Most of us have experienced a night or two where concerns about work, money or family have kept us awake. We also may have been on medications, such as some cold remedies, or had too much caffeine, and experienced difficulty falling asleep despite being tired. However, the medical condition of insomnia which is defined as lack of sleep or disturbed sleep that persists for over a month – is a problem that affects 10-17% of Americans. As discussed today on The Denver Channel 7, this problem has been brought to the forefront by the recent coverage on the death of pop star MIchael Jackson, and it has again raised the issue of whether medications are the best treatment for insomnia. The answer to that question is that it depends on what is causing the insomnia.
There are actually two types of insomnia: primary and secondary. Let’s start with secondary insomnia. This is insomnia that is the result of something else – a disease, a medication/chemical or due to a psychiatric conditions. Primary insomnia is then any insomnia that is not caused by something else.
If a person is experiencing insomnia, the first step is a medical history and examination to determine if there are any substances or conditions that are causing the insomnia. Some of the more frequent causes of insomnia include sleep apnea, thyroid disease, caffeine, anxiety, depression, steroid medications, diet pills and other stimulant medications, grief and bipolar disorder. In these cases, treatment of the condition or changes in medication are the first step to curing the insomnia.
It is important to get evaluated for disturbed sleep that has lasted for more than a month in order to prevent the problems associated with this disorder. We all know that lack of sleep can produce sleepiness, difficulty with concentration and irritability. But did you know that lack of sleep is associated with high blood pressure, increased risk of heart attack and stroke, and with heart failure? These are things that can occur with chronic lack of sleep, and all things that can be avoided if we get the appropriate help. To take a sleep quiz that can help you determine if you need medical intervention, take the Porter Website sleep quiz.
For those who have primary insomnia after the workup, the medical literature would support that behavioral interventions – such as stress reduction, biofeedback and good sleep hygeine are just as effective as sleep medications and have significantly fewer side effects.
Good sleep hygiene is something that all of us can do on our own. It is simply putting certain practices into place that increase the chance that our bodies will learn to sleep at the appropriate times. The following is a list of things you can do to practice good sleep hygiene:
1. Avoid alcoholic beverages and caffeine near the time you go to sleep – caffeine will keep you awake and alcohol may make you fall asleep – but you will “rebound” and wake up several hours later
2. Always go to bed at the same time
3. Keep the bed reserved for sleep, and sexual activity – avoid working/reading/watching TV in bed
4. Avoid exercise for 3-4 hours prior to bedtime
5. Try to wake up at the same time every day
6. Do not sleep during the day
Good sleep is an important part of your good health,
Dr. Dianne
Mon, Jul 6, 2009
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