We spend a third of our lives sleeping! Although we are in an age of productivity and competitiveness, it may seem that sleep is a waste of time, in fact it is an essential component of our physical and mental health.
Do you suffer from insomnia?
Learn everything you need to know about this disorder: what is insomnia and how to treat it
Effects of insomnia
When it comes to insomnia, a large part of the population is facing this problem. An estimate of World Health Organization shows that two-thirds of adults in developed countries fail to get 8 hours of sleep a night.
Consequences of sleep deprivation are many: damage to the immune system, a doubled risk of cancer, increased blood sugar to a pre-diabetic stage, susceptibility to Alzheimer’s, cardiovascular disease.
Unfortunately it contributes to all major psychiatric disorders, especially anxiety and depression. Increases suicidal ideation and risk of suicide.
These effects are already visible in countries where the amount of sleep has been dramatically reduced over the last century, such as the US, the UK, Japan and Western European countries, where there is also the highest incidence of sleep-related diseases sleep deprivation.
Insomnia is difficulty falling a sleep inability to fall asleep or repeated waking at night. Depending on duration, insomnia can be acute or chronic (lasting more than three months).
Causes of insomnia
It can be caused by
- time difference,
- a disease,
- the medicines you take or even the amount of coffee you drink.
Other possible causes include separate sleep disorders, as well as mental disorders such as anxiety or depression. But more and more specialists are starting to treat it as an individual condition. It is not treated as a symptom.
Global studies estimate that insomnia affects 33% of the population, making it the most common sleep disorder, with dramatic effects on quality of life and health. Fortunately, however, as the incidence of insomnia has risen, the treatment of insomnia.
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The treatment of insomnia consists of therapy and medication.
Non-pharmacological therapy has effects that settle in after a certain period after initiation. It has no side effects and is more effective in the long term.
Cognitive behavioural therapy has recently begun to be used in the treatment of insomnia, especially in North America and the United Kingdom. It has proven so effective that the American College of Physicians recommends it as the first line of treatment for insomnia.
Therapy involves behavioural, cognitive, sleep restriction and sleep hygiene education:
❶ changing the negative association of sleep with wakefulness as a result, spending time in the bedroom only when you’re asleep; – if you don’t fall asleep when you go to bed, get out of bed after 20 minutes and go to another room;
❷ keep a sleep diary in which you note the time you went to bed, how long it took to fall asleep and when you woke up, so that you can establish an optimal bedtime and sleep requirement, as there are individual variations for these values;
❸ wake up every morning at the same time, including weekends.
Relaxation techniques are useful in reducing muscle tension and thoughts that can affect sleep onset. Studies show that people who practice them sleep longer and fall asleep faster. There are several relaxation techniques that can be practised in bed in the evening:
❶ Progressive muscle relaxation: the technique involves tensing all muscle groups in turn, and then consciously relaxing.
❷ Autogenic training, derived from hypnosis, in which you cultivate a sense of weight and warmth in the body through verbal and visual techniques;
❸ Visualisations are the most common form of relaxation, in which we imagine peaceful, pleasant scenes that induce a state of calmness, leading to a lower pulse and breathing rate. The counting of sheeps may be classified in this category. All the types of relaxation listed involve more complicated techniques, which can be learnt in dedicated courses.
Medicines for insomnia
Only resort to medication when other methods have failed.
There are several classes of medicines used:
❶ Benzodiazepines have sedative, hypnotic, anxiolytic, relaxing effects and are effective in treating short-term insomnia.
Their use for more than 4 weeks is associated with an increased risk. They decrease the time it takes to fall asleep, increase the length of sleep, but worsen the quality of sleep. They also have a number of side effects, which should be considered before deciding to take this treatment.
❷ Non-benzodiazepines are a class of hypnotics and sedatives developed to reduce the side effects of benzodiazepines. It offers the same benefits, through the same mechanism.
Their use is safer because they do not cause withdrawal symptoms. Residual drowsiness on awakening is reduced compared to benzodiazepines. These benefits have led to their increasing popularity in the treatment of insomnia. Zolpidem is the name of a representative of this class. It is the most prescribed medicine in the world today for the treatment of insomnia.
❸ Melatonin agonists are hypnotics with a different mechanism of action, targeting melatonin – a hormone that regulates the sleep-wake cycle.
They do not have a sedative effect, but contribute to the mechanisms that regulate sleep. They can be used long term, and is effective in treating chronic insomnia.
❹ Sulvorexate is representative of a new approach to curing insomnia, it targets orexin, a hormone that promotes wakefulness.
How to get rid of insomnia
Insomnia rarely occurs on its own. Most often insomnia occurs as a symptom of other mental disorderssuch as anxiety disorders, depression or other more severe mental disorders. Often the treatment of insomnia is done concurrently with treatment for the above. It includes the evening administration of drugs specific to them, but which also have beneficial effects on sleep (sedative antidepressants, antipsychotics or sedative orthotics).
Improving sleep quality – SLEEP WATCHERS programme
Objective assessment of sleep quality through professional monitoring systems. They analyse multiple parameters (sleep duration, sleep phase, sleep temperature). They provide important information to the psychiatrist to help the patient with sleep problems.
The patient will assess his/her sleep quality before and after the introduction of medication.