Insomnia is one of my more annoying symptoms among quite a few others.
Upon hearing the patient's complain of "insomnia", one of the initial reaction of the physician is to assess whether he/she is depressed.
Fortunately, I am not, nor have I ever been depressed in my life.
In my particular case, its believe to be cause by a combination of chronic pain and circadian rhythm disorder, secondary to other diagnoses.
When I was in USA, I used to stay up all night all the time, not intentionally.
When I first arrived to Australia, I slept really well, at least for a while, and then slowly I became an insomniac again.
Insomnia Causes Insomnia may result from either psychological or physical causes.
The most common psychological problems include anxiety, stress, and depression.
In fact, insomnia may be an indicator of depression. Many people will have insomnia during the acute phases of a mental illness.
Physiological causes span from circadian rhythm disorders, sleep-wake imbalance, to a variety of medical conditions. Following are the most common medical conditions that trigger insomnia:
Chronic pain syndromes
Congestive heart failure
Chronic obstructive pulmonary disease (COPD)
Degenerative diseases, such as Alzheimer disease (Often insomnia is the deciding factor for nursing home placement.)
Certain groups are at higher risk for developing insomnia:
Travelers
Shift workers
Seniors
Adolescent or young adult students
People with chronic pain, cardiopulmonary disease
Pregnant women
Women in menopause
Certain medications have been associated with insomnia.
Among them are certain over-the-counter cold and asthma preparations.
The prescription varieties of these medications may also contain stimulants and thus produce similar effects on sleep.
Medications for high blood pressure have also been associated with poor sleep.
Common stimulants associated with poor sleep include caffeine and nicotine.
You should consider not only restricting caffeine use in the hours immediately before bedtime but also limiting your total daily intake.
People often use alcohol to help induce sleep, as a nightcap.
However, it is a poor choice.
Alcohol is associated with sleep disruption and creates a sense of nonrefreshed sleep in the morning.
A disruptive bed partner with loud snoring or periodic leg movements also may impair your ability to get a good night's sleep.
Delayed sleep-phase syndrome (DSPS), also known as delayed sleep-phase disorder or as circadian rhythm sleep disorder delayed sleep-phase type (DSPT), is a chronic disorder of sleep timing.
People with DSPS tend to fall asleep at very late times, and also have difficulty waking up in the morning.
Often, people with the disorder report that they cannot sleep until early morning, but they fall asleep at about the same time every "night", no matter what time they go to bed.
Unless they have another sleep disorder such as sleep apnea in addition to DSPS, patients can sleep well, and have a normal need for sleep.
Therefore, they find it very difficult to wake up in time for a typical school or work day if they have only slept for a few hours.
However, they sleep soundly, wake up spontaneously, and do not feel sleepy again until their next "night" if they are allowed to follow their own late schedule, e.g. sleeping from 4 a.m. to noon.
The syndrome usually develops in early childhood or adolescence,[1] and sometimes disappears in adolescence or early adulthood.
It can be to a greater or lesser degree treatable, but cannot be cured.
DSPS was first formally described in 1981 by Dr. Elliot D. Weitzman and others at Montefiore Medical Center.
It is responsible for 7 -10% of cases of chronic insomnia.
However, as few doctors are aware of its existence, it often goes untreated or is treated inappropriately.
DSPS is often frequently misdiagnosed as primary insomnia or as a psychiatric condition.
The following features of DSPS distinguish it from other sleep disorders:
People with DSPS have at least a normal - and often much greater than normal - ability to sleep during the morning, and sometimes in the afternoon as well.
In contrast, those with chronic insomnia do not find it much easier to sleep during the morning than at night.
People with DSPS fall asleep at more or less the same time every night, and sleep comes quite rapidly if the person goes to bed near the time he or she usually falls asleep.
Young children with DSPS resist going to bed before they are sleepy, but the bedtime struggles disappear if they are allowed to stay up until the time they usually fall asleep.
DSPS patients can sleep well and regularly when they can follow their own sleep schedule, e.g. on weekends and during vacations.
DSPS is a chronic condition.
A diagnosis of DSPS is generally not given unless symptoms have been present for at least a month.
As of May 2007, the new International Classification of Sleep Disorders has changed the name from Delayed Sleep Phase Syndrome to Delayed Sleep Phase Disorder.
Post edited by: Scott_1984, at: 2007/11/17 23:23
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