To Sleep, Perchance to Dream

A good night’s sleep is one of the best natural restoratives to most of us. Sleep is as important to your health as a healthy diet or regular physical activity.  Some people, however, cannot enjoy the benefits adequately: they suffer from sleep disorders. These are changes in the way people sleep, and they can affect one’s overall health, safety, and quality of life. Some of the common sleep disorders include several types of sleep apnea, in which abnormal patterns of breathing during sleep interfere with sleep quality, restless legs syndrome, where people have an urge to move their legs while trying to fall asleep, and narcolepsy, characterized by extreme sleepiness during the day. But the most common and well known sleep disorder is insomnia. This is a sleep disorder that can make it hard to fall asleep, hard to stay asleep, or cause you to wake up too early and not be able to get back to sleep. Most adults need seven to eight hours a night of sleep, though that may vary from person to person. Some people may experience short-term or acute insomnia, lasting days or weeks, usually the result of stress or a traumatic event. Some people, however, have long-term or chronic insomnia, which lasts for a month or more. Insomnia may be the primary problem, or may be associated with other medical conditions or some medications (secondary insomnia). Conditions such as asthma, depression, arthritis, cancer, heartburn or pain can cause insomnia. Medications used to treat colds, allergies, depression, high blood pressure, and asthma may interfere with sleep. Substance abuse, alcohol, for instance, may also cause insomnia. Symptoms include difficulty falling asleep, waking up often during the night, and having trouble going back to sleep, waking up too early in the morning, and feeling tired upon waking. Insomnia may also cause sleepiness during the day, irritability, and problems with concentration and memory.  Insomnia becomes more common with age. Older people experience changes in sleep patterns, and typically use more medications to treat other health conditions. They are also less physically active, and are prone to several chronic health disorders that can interfere with sleep. The doctor will evaluate insomnia with a medical history, a physical examination, and also a sleep history. Sometimes special tests may be ordered at a sleep center. Acute insomnia may not require treatment. Mild insomnia can often be prevented or cured by practicing good sleep habits, such as trying to go to sleep at the same time each night, and getting up at the same time each morning, avoiding naps during the day, avoiding prolonged use of phones or reading devices (“e-books”) before bed, avoiding caffeine, nicotine or alcohol late in the day, and refraining from heavy meals before going to bed. Getting regular exercise also helps, although exercise should be avoided close to bedtime. Chronic insomnia must be treated by first treating any underlying conditions or heath problems that may be causing the insomnia. Rapid onset, short-acting drugs can help prevent effects such as drowsiness the following day. Over-the-counter sleeping pills should be avoided because they may have undesired side-effects, and tend to lose their effectiveness over time. Behavioral approaches help change behaviors that worsen insomnia, and teach new behaviors to promote sleep. Relaxation exercises, sleep restriction therapy, and reconditioning may also be useful.



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