FREE ESSAY ON IMSOMNIA

IMSOMNIA

What is insomnia?
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 
Insomnia is not defined by the number of hours of sleep a person gets or how long it
takes to fall asleep. Individuals vary normally in their need for, and their satisfaction
with, sleep. Insomnia may cause problems during the day, such as tiredness, a lack of
energy, difficulty concentrating, and irritability. Insomnia can be classified as
transient (short term), intermittent (on and off), and chronic (constant). Insomnia
lasting from a single night to a few weeks is referred to as transient. If episodes of
transient insomnia occur from time to time, the insomnia is said to be intermittent.
Insomnia is considered to be chronic if it occurs on most nights and lasts a month or
more.
What causes it?
Certain conditions seem to make individuals more likely to experience insomnia. Examples
of these conditions include: 
Advanced age (insomnia occurs more frequently in those over age 60) 
Female gender 
A history of depression 
If other conditions (such as stress, anxiety, a medical problem, or the use of certain
medications) occur along with the above conditions, insomnia is more likely. There are
many causes of insomnia. Transient and intermittent insomnia generally occur in people
who are temporarily experiencing one or more of the following: 
Stress 
Environmental noise 
Extreme temperatures 
Change in the surrounding environment 
Sleep/wake schedule problems such as those due to jet lag 
Medication side effects 
Chronic insomnia is more complex and often results from a combination of factors,
including underlying physical or mental disorders. One of the most common causes of
chronic insomnia is depression. Other underlying causes include arthritis, kidney
disease, heart failure, asthma, sleep apnea, narcolepsy, restless legs syndrome,
Parkinson's disease, and hyperthyroidism. However, chronic insomnia may also be due to
behavioral factors, including the misuse of caffeine, alcohol, or other substances;
disrupted sleep/wake cycles as may occur with shift work or other nighttime activity
schedules; and chronic stress. In addition, the following behaviors have been shown to
perpetuate insomnia in some people: 
Expecting to have difficulty sleeping and worrying about it 
Ingesting excessive amounts of caffeine 
Drinking alcohol before bedtime 
Smoking cigarettes before bedtime 
Excessive napping in the afternoon or evening 
Irregular or continually disrupted sleep/wake schedules 
These behaviors may prolong existing insomnia, and they can also be responsible for
causing the sleeping problem in the first place. Stopping these behaviors may eliminate
the insomnia altogether. 
Who gets insomnia?
Insomnia is found in males and females of all age groups, although it seems to be more
common in females (especially after menopause) and in the elderly. The ability to sleep,
rather than the need for sleep, appears to decrease with advancing age. 
How is it diagnosed?
Patients with insomnia are evaluated with the help of a medical history and a sleep
history. The sleep history may be obtained from a sleep diary filled out by the patient
or by an interview with the patient's bed partner concerning the quantity and quality of
the patient's sleep. Specialized sleep studies may be recommended, but only if there is
suspicion that the patient may have a primary sleep disorder such as sleep apnea or
narcolepsy. 
How is it treated?
Transient and intermittent insomnia may not require treatment since episodes last only a
few days at a time. For example, if insomnia is due to a temporary change in the
sleep/wake schedule, as with jet lag, the person's biological clock will often get back
to normal on its own. However, for some people who experience daytime sleepiness and
impaired performance as a result of transient insomnia, the use of short-acting sleeping
pills may improve sleep and next-day alertness. As with all drugs, there are potential
side effects. The use of over-the-counter sleep medicines is not usually recommended for
the treatment of insomnia.
Treatment for chronic insomnia consists of: 
First, diagnosing and treating underlying medical or psychological problems. 
Identifying behaviors that may worsen insomnia and stopping (or reducing) them. 
Possibly using sleeping pills, although the long-term use of sleeping pills for chronic
insomnia is controversial. A patient taking any sleeping pill should be under the
supervision of a physician to closely evaluate effectiveness and minimize side effects.
In general, these drugs are prescribed at the lowest dose and for the shortest duration
needed to relieve the sleep-related symptoms. For some of these medicines, the dose must
be gradually lowered as the medicine is discontinued because, if stopped abruptly, it can
cause insomnia to occur again for a night or two. 
Trying behavioral techniques to improve sleep such as relaxation therapy, sleep
restriction therapy, and reconditioning 
Relaxation therapy 
There are specific and effective techniques that can reduce or eliminate anxiety and body
tension. As a result, the person's mind is able to stop racing, the muscles can relax,
and restful sleep can occur. It usually takes much practice to learn these techniques and
to achieve effective relaxation. 
Sleep restriction 
Some people suffering from insomnia spend too much time in bed unsuccessfully trying to
sleep. They may benefit from a sleep restriction program that at first allows only a few
hours of sleep during the night. Gradually the time is increased until a more normal
night's sleep is achieved. 
Reconditioning 
Another treatment that may help some people with insomnia is to recondition them to
associate the bed and bedtime with sleep. For most people, this means not using their
beds for any activities other than sleep and sex. As part of the reconditioning process,
the person is usually advised to go to bed only when sleepy. If unable to fall asleep,
the person is told to get up, stay up until sleepy, and then return to bed. Throughout
this process, the person should avoid naps and wake up and go to bed at the same time
each day. Eventually the person's body will be conditioned to associate the bed and
bedtime with sleep. 
Talk to your doctor if you are having trouble getting good, refreshing sleep each night.
Together you can identify possible reasons for your sleeping difficulty and then try
appropriate measures to correct the problem. 
Bibliography
Bruno, Frank Jow. Get a Good Night's Sleep New York: Macmillan General Reference, 1997.