Treatment for Chronic Insomnia
May 10, 2011 by admin
Filed under Diseases And Conditions
Bharat Bista asked:
Insomnia is the most common sleep problem reported by adults. Approximately one-half of all adults have occasional sleep problems during the course of any year. Insomnia is characterized by the inability to fall asleep or to maintain sleep, usually due to an underlying condition or cause. Both men and women of all ages suffer from insomnia, but it is more common in females and older adults. Individuals suffering from insomnia may experience any or all of the following symptoms:
Difficulty falling asleep
Difficulty staying asleep
Waking too early in the morning
Typically, insomnia is associated with feelings of restlessness, irritability, anxiety, unrefreshing sleep, and daytime fatigue. Medical or psychiatric conditions that are sometimes associated with insomnia include depression, anxiety, substance abuse disorders, obstructive sleep apnea, restless legs syndrome, and chronic medical conditions. Medications and other substances, such as caffeine, alcohol, or nicotine, can also play an important role in the development or persistence of insomnia. Some commonly used medications, such as antidepressants, antihypertensive, antihistamines, and decongestants, have been known to cause insomnia and sleep disruption. Before discontinuing any medication, however, it is very important to discuss your concerns with your doctor first.
For most people with insomnia, the symptoms last a few days to weeks, and then resolve spontaneously. In many of these cases, the underlying cause of insomnia may be a transient life stress or change in the daily routine of an individual. However, for those who have chronic insomnia, lasting for three months or longer, the effects of poor sleep can take a significant toll on quality of life and general well-being. The effects of chronic insomnia include reduced quality of life, impaired social functioning, diminished work productivity, missed work days, impaired memory and concentration, and depression. In essence, chronic insomnia can deprive individuals of their ability to function both socially and professionally, which can then lead to increasing problems in these areas of life.
In addition to decreased job performance, insomnia is associated with increased absenteeism. People with insomnia are at increased risk for various kinds of accidents, both at work and while operating motor vehicles.
Managing Insomnia
Chronic insomnia is characterized by its chronicity. Thus, individuals with chronic insomnia can expect that the problem may be life-long. However, there are successful treatments available that can help to control the severity and to minimize the long-term effects of insomnia.
Scientific research has demonstrated that the most successful treatment protocol for chronic insomnia is a combination of medication and cognitive behavioral therapy (CBT). CBT is a series of behavioral interventions used to improve one’s ability to initiate and to maintain sleep. Specifically, CBT is a group of techniques that can be learned to help one sleep better. Generally, CBT is conducted in individual or small group formats, over a period of several weeks. As mentioned earlier, CBT is most successful in conjunction with medication for the treatment of chronic insomnia. However, treatment with medication is not required in every case.
So what exactly is CBT?
CBT encompasses several different techniques, which may be used all together or individually. These various techniques include sleep hygiene training, relaxation therapy, stimulus control therapy, sleep restriction, and cognitive therapy. Sleep hygiene training refers to re-learning habits that encourage and promote sleep. Maintenance of a quiet sleep environment may mean excluding a pet from the bedroom or getting a bed partner to seek help for a snoring problem. Relaxation therapy helps to reduce physiologic and cognitive arousal at bedtime. Some people may be unaware of how tension and stress affect their sleep. Stimulus control therapy works by limiting the presence of external stimuli or factors that may bring anxiety or stress into the bedroom environment. Implementation of this technique can help to establish the bedroom as a place to relax and unwind, away from the stresses of the world. Sleep restriction limits the amount of time spent lying awake in bed. This technique requires close oversight by a physician or psychologist, using sleep diaries, to ensure successful treatment. Cognitive therapy works to refute an individual’s thoughts about sleeplessness and the fear and anxiety related to these thoughts. Cognitive therapy has the potential to provide patients with good tools to deal with insomnia.
CBT is generally conducted by psychologists or physicians with specialized training in these techniques. Unfortunately, CBT for chronic insomnia is not readily available everywhere; however, by doing some research through internet resources or by contacting the National Sleep Foundation (www.sleepfoundation.org) or the American Academy of Sleep Medicine (www.aasmnet.org), you may be able to find someone in your area. At the Dallas Center for Sleep Disorders, we offer Insomnia Workshops with CBT for chronic insomnia. You can contact us for more information (www.dallas-sleep.com or 972-473-7300).
Insomnia is the most common sleep problem reported by adults. Approximately one-half of all adults have occasional sleep problems during the course of any year. Insomnia is characterized by the inability to fall asleep or to maintain sleep, usually due to an underlying condition or cause. Both men and women of all ages suffer from insomnia, but it is more common in females and older adults. Individuals suffering from insomnia may experience any or all of the following symptoms:
Difficulty falling asleep
Difficulty staying asleep
Waking too early in the morning
Typically, insomnia is associated with feelings of restlessness, irritability, anxiety, unrefreshing sleep, and daytime fatigue. Medical or psychiatric conditions that are sometimes associated with insomnia include depression, anxiety, substance abuse disorders, obstructive sleep apnea, restless legs syndrome, and chronic medical conditions. Medications and other substances, such as caffeine, alcohol, or nicotine, can also play an important role in the development or persistence of insomnia. Some commonly used medications, such as antidepressants, antihypertensive, antihistamines, and decongestants, have been known to cause insomnia and sleep disruption. Before discontinuing any medication, however, it is very important to discuss your concerns with your doctor first.
For most people with insomnia, the symptoms last a few days to weeks, and then resolve spontaneously. In many of these cases, the underlying cause of insomnia may be a transient life stress or change in the daily routine of an individual. However, for those who have chronic insomnia, lasting for three months or longer, the effects of poor sleep can take a significant toll on quality of life and general well-being. The effects of chronic insomnia include reduced quality of life, impaired social functioning, diminished work productivity, missed work days, impaired memory and concentration, and depression. In essence, chronic insomnia can deprive individuals of their ability to function both socially and professionally, which can then lead to increasing problems in these areas of life.
In addition to decreased job performance, insomnia is associated with increased absenteeism. People with insomnia are at increased risk for various kinds of accidents, both at work and while operating motor vehicles.
Managing Insomnia
Chronic insomnia is characterized by its chronicity. Thus, individuals with chronic insomnia can expect that the problem may be life-long. However, there are successful treatments available that can help to control the severity and to minimize the long-term effects of insomnia.
Scientific research has demonstrated that the most successful treatment protocol for chronic insomnia is a combination of medication and cognitive behavioral therapy (CBT). CBT is a series of behavioral interventions used to improve one’s ability to initiate and to maintain sleep. Specifically, CBT is a group of techniques that can be learned to help one sleep better. Generally, CBT is conducted in individual or small group formats, over a period of several weeks. As mentioned earlier, CBT is most successful in conjunction with medication for the treatment of chronic insomnia. However, treatment with medication is not required in every case.
So what exactly is CBT?
CBT encompasses several different techniques, which may be used all together or individually. These various techniques include sleep hygiene training, relaxation therapy, stimulus control therapy, sleep restriction, and cognitive therapy. Sleep hygiene training refers to re-learning habits that encourage and promote sleep. Maintenance of a quiet sleep environment may mean excluding a pet from the bedroom or getting a bed partner to seek help for a snoring problem. Relaxation therapy helps to reduce physiologic and cognitive arousal at bedtime. Some people may be unaware of how tension and stress affect their sleep. Stimulus control therapy works by limiting the presence of external stimuli or factors that may bring anxiety or stress into the bedroom environment. Implementation of this technique can help to establish the bedroom as a place to relax and unwind, away from the stresses of the world. Sleep restriction limits the amount of time spent lying awake in bed. This technique requires close oversight by a physician or psychologist, using sleep diaries, to ensure successful treatment. Cognitive therapy works to refute an individual’s thoughts about sleeplessness and the fear and anxiety related to these thoughts. Cognitive therapy has the potential to provide patients with good tools to deal with insomnia.
CBT is generally conducted by psychologists or physicians with specialized training in these techniques. Unfortunately, CBT for chronic insomnia is not readily available everywhere; however, by doing some research through internet resources or by contacting the National Sleep Foundation (www.sleepfoundation.org) or the American Academy of Sleep Medicine (www.aasmnet.org), you may be able to find someone in your area. At the Dallas Center for Sleep Disorders, we offer Insomnia Workshops with CBT for chronic insomnia. You can contact us for more information (www.dallas-sleep.com or 972-473-7300).
Sleep Aids: How to Treat your Insomnia
May 10, 2011 by admin
Filed under Organic Compounds
Antonio LeMaire asked:
The terms “Sleep Aids” and “Sleeping Aids” refer to the various therapies, medications and supplements that can help you enjoy a sound and peaceful sleep when stress, travel or other disruptions keep you awake. Sleeping aids and pills are nothing new as our ancestors have been using herbal potions and the opiate laudanum to induce sleep for centuries.
The early 1900s witnessed the introduction of barbiturates, and in the 1960s, benzodiazepines arrived on the scene. There are many safer classes of drugs like non benzodiazepine hypnotics that can easily help us to overcome sleeping disorders today.
Even though you might know the tips for a good night’s sleep like sticking to a regular sleep schedule, regular exercise, avoiding caffeine and daytime naps, controlling stress, and relaxation before bedtime, sleep can still elude you. Sleeping aids can help you in such circumstances. They are available in many forms that cure and treat various types of sleeping disorders.
Sleeping Disorders
Sleeping disorders may appear in many forms, like failing to sleep the whole night, feeling sleepy and tired during the day though you had enough sleep, having crawling sensations in your legs, and snoring. Some of the most commonly occurring sleeping disorders are:
* Insomnia – failing to sleep
* Sleep apnea – breathing interruptions during sleep
* Restless legs syndrome – a tingling or prickly sensation in the legs
* Narcolepsy – sleep attacks during the day
* Parasomnias- nightmares, night terrors, sleep walking, sleep talking, head banging, wetting the bed and grinding your teeth
Insomnia
Insomnia is a common type of sleeping disorder where you have trouble falling or staying asleep, or you wake up feeling dull and tired. People with insomnia would have some or all of the following symptoms:
* Trouble falling asleep
* Waking up repeatedly during the night, and not able to go back to sleep again
* Waking up too early in the morning
* Feeling tired upon waking
* Sleepiness and sleep attacks during the day
* Irritability
* Problems with concentration or memory
Insomnia Causes
There are many reasons for insomnia. Insomnia is sometimes caused by a medical problem (primary insomnia). It can also be caused by depression and certain medications. Insomnia can either be a short term problem lasting less than a month (acute) or a problem that lasts longer than a month (chronic).
The main causes of acute insomnia include:
* Stress
* Illness
* Emotional or physical discomfort
* Environmental aspects like noise, light, or extreme temperatures that affect sleep
* Specific medications used for the treatment of colds, allergies, depression, high blood pressure and asthma
* Working a night shift.
The causes of chronic insomnia include:
* Depression and/or anxiety
* Chronic stress
* Pain or discomfort at night
Insomnia Treatment
There are many treatments for sleep disorders. Sometimes just having regular sleep habits, lifestyle change, exercise etc. can help in overcoming insomnia and other sleeping disorders. However, it is always best to ask a doctor for a proper diagnosis to identify the cause of insomnia to ensure you are prescribed the correct treatment.
There are medical as well as self-help non-medical treatments for insomnia.
Medical Treatment of Insomnia
Using medication is the most popular way of treating insomnia. Reports say that almost 25% of Americans take some form of medication for the treatment of insomnia. You are advised to take insomnia medications only when:
* The cause of insomnia has been identified
* Sleep troubles cause problems in carrying out daily activities
* Behavioral approaches are ineffective
* Insomnia is acute (temporary or short-term.)
* Insomnia occurs along with a known medical or physical condition
Insomnia Medication Treatment Guidelines
When you start taking medication for the treatment of insomnia, be sure the medication:
* Starts with the lowest possible effective dose
* Is for a short term, if used nightly
* Is alternating or sporadic, if used long-term
* Is accompanied with good sleep practices and/or behavioral approaches
Hypnotics, Antidepressants and Anxiolytics
The choice of a prescription medication for the treatment of insomnia greatly depends on the patient’s diagnosis, history of drug or alcohol abuse, age, medical conditions etc. Generally, there are three types of prescription medications for the treatment of insomnia: Hypnotics, Antidepressants and Anxiolytics.
Hypnotics are the most effective prescription sleeping aids that induce and promote sleep.
Antidepressants are the best solution for the treatment of insomnia when the cause of the sleeping disorder is related to depression. However, a patient should discuss the problem with a doctor as some antidepressants can also cause insomnia.
Anxiolytics are anti-anxiety drugs prescribed for the treatment of insomnia due to anxiety.
Self-Help & Non-Medicinal Insomnia Treatments
Self-help and non-medicinal treatments of insomnia may include:
* Improved sleep habits and environment (sleep hygiene)
* Stress management and relaxation techniques
* Acupuncture and massage
* Cognitive behavior therapy and
* Herbal remedies, nutritional supplements, and homeopathic remedies
Some people prefer non-medicinal and self–help strategies to treat insomnia as they tend to be less addictive, and drug-free alternatives have fewer side effects. Self-help and non-medicinal treatments of insomnia may also be less expensive than prescription drugs.
Effectiveness of Hypnotics for Insomnia Treatment
Clinical studies have examined data that proves the efficacy and reliability of hypnotics like Rozerem for the treatment of insomnia. After comparing hypnotics to a placebo for the treatment of insomnia, experts have come to the conclusion that hypnotics like Rozerem:
* shorten the time needed to fall asleep
* increase the total sleep time
* decrease the number of repeated awakenings
* enhance sleep quality
The terms “Sleep Aids” and “Sleeping Aids” refer to the various therapies, medications and supplements that can help you enjoy a sound and peaceful sleep when stress, travel or other disruptions keep you awake. Sleeping aids and pills are nothing new as our ancestors have been using herbal potions and the opiate laudanum to induce sleep for centuries.
The early 1900s witnessed the introduction of barbiturates, and in the 1960s, benzodiazepines arrived on the scene. There are many safer classes of drugs like non benzodiazepine hypnotics that can easily help us to overcome sleeping disorders today.
Even though you might know the tips for a good night’s sleep like sticking to a regular sleep schedule, regular exercise, avoiding caffeine and daytime naps, controlling stress, and relaxation before bedtime, sleep can still elude you. Sleeping aids can help you in such circumstances. They are available in many forms that cure and treat various types of sleeping disorders.
Sleeping Disorders
Sleeping disorders may appear in many forms, like failing to sleep the whole night, feeling sleepy and tired during the day though you had enough sleep, having crawling sensations in your legs, and snoring. Some of the most commonly occurring sleeping disorders are:
* Insomnia – failing to sleep
* Sleep apnea – breathing interruptions during sleep
* Restless legs syndrome – a tingling or prickly sensation in the legs
* Narcolepsy – sleep attacks during the day
* Parasomnias- nightmares, night terrors, sleep walking, sleep talking, head banging, wetting the bed and grinding your teeth
Insomnia
Insomnia is a common type of sleeping disorder where you have trouble falling or staying asleep, or you wake up feeling dull and tired. People with insomnia would have some or all of the following symptoms:
* Trouble falling asleep
* Waking up repeatedly during the night, and not able to go back to sleep again
* Waking up too early in the morning
* Feeling tired upon waking
* Sleepiness and sleep attacks during the day
* Irritability
* Problems with concentration or memory
Insomnia Causes
There are many reasons for insomnia. Insomnia is sometimes caused by a medical problem (primary insomnia). It can also be caused by depression and certain medications. Insomnia can either be a short term problem lasting less than a month (acute) or a problem that lasts longer than a month (chronic).
The main causes of acute insomnia include:
* Stress
* Illness
* Emotional or physical discomfort
* Environmental aspects like noise, light, or extreme temperatures that affect sleep
* Specific medications used for the treatment of colds, allergies, depression, high blood pressure and asthma
* Working a night shift.
The causes of chronic insomnia include:
* Depression and/or anxiety
* Chronic stress
* Pain or discomfort at night
Insomnia Treatment
There are many treatments for sleep disorders. Sometimes just having regular sleep habits, lifestyle change, exercise etc. can help in overcoming insomnia and other sleeping disorders. However, it is always best to ask a doctor for a proper diagnosis to identify the cause of insomnia to ensure you are prescribed the correct treatment.
There are medical as well as self-help non-medical treatments for insomnia.
Medical Treatment of Insomnia
Using medication is the most popular way of treating insomnia. Reports say that almost 25% of Americans take some form of medication for the treatment of insomnia. You are advised to take insomnia medications only when:
* The cause of insomnia has been identified
* Sleep troubles cause problems in carrying out daily activities
* Behavioral approaches are ineffective
* Insomnia is acute (temporary or short-term.)
* Insomnia occurs along with a known medical or physical condition
Insomnia Medication Treatment Guidelines
When you start taking medication for the treatment of insomnia, be sure the medication:
* Starts with the lowest possible effective dose
* Is for a short term, if used nightly
* Is alternating or sporadic, if used long-term
* Is accompanied with good sleep practices and/or behavioral approaches
Hypnotics, Antidepressants and Anxiolytics
The choice of a prescription medication for the treatment of insomnia greatly depends on the patient’s diagnosis, history of drug or alcohol abuse, age, medical conditions etc. Generally, there are three types of prescription medications for the treatment of insomnia: Hypnotics, Antidepressants and Anxiolytics.
Hypnotics are the most effective prescription sleeping aids that induce and promote sleep.
Antidepressants are the best solution for the treatment of insomnia when the cause of the sleeping disorder is related to depression. However, a patient should discuss the problem with a doctor as some antidepressants can also cause insomnia.
Anxiolytics are anti-anxiety drugs prescribed for the treatment of insomnia due to anxiety.
Self-Help & Non-Medicinal Insomnia Treatments
Self-help and non-medicinal treatments of insomnia may include:
* Improved sleep habits and environment (sleep hygiene)
* Stress management and relaxation techniques
* Acupuncture and massage
* Cognitive behavior therapy and
* Herbal remedies, nutritional supplements, and homeopathic remedies
Some people prefer non-medicinal and self–help strategies to treat insomnia as they tend to be less addictive, and drug-free alternatives have fewer side effects. Self-help and non-medicinal treatments of insomnia may also be less expensive than prescription drugs.
Effectiveness of Hypnotics for Insomnia Treatment
Clinical studies have examined data that proves the efficacy and reliability of hypnotics like Rozerem for the treatment of insomnia. After comparing hypnotics to a placebo for the treatment of insomnia, experts have come to the conclusion that hypnotics like Rozerem:
* shorten the time needed to fall asleep
* increase the total sleep time
* decrease the number of repeated awakenings
* enhance sleep quality
