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  Name Insomnia
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  DiseasesDB 26877
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  EMedicineTopic 2698
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Insomnia is a , Stress , Anxiety , Medication s, Herbs , Caffeine , Depression , Bipolar Disorder ,
emotional or mental tension, work problems, financial stress, unsatisfactory sex life and sometimes occurs for no apparent reason.http://www.paralumun.com/sleeplessness.htm
An overactive mind or physical pain may also be causes. Finding the underlying cause of insomnia is usually necessary to cure it. Insomnia can be common after the loss of a loved one, even months or a year after the death, if they are not grieving correctly (pretending they are over it when they are not).


TYPES OF INSOMNIA

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Three types of insomnia exist: transient, acute, and chronic
#Transient insomnia lasts from one night to a few weeks. Most people occasionally suffer from transient insomnia due to such causes as Jet Lag or short-term anxiety. If this form of insomnia continues to occur from time to time, the insomnia is classified as intermittent.
# Acute insomnia is the inability to consistently sleep well for a period of between three weeks to six months.
# Chronic insomnia is regarded as the most serious; persists almost nightly for at least a month.


INSOMNIA VERSUS POOR SLEEP QUALITY

Poor sleep quality can occur as a result of sleep apnea or Major Depression . Poor sleep quality is caused by the individual not reaching stage 4 or delta sleep which has restorative properties. There are, however, people who are unable to achieve stage 4 sleep due to brain damage who still lead perfectly normal lives.

  • Sleep Apnea is a condition that occurs when a sleeping person's breathing is interrupted, thus interrupting the normal sleep cycle. With the obstructive form of the condition, some part of the sleeper's respiratory tract loses muscle tone and partially collapses. People with obstructive sleep apnea often do not remember awakening or having difficulty breathing, but they complain of excessive sleepiness during the day. Central sleep apnea interrupts the normal breathing stimulus of the Central Nervous System , and the individual must actually wake up to resume breathing. This form of apnea is often related to a cerebral vascular condition, congestive heart failure, and premature aging.


Major depression leads to alterations in the function of the hypothalamus and pituitary causing excessive release of cortisol which can lead to poor sleep quality.

Nocturnal polyuria or excessive nighttime urination can be very disturbing to sleep.1 Nocturnal polyuria can be nephrogenic (related to kidney disease) or it may be due to prostate enlargement or hormonal influences. Deficiencies in vasopressin, which is either caused by a pituitary problem or by insensitivity of the kidney to the effects of vasopressin, can lead to nocturnal polyuria. Excessive thirst or the use of diuretics can also cause these symptoms.


TREATMENT FOR INSOMNIA

In many cases, insomnia is caused by another disease or psychological problem. In this case, medical or psychological help may be useful.


Medications

Many insomniacs rely on Sleeping Tablet s and other Sedative s to get rest. All sedative drugs have the potential of causing psychological dependence where the individual cannot psychologically accept that they can sleep without drugs. Certain classes of sedatives such as benzodiazepines and newer non-benzodiazepine drugs can also cause physical dependence which manifests in withdrawal symptoms if the drug is not carefully titrated down. Anti-depressants may have equal effect with less long-term harm than benzodiazepines.Buscemi N, Vandermeer B, Friesen C, Bialy L, Tubman M, Ospina M, Klassen TP, Witmans M. The efficacy and safety of drug treatments for chronic insomnia in adults: a meta-analysis of RCTs. J Gen Intern Med. 2007 Sep;22(9):1335-50. Epub 2007 Jul 10. PMID 17619935


  • Non-benzodiazepine prescription drugs, including the Nonbenzodiazepine s Ambien and Lunesta , have a cleaner side effect profile than the older benzodiazepines; however, there are controversies over whether these non-benzodiazepine drugs are superior to benzodiazepines. These drugs appear to cause both Psychological Dependence and Physical Dependence , and can also cause the same memory and cognitive disturbances as the benzodiazepines along with morning sedation.


  • Melatonin has proved effective for some insomniacs in regulating the sleep/waking cycle, but lacks definitive data regarding efficacy in the treatment of insomnia. Melatonin agonists, including Ramelteon ( Rozerem ), seem to lack the potential for abuse and dependence. This class of drugs has a relatively mild side effect profile and lower likelihood of causing morning sedation.


  • The Antihistamine Diphenhydramine is widely used in nonprescription sleep aids, with a 50 mg recommended dose mandated by the FDA. In the United Kingdom, Australia, New Zealand, South Africa, and other countries, a 50 to 100 mg recommended dose is permitted. While it is available over the counter, the effectiveness of these agents may decrease over time and the incidence of next-day sedation is higher than for most of the newer prescription drugs. Dependence does not seem to be an issue with this class of drugs.



  • Low doses of certain Atypical Antipsychotics such as Quetiapine (Seroquel) are also prescribed for their sedative effect but the danger of neurological and cognitive side effects make these drugs a poor choice to treat insomnia.



Other substances

Some insomniacs use Herb s such as Valerian , Chamomile , Lavender , Hops , and Passion-flower . Valerian has undergone multiple studies and appears to be modestly effective.234 Cannabis Indica has also been suggested as a very effective treatment for insomnia. http://www.cannabis.net/medical-marijuana/pot-docs.html

Alcohol may have sedative properties, but the REM Sleep suppressing effects of the drug prevent restful, quality sleep. Middle-of-the-night awakenings due to Polyuria or other effects from alcohol consumption are common, and hangovers can also lead to morning grogginess.

Insomnia may be a symptom of Magnesium Deficiency , or lower Magnesium levels. A healthy diet containing Magnesium , can help to improve sleep in individuals without an adequate intake of Magnesium .5

Pomegranates are also believed to help insomniacs sleep. Other reports cite the use of an elixir of cider vinegar and honey but the evidence for this is only anecdotal. 6


Non-medicinal, complimentary and alternative medicine