Evaluation Of A Patient With Insomnia
As insomnia is both a symptom and a disorder in itself, detailed evaluation of the problem is imperative before reaching a clinical diagnosis. The treating clinician should have a high index of suspicion of insomnia or sleep difficulty when patients present with the following symptoms: fatigue, excessive daytime sleepiness, major and/or minor depressive episode, generalized anxiety disorder, memory/concentration complaints, pain.
The mandatory assessment of insomnia includes the following.
Sleep history is the first step in evaluation of primary insomnia, which provides the clinician with a structured approach to a diagnosis. It requires a general description of the disorder, i.e., its duration, severity, variation, and daytime consequences. The NHLBI Working Group has devised the following approach which may be followed .
Treatment Of Chronic Insomnia
The treatment of chronic insomnia consists of initially diagnosing and treating the underlying medical or psychological problems. The identification of behaviors that may worsen insomnia follows and stopping them would help eliminate insomnia. Next, a possible trial of pharmacology can be tried, although the long-term use of drugs for chronic insomnia is controversial. This is in spite of the fact that the US FDA has approved three medications for the treatment of insomnia with no limitation on the duration of their use. A trial of behavioral techniques to improve sleep, such as relaxation therapy, sleep restriction therapy, and reconditioning, is however useful. Behavioral intervention combined with pharmacologic agents may be more effective than either approach alone.
Can My Insomnia Be Cured
Absolutely. It may not be easy though, as curing insomnia often means improving your sleep hygiene and establishing habits that are more conducive to good sleep. And habits, especially routines you follow every day, can be tough to break.
But it is possible. And according to Aouad, each small step you take to establish better sleep is an important one.
I think people underestimate how much making small changes to their habits can be beneficial, Aouad says. Even though those habits can be hard to change, gradually changing them over time can really improve someones sleep.
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How To Relieve Insomnia Without Medication: Part 1
Feeling sleepy? Youre not alone. According to the CDC, on any given day, as many as one in five adults suffers from an insufficient amount of sleep! Insomnia affects adolescents, adults and the elderly. And as we age, sleep can become even more elusive, so developing good sleep habits when youre younger can pay off later in life.
Do Oral Appliances For Sleep Apnea Work
If you have been diagnosed with sleep apnea, your doctor may have recommended an oral appliance as a treatment option. Oral appliances are devices that are worn in the mouth to keep the airway open during sleep. They are often used to treat mild to moderate sleep apnea, in addition to other treatments such as CPAP or continuous positive airway pressure therapy. In this article, we will answer some common questions about oral appliances for sleep apnea. We will discuss what sleep apnea is, how it is diagnosed, and the benefits and risks of using oral appliances to help you make an informed decision about whether or not oral appliance therapy is right for you.
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Cognitive Behavioral Therapy For Insomnia
CBT-i is considered a first-line treatment for insomnia because it does not carry the health risks associated with sleep medication. In most cases, CBT-i is provided by a licensed psychologist who has received training for this type of treatment. CBT-i focuses on pinpointing the anxieties people with insomnia often have about sleep, and then replacing these anxieties with healthier beliefs and attitudes. Additionally, this type of therapy may one or more of the following components:
The number of qualified behavioral sleep medicine therapists in the U.S. is fairly limited. You can locate CBT-i providers and verify their credentials through certain professional organizations, including the American Psychological Association, American Board of Sleep Medicine, Association of Behavioral and Cognitive Therapies, and Society of Behavioral Sleep Medicine.
When And How Should I Seek Sleep Treatment From A Sleep Specialist
Almost everyone has sleep problems at some point in their lives. If its a temporary sleep problem, you can find the reason behind it an argument with your spouse, problem at work, jet lag. Such problems are temporary and typically end in a couple days.
If you have been unable to sleep well for a month or more, its advisable to see a doctor. See if you match the common symptoms of insomnia mentioned above. If you do, its time to consult a sleep specialist.
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How To Treat Insomnia Working Techniques For Everyone
Knowing how to treat insomnia is important if you are suffering from it. Many people do not realize just how severe the condition can be until they have it themselves. Insomnia can affect a persons quality of life. Not only does it cause difficulty falling and staying asleep, but it also causes irritability and difficulty concentrating. What exactly is insomnia?
Medication Treatment Options for Chronic Insomnia There are several treatment options for insomnia, including prescription medications. CBD is in many cases prescribed for people suffering from acute insomnia, as well.Other medications include Ambian, Anafranil, and Lunesta. These treatment options for chronic insomnia usually work very well, but there are some lifestyle changes that may be necessary to effectively treat the condition.
As insomnia is a common problem, there are many ways to treat the symptoms of insomnia as well as the underlying cause of the disorder. Treatments such as herbal medicine or alternative remedies are available, but people who prefer to treat the disorder naturally can also do so. Some alternative methods for treating insomnia symptoms include acupuncture, aromatherapy, deep breathing, meditation, hypnosis and homeopathy. Natural treatments are often preferable because they do not have the side effects of conventional medicines.
The Way Chronic Insomnia Works Also Reveals Its Cure
What I found so fascinating about the 3P model of insomnia is this: the way chronic insomnia works also reveals its cure. By looking at this model, you gain objectivity and valuable insights why your sleeplessness started, but more importantly, why it doesnt go away.
As every person is to some degree vulnerable to develop insomnia, there is no uniqueness or magic about this condition. Even if you are not predisposed to develop insomnia, it still could be kicked off by a trigger event.
If your sleep problem persists, the model indicates the way to solve it. You may not be able to change the predisposing/risk or precipitating/trigger factors, but what you can influence are the perpetuating factors , the way you respond to your insomnia. Here lies the real secret of curing insomnia. It is your doing, your focus on trying to get rid of insomnia which is the main contributor to your sleep struggle by testing different experiments and remedies and by blocking out unpleasant thoughts you spend your time and energy on resistance rather than changing the situation.
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Over The Counter Sleep Aids
You can buy herbal remedies over the counter that are promoted to help people sleep. These include kava, valerian, passionflower, hops, sour date, mimosa, lavender, California poppy and chamomile.
There is little scientific evidence about whether these remedies work, or the consequences of taking them for a long time.
It is important to talk to your doctor before you take a sleeping aid, as it may interact with your other medications. Make sure you follow the instructions on the label carefully and do not take them for a long period of time. You should avoid alcohol when you are taking over the counter sleeping aids.
Managing And Treating Insomnia
Insomnia is a frustrating disorder to live with, and the emotional distress it causes tends to worsen over time. Many people, especially those whose insomnia comes and goes, dont seek formal treatment for it. But chronic insomnia isnt something that must be tolerated or endured. There are several empirically-supported treatment options for insomniaincluding some that can be completed over a short period of time. The front-line treatment for insomnia, CBT-I, has proven to be highly effective in many cases and typically only requires a few months of committment. Self-help strategies, though they require dedication and effort to maintain, can also produce significant results for many sufferersand may even improve other aspects of physical and mental health along the way.
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Are There Any Risks To Using An Oral Appliance
There are a few risks associated with oral appliance therapy for sleep apnea. The most common is that the oral appliance can cause temporomandibular joint pain, which is when you experience pain and discomfort in your jaw joint. With an oral appliance, you also risk tooth movement and changing your bite due to your teeth shifting from the device in your mouth all night which is similar to how a retainer works. Other risks include excessive salivation, dry mouth, and skin irritation around the mouth. If you are experiencing any of these side effects, talk to your doctor right away as they may recommend alternative treatments.
Insomnia: Why It Happens And How To Treat It
Medically reviewed by Kristin Hall, FNP
Cant sleep? Insomnia is an exceptionally common issue, with about one in every four American adults experiencing some form of difficulty sleeping every year.
Insomnia is a type of sleep disorder. If youre affected by insomnia, you might find it harder than normal to fall asleep. You may also find it difficult to stay asleep, to wake up at a normal time, or to wake up without feeling tired.
Dealing with insomnia can be an incredibly stressful experience that affects you not just during the night, but also throughout the day.
Luckily, options are available. Below, weve explained what insomnia is and how it happens, as well as the numerous treatment options that are available to help you enjoy better, deeper sleep and fewer sleep-related difficulties.
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When Should I See My Doctor
It is a good idea to see your doctor if you are having trouble sleeping or you are having problems with your mood, feeling restless in bed, snoring badly or waking up not feeling refreshed. Keeping a sleep diary is a good way to track symptoms, which you can share with your health professional.
If they think you have insomnia, your doctor may refer you to see a sleep specialist or psychologist.
Is Cbt Effective For Insomnia
Yes. Cognitive behavioral therapy that is specifically targeted at insomnia has been found in research to be generally more effective than medication, with effects that persist long after treatment has ended. CBT-I targets the anxious thoughts associated with going to bed, as well as the counterproductive behaviorslike sleeping in on the weekends or doing work in bedthat get in the way of restful sleep. A round of CBT-I usually lasts a few weeks to a few months.
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Do You Find It Hard To Sleep And Feel Tired Whole Day Visit Koala Center For Sleep And Tmj Disorders As We Have Multiple Locations Near You Please Call Us For More Information Or Simply Book An Appointment Online
Dealing with severe insomnia can be debilitating without professional support. This is what we offer here at Koala® Center for Sleep & TMJ Disorders, and with our support youll be able to sleep more soundly for a better life. Get in touch with us today so we can tell you everything you need to know about insomnia and what we can do about it at our clinic.
Tips To Beat Insomnia
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How Insomnia Develops: The 3p Model Of Insomnia
The 3P model of insomnia from Spielman and Glovinsky offers you a structured explanation of how insomnia starts and how people get stuck. When I came across this model, it wasnt just that I suddenly understood that my sleep problem wasnt unique more important was the realization that while insomnia was the cause of my pain, the way insomnia worked and impacted my life also showed me how to cure it. I know this sounds a bit simplistic but lets dive in a bit deeper and you will see what I mean.
According to the 3P model, there are three primary factors why you develop insomnia and why it is not easily going away: predisposing factors, or risk factors precipitating factors, or triggers and perpetuating factors, which refer to your practices or coping strategies reinforcing your sleeplessness. Lets have a closer look at each one of them.
Make Sleep A Priority
Chronic insufficient sleep often occurs when people choose to sacrifice sleep in favor of work, leisure, or other obligations. To counteract this, its critical to take steps to make sleep a priority:
- Have a consistent sleep schedule: You should strive to go to bed and wake up at the same times every day. In planning those times, make sure to budget time to get enough sleep. Once youve settled on your schedule, follow it closely, even on weekends. Stability in your sleep routine helps avoid fluctuations in your nightly sleep.
- Set boundaries in your work and social life: Its easy for the demands of your personal or professional life to chip away at your dedicated time for sleep, so its helpful to set boundaries so that you preserve the full time you need for rest each night.
- Have a bedtime routine: Get yourself ready each night with the same steps such as quietly reading or stretching, putting on pajamas, and brushing your teeth. A steady bedtime routine can put you in the right frame of mind to sleep well each night.
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Definition Of Chronic Insomnia
Although there are various definitions of chronic insomnia, the most widely accepted is the one that defines it to be a condition characterized by “inadequate quantity or quality of sleep characterized by a subjective report of difficulty with sleep initiation, duration, consolidation, or quality that occurs despite adequate opportunity for sleep, and that results in some form of daytime impairment and has persisted for at least one month”. The causes of this are many, the most important of which are medications, drug or alcohol abuse, psychiatric disorders like depression or anxiety, medical disorders , poor sleep hygiene, and other disorders like sleep apnea, periodic limb movements, conditioned insomnia , restless legs syndrome, circadian rhythm disorder or advanced/delayed sleep-phase syndrome. Neurological causes such as fibromyalgia and Morvan’s syndrome, medical causes such as gastroesophageal reflux disease, and in children, sleep-onset association disorder and limit-setting sleep disorder also need to be identified and addressed since these can commonly present as chronic insomnia.
Is Taking Naps Good When You Have Insomnia And Want To Feel Rested
You should take naps in the right situation. If you feel really sleep deprived and have to work or drive in a couple hours, then its good to take a nap to feel more alert. But if you have nothing significant to do, avoid napping and use the sleepy feeling to sleep at night. Taking naps during the day will cause you to feel awake at night. So weigh your options.
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Are All Definitions Of Sleep Deprivation The Same
In sleep medicine, sleep deprivation is defined based on sleep duration, which is the total amount of time a person spends asleep. In reality, though, being well-rested is about more than just how many hours you sleep. As a result, the terms sleep deficiency or sleep insufficiency are more frequently used to describe factors that reduce the quantity and/or quality of sleep and keep a person from waking up refreshed.
In this way, sleep deficiency has a broader application. For example, a person who sleeps for a total of eight hours but with many awakenings that fragment their sleep may have insufficient sleep even though their sleep duration technically meets the recommended amount.
This terminology can be distinct from everyday conversation in which the term sleep deprivation may be used with a wider meaning that refers to poor sleep overall and not just total sleep duration.
Even in the medical field, studies may use different technical definitions of sleep deprivation as some classify it as seven hours of sleep or fewer while others use six hours as the cutoff.