Insomnia

Lack of sleep or distrubed sleep are common complaints that may be caused by a number of physical and emotional disorders. With advancing age, the total amount of sleep tends to shorten, and sleep becomes more interrupted. Many people with fixed habits who are overconcerned with their health may become anxious over these changes and ask for treatment. Initial insomnia is commonly associated with an emotional disturbance such as depression, anxiety or a phobic state and other symptoms of emotional problem. In some cases, a person with insomnia falls asleep normally but awakes several hours before their usual time and either cannot fall asleep again or drifts into restless unsatisfying sleep. This pattern of insomnia is most often associated with depression, and since tendencies to self-reproachful and self-punitive thinking are often magnified in the morning, persistent early morning awakening should be taken seriously and carefully investigated.

Insomnia may also result from inappropriate use of sedatives, often prescribed for insomnia. An inverted sleep rhythm may develop, especially in elderly persons given heavy doses of sedatives. They become drowsy in the morning and may sleep during most of day. At night their sleep is fitful and interrupted. If the sedation is increased, a pattern develops of daytime somnolence, and restlessness and wandering in a clouded or confused state during the night.

The treatment of insomnia depends on the underlying cause. Most people with insomia respond to reassurance that their sleeplessness is a result of normal anxieties or a physical disorder, which will also treated. Giving an opportunity to ventilate his anxieties will often ease the distress and help to reestablish normal sleep patterns. In Insomnia due to a severe emotional disturbance and in refractory cases due to more common causes, hypnotic medication may be required, especially if the sleeplessness impairs the patients efficiency and sense of well-being. In insomnia that accompanies depression, a antidepressant can be given along with a hypnotic or if taken alone about 1 hour before bedtime.