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Will the sandman ever come?

Insomania-is a taunting condition that beckons from the dark, subjecting those taunted, into wakeful limbo. The sandman just won't come knocking until the long hand strikes two, sometimes, even much later. But this serious problem, if unchecked, can cause a disruption in your energy levels and in extreme cases death.

Insomnia, however, is not limited to staying awake till the wee hours of the morning. It covers a wide range of sleeping problems: you have difficulty falling asleep, you always wake up early even if you went to bed late, you wake up periodically during the night, you wake up and can't get back to sleep or you sleep soundly yet when you get up, you feel like you haven't slept a wink!

Lack of sleep is bad for you. It affects your performance, level of awareness and concentration. You tire easily and it can cause you to nod off while driving. In the US, 40 percent of fatal accidents are fatigue-related, in the UK its 25 percent and even on air, according to NASA's Aviation Safety Reporting, it's about 21 percent.

“Individuals who do sleep, less who have chronic insomnia have more than double the risk of mortality than those who sleep normally. Risk for an individual who sleeps less than six hours a day, the risk of dying is going to be twice that,” says Dr Brian Green, Director of the Cardiopulmonary/Neurodiagnostic Department & Sleep Disorder Laboratory at the American Hospital Dubai. “Along that same line, the individual who sleeps less has a higher mortality risk than those who smoke, those who drink and has ischemic heart disease. It's a very high risk for those individuals with sleep deprivation.”

There are two basic classifications of insomnia: Persistent Insomnia (long-term), Transient Insomnia (short-term) or Intermittent Insomnia (recurring). Persistent Insomnia or Chronic Insomnia can either be Primary (not related to a health problem) or Secondary (can be caused by a health problem). Primary Insomnia can be caused by Circadian Rhythm Stressors (stress like jet lag, shifting work hours and variability in your work schedule, etc.), Social Stressors (a death in the family, marriage problems, divorce, etc.), Environmental Stressors (new bed partner, a new house, noisy environment where there is construction outside your building, etc.).

“The predominant cases of insomnia, you can find in females and in the older population. As you age you find that you sleep less and you have more problems with insomnia. We are talking about anywhere from 10-35 percent of the population at one point in time will have insomnia in their lives,” shares Dr Green. But it is not clear why more women experience insomnia than their male counterparts. Some studies suggest social factors such as unemployment and divorce, as well as the pre-menopausal period (before menopause) as the lead causes.

Dr Green clarifies that insomnia, more often than not, is only a symptom and not a disease itself, “Most people are diagnosed with insomnia secondary to something else.” If you can safely identify that your insomnia is Transient or Short-term then you do not need to seek medical attention. However, “if it persists for an extended period of time where it starts to affect your performance, then you should seek medical attention.”

When insomnia sufferers seek help at the Sleep Laboratory, they are screened first for any medical reasons that can be causing the sleeping problem. “Then if we have suspicions we will order laboratory tests. It could be complete red blood cell count, could be renal function test, it could be ECG, it could be a complete wide range of issues. Then we may recommend that they go see another specialist.”

“Except for Primary Insomnia, insomnia's usually caused by some type of psychophysiological condition or medical condition. If you treat the medical condition then the insomnia will disappear,” says Dr Green.

Shut eye
If it's not a medical condition, “Then you're going to start on some type of behavioural treatment trying to, maybe focus on, say for example improving sleep hygiene,” says Dr Green. Sleep hygiene is the practice of following guidelines to promote a fulfilling sleep. “Essentially, what we are talking about are lifestyle practices that predispose people to poor sleep quality. For example, the lab admits people who say that they have difficulty sleeping, or they wake up unrefreshed but after answering a standard sleep questionnaire it emerges that the patient drinks 20 cans of soda a day – which is high in the stimulant caffeine – or they drink coffee right up to the time they're going to bed. Some people also watch the news before going to bed which in turn disturbs their sleep. These are issues of sleep hygiene which are quite easy to deal with but quite often people just don't recognise the connection between these sleep hygiene issues and their insomnia.”

So the root of the problem may just be right in front of us – the television, the coffee, the soda, the food. Almost all aspects of our lives can affect our sleep, or the lack of it. It is important to eliminate the reasons why we stay up late. We don't only remove, we also add, to the factors that promote fulfilling sleep.

Good sleep hygiene

• Go to bed and wake up at the same time each day

• Use meditation or relaxing techniques before going to sleep

• Dedicate your room to sleeping; no TV, no radio, no computer, not even reading

• Use your bed exclusively for sleeping or sex; do not read, watch TV, play cards or work on it

• Avoid eating large meals within one hour of your bedtime

• Avoid stimulants like coffee, tea and soda within one hour of your bedtime. Avoid alcohol as well which acts as a stimulant when taken in small doses. If you are very sensitive to caffeine, don't take caffeinated beverage within 5-6 hours of your bedtime

• Avoid nicotine as well

• Make you room ideal for sleeping; make sure that it is well-ventilated, has clean sheets and properly-darkened

• Avoid sleeping during the day

• Set a new pre-sleep habit such as a warm bath

• Exercise everyday, in the morning, ideally, or at least 5-6 hours before your bedtime

Social stressors can also plague the mind, and keep one awake deep into the night. Relaxation therapies can help a lot. Treatments like acupuncture, reflexology, massage and aromatherapy may help in relaxing the mind and body. “Essential oils are often balancing in their effects, helping the body to return from an imbalanced state, which leads to illness to the ideal balance, representing health and well-being,” says Sunita Techchand, a Clinically-certified Aromatherapist. “The use of massage has a deep, relaxing and calming effect on the mind through touch. Secondly, aromatic baths are useful, as water itself is therapeutic. If the bath is combined with essential oils, each enhances the potent effect of the other, therefore relieving the body of the day's aches and pains.”

Lack of sleep may cause

• Aching muscles
• Decreased mental activity
• Decreased concentration
• Dizziness
• General confusion
• Headaches
• Impatience
• Irritability
• Memory lapses
• Slow reaction time
• Weight gain

Source: Arabian Woman
Posted: 26/07/2008

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