What is Insomnia?

Sleep is a condition of body and mind which typically recurs for several hours every night, in which the nervous system is inactive, the eyes closed, the postural muscles relaxed, and consciousness practically suspended

Insomnia is a sleep disorder that is a subjective experience of inadequate or poor quality sleep.

“I’M UP”

I- difficulty Initiating sleep

M-difficulty Maintaining sleep

U-Unrefreshing sleep

P-Premature awakening

Why is sleep important?

Help protect your mental health, physical health, quality of life, and safety.

Brain works well-to learn and remember information

Involved in healing and repair of heart and blood vessels.

Supports healthy growth and development

Being productive at work and school/better concentration e.g. while driving

What are the symptoms of Insomnia?

• Trouble falling asleep
• Many awakenings during the night with difficulty going back to sleep
• Daytime drowsiness
• General tiredness
• Anxious and Irritability
• Forgetful with difficulty concentrating

How much sleep does a person need?

Individuals vary greatly in their need for sleep; there are no established criteria to determine exactly how much sleep a person needs.

The National Institutes of Health (NIH) suggests that most average adults need about 7 to 9 hours of sleep each night.

What are the types of Insomnia?

-Sleep Latency-If the problem is not being able to fall asleep

-Sleep Maintenance-If the problem is not being able to stay asleep

Types of Insomnia

1. Transient-less than 2 weeks
2. Intermittent-repetitive episodes of transient insomnia
3. Chronic-continuing difficulty with sleep

What are the daytime consequences of Insomnia?

• Tiredness and Lack of Energy
• Poor Concentration and performance
• Irritability and/or depression
• Feeling unwell
• Less able to enjoy life
• Increased illness

What are the other consequences of Insomnia?

• Absenteeism/inability to accomplish daily tasks
• Decreases in mental performance and motor functioning/fewer promotions
• Interpersonal difficulties-with families, friends and at work
• Increased healthcare utilization
• Auto accidents
• Mood disturbance-Depression/anxiety

What are the risk factors for Insomnia?

• Prior episode
• Female gender(1.3 times more)
• Age > 65(1.5 times)
• Snoring
• Depression
• Lower Socioeconomic status
• Divorce/Separation
• Widowhood
• Concurrent Medical problems

What are the Psychiatric causes of Insomnia?

• Depression
• Generalized Anxiety Disorders
• Acute stress Disorder
• Post-traumatic stress Disorder(PTSD)
• Obsessive-compulsive disorder
• Personality disorders
• Bipolar mood disorder
• Psychotic disorders e.g. Schizophrenia

How do you manage Insomnia?

• Don’t Spend excessive time in bed, including daytime napping
• Get into bed when sleepy
• Maintain a regular sleep/wake schedule
• Bed is for sleep and not for watching TV!
• Increase exercise and fitness
• Avoid Caffeine and nicotine at least 4-6 hours before going to bed

How do you manage Insomnia?

• Never use Alcohol to go to sleep-it induces sleep but causes frequent awakening and chronic use causes insomnia
• Avoid excessive liquids or a heavy meal in the evening
• Minimize noise, light and temperature during sleep(a cooler darker room is better)
• Move visible alarm clock away from bed if it is distracting

Relaxation training

• Engage in activities you find relaxing shortly before bed or while in bed and develop a bedtime routine
• Listening to soothing music
• Muscle relaxation exercises
• Observing a pleasant image
• -Deal with your worries before sleeping!

Are there medications to treat Insomnia?

• Medications that make you sleep are called Hypnotics
• There are several types of Hypnotics:
  • Sedating Antihistamines e.g. diphenhydramine
  • Herbals e.g. lavender, chamomile
  • Benzodiazepines e.g. zaleplon, zolpidem
  • Benzodiazepine-like medication
  • Melatonin receptor agonists e.g. melatonin, ramelteon
  • Antidepressants e.g. trazodone, mirtazapine
  • Antipsychotics e.g. olanzapine, clozaril, quetiapine