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Insomnia is defined as a prolonged or abnormal inability
to sleep. However, there are subsets of insomnia. The inability
to get to sleep, awakening in the middle of a deep sleep, having
difficulty falling back to sleep, the absence of rapid eye movement
(REM) sleep, are all forms of insomnia. Anything that interferes
with a restful night’s sleep may be defined as insomnia.
Causes of Insomnia
There can be many causes for insomnia. We will only touch on a
few of these. A common cause of an interrupted sleep pattern is
increased alcohol ingestion. REM sleep is a physiological state,
which occurs periodically during sleep, approximately every 90 minutes.
There is heightened brain activity during this time. The reason
this state is called rapid eye movement sleep, or REM sleep, is
the eyes do move rapidly under the eyelids. This sometimes can be
seen when watching someone sleeping. There is increased breathing,
heart rate and genital engorgement during this time. Approximately
80% of individuals do report dreams during this time, and we do
know that REM sleep does produce the excretion of acetylcholine.
We know that increased alcohol ingestion definitely interrupts,
and even inhibits REM sleep, although we are uncertain of the exact
physiological mechanism. Tension, stress, anxiety, conflicts in
the home, as well as rumination over the day’s events, or
the events of an upcoming day are more common causes of insomnia.
Insomnia Treatment
There are a variety of techniques dedicated to alleviating initial
insomnia. Initial insomnia is difficulty in initially falling asleep.
Techniques include drinking warm milk, listening to music, getting
up earlier the next morning, avoiding naps during the day, having
a fan or television constantly running in the bedroom on low, massages,
meditation, and the list goes on.
Before resorting to medication, this author strongly suggests the
following:
Performing some type of exercise, pushups or sit-ups an hour before
bed.
Never going to bed on an empty stomach.
Try to avoid any family conflicts within 5-6 hours of going to bed,
and if possible, please try to resolve those to some degree before
going to bed.
In the worst case scenario, over-the-counter Benadryl, 25 mg.,
may be very effective in helping you fall asleep initially, and
should be tried before moving on to pharmaceutical medications.
Medical conditions affecting sleep patterns need to be ruled out,
such as hyperthyroidism, diabetes, and many endocrine disorders
can cause insomnia.
Meditation techniques are extremely helpful, and these will be
discussed in the section on meditation.
If one has exhausted all methods for resolving their insomnia,
as a last resort, pharmaceutical medication can be helpful. There
are some excellent medications that are nonaddicting, and do not
cause one to be groggy the next day. Sonata is a relatively new
medication, which has a very short half-life, and only stays in
the system 4 hours. You start feeling the effects in 30-45 minutes
after ingestion, and it is an excellent, safe medication to treat
insomnia.
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