep diary; it's the best way to keep track of your sleeplessness and sleeping pattern. Keeping a diary for two weeks will reveal information about your sleep schedule and may uncover unhealthy patterns and things you weren't aware of. A physician's guidance and opinion is advisable if you have any concerns about your sleep.
  
• Practicing good sleep hygiene, including avoidance of alcohol, caffeine and tobacco in the evening. Also, heavy foods and exercise should be avoided at least three hours prior to sleep. However, if you are hungry while trying to fall asleep, eating a light snack is definitely advised because the hunger will only add fuel to the fire of keeping you awake.
  
• Research supplements and homeopathic remedies. Sleep aids (sleeping pills) can help induce sleep, but so can home remedies such as light therapy, relaxation aids, biofeedback or sound therapy and other techniques. Consult your physician before starting an herbal regiment.