Insomnia & Sleep/Energy



Insomnia & Sleep/Energy

Do you have trouble sleeping through the night?
Is falling asleep difficult for you?
Do you wake up more tired than when you went to bed?

If your answer to one of these questions is “yes,” you may be suffering from insomnia.

Insomnia is defined as the inability to have enough hours of good quality sleep that results in feeling rested or restored the following day. More than 1 out of 3 of adults report some intermittent sleeping problems and nearly 15% have difficulty almost daily for more than a month.

You might tend to ignore your need for restful sleep. The right amount of hours of restful sleep, however, is necessary to support good physical and emotional health.

Take an on-line self-assessment inventory for insomnia.

Print out a self-assessment inventory for insomnia.  (This is a PDF file. To view it, you will need Adobe Acrobat Reader. To take the inventory, print the PDF file and fill in your answers.)

Symptoms of a sleep disturbance (insomnia) vary from being annoying, to bothersome, to debilitating, making it impossible to fulfill your daily responsibilities and even making it unsafe to drive a care.

For a sleep disturbance to be considered insomnia, it must not only be present but must also impair a person’s daytime functioning.

  • Difficulty falling asleep
  • Waking up frequently during the night
  • Difficulty falling asleep after awakening
  • Waking up too early in the morning
  • Not feeling refreshed after waking up from sleep
  • Daytime sleepiness
  • Problems concentrating
  • Irritability

Identifying the cause or causes of insomnia requires a careful and thorough evaluation which may include a number of the following procedures and tests:

  • History and physical examination
  • Blood work to assess certain hormone levels
  • Psychological assessment
  • Sleep journal
  • Overnight sleep study
  • Fatigue severity scale
  • Mood rating scales

These procedures help with making the proper diagnosis and also provide a base line for monitoring your care to assure that treatment interventions are effective.

Based on the cause of you insomnia, various combinations of medications, physical devices, and various treatment modalities such as cognitive strategies, relaxation exercises, and self-hypnosis can be utilized to help you attain refreshed sleep.

Breathing Problems

If the problem is sleep related breathing, then a specialized program called a C-PAP may be recommended. Sleep apnea affects millions of men and women especially those in their 40?s and 50?s. Untreated sleep apnea can contribute to obesity, heart problems, and depression. A sleep study can help confirm the diagnosis.

Another common sleep problem the is related to hyper-arousal. In this situation the activating portions of the brain do not shut off when the person goes to bed. Treatment may include various sleep-inducing medications. A problem with most over-the-counter sleep aids is that they produce next day drowsiness. The most commonly prescribed medications are short acting allowing you to feel refreshed after your sleep and not at all drowsy.

A person’s anxiety and anticipation about not sleeping sets the stage for not sleeping. Due to the nightly reinforcement of this conditioning process, a pattern is established that will only stop with treatment. A comprehensive treatment strategy with include a combination of interventions that include strategies to address the belief system and attitudes related to the anticipation of the insomnia that will support a cycle of poor sleep if not treated.

Psychological and Cognitive Strategies

After an acute period of insomnia, individuals may fear a repeat episode and attempt forced sleep. Unfortunately, this simply worsens the problem. In this case, conditioning usually plays a part in the cause of the persistence of insomnia symptoms.

Regardless of the cause of insomnia, therefore, various psychological and cognitive behavioral strategies, including relaxation exercises and self-hypnosis, may be quite helpful as part of a treatment regime to alleviate the symptoms of insomnia.

Medication Strategies

Finally, sometimes the insomnia related to a physical problem, such as, hormones, pain, anxiety, depression. Once the specific cause of the insomnia is diagnosed, treatment can include the appropriate medication at the optimal dosage, time of day, and for the appropriate duration, will be initiated.

The most common psychiatric problems causing sleep disturbance are depression, anxiety, post-traumatic stress disorder, and bipolar disorder. When the underlying psychiatric condition is successfully treated, the sleep problem usually improves. Other common problems resulting in sleep disturbance can be related to hormone issues or pain that is distracting and prevents relaxation needed to sleep soundly.

If you believe that your sleep pattern is not supporting enough restful sleep, consultation and treatment with a psychiatrist specializing in treatment for insomnia most often can help.