Problems Sleeping

Insomnia

Insomnia is a type of sleep disorder. Individuals with insomnia find it difficult to fall asleep, stay asleep, or both.

People with insomnia often don’t feel refreshed when they wake up from sleeping, either. This can lead to fatigue and other symptoms.

Insomnia is the most common of all sleep disorders. About one-third of all adults report insomnia symptoms. But between 6 to 10 percent of all adults have symptoms severe enough for them to be diagnosed with insomnia disorder.

Insomnia is a disorder in which people have trouble falling asleep or staying asleep. Doctors make a clinical diagnosis of insomnia if both of these criteria apply:

Causes

Sleep difficulties occurring at least three nights a week for a minimum of three months.

Sleep difficulties creating major distress or functional difficulties in a person’s life.

The causes of your insomnia will depend on the type of sleeplessness you experience.

Short-term insomnia may be caused by stress, an upsetting or traumatic event, or changes to your sleep habits.

Chronic insomnia lasts for at least three months and is usually secondary to another problem or a combination of problems, including:

-medical conditions which make it harder to sleep, such as arthritis or back pain

-psychological issues, such as anxiety or depression

-substance use

Risk factors for insomnia

high levels of stress

emotional disorders, such as depression or distress related to a life event

lower income

traveling to different time zones

sedentary lifestyle

changes in work hours, or working night shifts

Certain medical conditions, such as obesity and cardiovascular disease, can also lead to insomnia. Menopause can lead to insomnia as well.

If you want to understand the importance of sleep watch this TED talk by Dr Matt Walker

https://www.youtube.com/watch?v=5MuIMqhT8DM

 

Tips for managing Insomnia

The following NHS websites provide useful information on managing insomnia.

https://www.nhs.uk/oneyou/every-mind-matters/sleep/?WT.tsrc=Search&WT.mc_id=Sleep&gclid=EAIaIQobChMI0oCu9tbn5gIVRLDtCh2T6A9BEAAYASAAEgJPMPD_BwE

 

https://www.nhs.uk/conditions/insomnia/

The sleep council is an organisation promoting the importance of good sleep and has a number of useful resources on its menu.

https://sleepcouncil.org.uk/

 

Sleep Diary:

https://www.10minutecbt.co.uk/wp-content/uploads/2014/03/sleep-diary.pdf

 

How can your GP help?

Insomnia is best managed by non medication approaches. If the helpful guidance in the web sites above fail then your GP may recommend referral for Cognitive Behavioural Therapy (CBT) by a counsellor. This is provided locally by Time To talk and you can self refer for this service via the Adult Mental Health section on the Surgery website.

Medication can help if used for short periods but only treat the symptom not the cause. Older, sedating Antihistamines are available over the counter with pharmacists advice and do not have problems with dependence. Prescription sleeping tablets are based on a class of drug called Benzodiazepines. Your GP may recommend these in a small number of cases of insomnia, however the major drawback of these drugs are they are dependent forming and when this happens rebound insomnia occurs when they are withdrawn.

If medication is used for insomnia it is very important to be aware that it could impair driving and operating machinery.

There is an NHS sleep clinic in East Grinstead but this is for specialised sleep conditions like narcolepsy and does not deal with insomnia unless it is a very complex case.

 

Dr R Harvey Jan 2020