Young woman taking a nap on the bus ride

Insomnia can be a primary sleep problem or secondary to a mental condition or related to a medical illness or substance abuse.

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Prevalence

Asian man using a smartphone in bed until the early morning

Studies estimate that 10% to 15% of the adult population have a chronic sleep problem and an additional 25% to 35% of the population have transient or occasional sleep difficulties. Certain individuals are vulnerable for example the elderly whose sleep is more fragmented and teenagers who sometimes have difficulty falling asleep until late at night and waking early in the morning. Shift workers and those who travel frequently are also at increased risk for insomnia.

Related: Are You Getting Quality Sleep?

Causes

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Sleep can be affected by numerous factors and six groups of etiologies have been proposed for sleep difficulties. Physical or medical disorders for example conditions causing pain, itch, cough, breathlessness etc. can disrupt sleep. Substances such as caffeine, nicotine and alcohol also impair sleep.

Circadian rhythm problem such as shift work and jet lag; psychological factors and psychiatric disorder such as depression, anxiety and psychosis. Lifestyle issues, poor sleep habits and environmental factors such as noise, light and temperature also interrupt sleep.

If sleep problems persist and are bothersome or if they interfere with how you feel or function during the day, you may need to seek your doctors’ advice.

If sleep problems worsen and are not treated, complications such as psychiatric disorders can occur. The quality of life of the individual is likely to be compromised, the work performance effected and he or she is at significant risk of accidents such as vehicle accidents.

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Treatment / Help Available

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Treatment of sleep problem does depend upon the specific sleep problem and can be broadly classified into non-pharmacologic and pharmacologic treatment. Good sleep habits can prevent many cases from worsening, some recommendations for good Sleep Hygiene include:

  • Avoid excessive daytime naps
  • Do not go to bed until you are drowsy
  • Wake-up at approximately the same time each morning including weekends
  • Avoid alcohol and caffeine before bedtime
  • Exercise regularly
  • Make the sleep environment conducive to sleep
  • Have a light snack before bedtime
  • Pay proper attention to stress reduction

Sometimes sleep problem resolve spontaneously. At other times, medicines, for example, sleeping pills may be needed. Benzodiazepines are the most frequently prescribed hypnotics. There are also non-benzodiazepines, newer medications without the side-effects noted with benzodiazepines.

Other behavioural techniques to improve sleep include relaxation therapy, stimulus control and sleep restriction therapy. These are specific techniques that reduce or eliminate anxiety and body tension and recondition individuals to associate the bed and bedtime with sleep.

Seek treatment early. Don’t suffer unnecessarily. Help is available and effective.

Related: Insomnia - How to Get a Better Night's Sleep


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