Symptoms And Treatment Of Insomnia

Cognitive behavioral therapy for insomnia is a recent framework developed to address the dysfunctional cognitions and behaviors that contribute to poor sleeping patterns. Insomnia often presents as a comorbidity to a medical or psychiatric disorder, but may also be an isolated diagnosis. According to research studies, benzodiazepine-receptor agonists (BzRAs) and cognitive behavioral therapy (CBT) are the two most effective therapies for treatment and management of insomnia. And while both treatments are beneficial for short-term management of insomnia, CBTi produces long-term sustained benefits with no side effects thus being more advantageous that prescription drug use only. CBTi involves five components: stimulus control, sleep restriction, relaxation training, cognitive therapy and sleep hygiene education. Because CBTi is a fairly new approach, trained professionals may be difficult to find; creative delivery of therapy through telephone or Skype appointments may be necessary.

Martha is a 65 year old lady who suffers from insomnia based on the preliminary symptoms of sleeplessness. She is also under severe stress from her mum’s dependence condition which makes her unhappy with her retirement. Martha’s mum’s condition is of great influence to her insomnia disorder for she only thinks of her through out the day, caring for her leaving Martha with little time to check on her health. Insomnia is a disorder that mostly affects the elderly though it may affect people from all ages. It is the lack of sleep even when one feels to have some sleep. It is not a stand alone disease but a symptom which is defined by the duration one lacks quality sleep. Transient insomnia is not having sleep for a week, short term insomnia is lack of adequate sleep for 2-3 weeks, while sleeplessness for a month is termed as chronic insomnia. Various studies have shown that insomnia affects women more often than men and that 30%-50% of elderly Americans experience difficulty in initiating and maintaining adequate sleep. Diagnosing insomnia in a patient the health practitioner would evaluate the patient medical record and other factors that may contribute to insomnia. For example, snoring, psychological factors such as stress levels and drug use. Martha’s physician would check on her medical

Different age groups of people require different hours of sleep. Children and adolescents require nine to eleven hours of sleep per day. Adults need 7-9 hours, yet some people feel better sleeping lesser hours even with those guidelines. It is true that alcohol helps people sleep faster, but sleep is disrupted once the level which is in the blood starts to fall. It might lead to waking up and difficulties to fall back to sleep. It is true that depression and anxiety may lead to lead to insomnia but for a short time. People should understand that insomnia is not only brought by depression, but chronic pain, bad side-effects of a particular medication, worries and stress are also known to cause long-term insomnia (Okun et al., 2009). Depression and anxiety should not keep an individual awake for a long time but only for a short time. Additionally, the myth that it is right the lie in bed sleepless is not true. Everyone requires sleep during the day or at night, and it is necessary for the body and the brain to function properly. Notably, sleep is good for relaxing the brain in adults and in children, sleep is important for development (Szelenberger, 2006). One should not be fooled that sleep is not necessary, but those people with insomnia should practice relaxation techniques for them to fall asleep. It is true that people tend to sleep few hours as they

PSQI, a 19-item tool, assessed self-rated sleep quality measures over the prior month, and with a score of 5 or greater associated with poor sleep. ESS, an 8-item self-rated questionnaire, evaluated the impact of subjective perceived sleepiness on daily functioning in eight different environments with a score of 9 or greater being associated with a burden of day-time sleepiness. ISI, a 7-item tool, identified the presence, rated the severity and described the impact of insomnia with a score of 10 or greater identified as positive for

Ebben, M. R., & Narizhnaya, M. (2012). Cognitive and Behavioral Treatment Options for Insomnia. Mount Sinai Journal Of Medicine, 79(4)

Traditional treatments for chronic insomnia include drugs such as over-the-counter antihistamine preparations, with or without mild analgesics, benzodiazepine receptor agonists, sedating antidepressants, neuroleptics, melatonin, and herbal remedies such as valerian. The pharmacological advance has remained the most extensively used for decades, in spite of extensive concerns about long-term effectiveness, habituation, tolerance, and potential difficulties, especially in elderly people. Growing evidence suggests that non-pharmacological treatments, alone or perhaps in combination with drugs, produce clinically noteworthy and strong improvement. In looking at summary data about treatments, it should be noted, with some recent exceptions, outcome studies of pharmacotherapy are almost entirely restricted to brief treatment duration of less than 6 weeks. Even though little doubt exists about the helpfulness of hypnotic drugs for short-term treatment of acute insomnia, evidence shows that the effects of short-term pharmacotherapy trials degrade over time in patients with chronic insomnia. By contrast, cognitive-behavioural treatments are tough and robustly effective on long-term follow-up. In routine practice, pharmacotherapy and a variety of non-pharmacological interventions are sometimes united. Although clinical experience would seem to propose that this joint approach

I have always been enchanted by the idea of sleep. As a child, I laid in bed attempting to understand why I was unable to fall asleep. I knew I wasn’t the only one, but the snoring of my family convinced me otherwise. Biology taught me to understand genetics and environmental cues, but they were unable to explain to me how my sleep pattern was different. Unable to figure the cause of my sleep problems, I delved into self-treatments instead. Curiosity for knowledge in sleep therapy prompted my interest in understanding sleep consequences and health.

Medicine is a common treatment for insomnia, but the effectiveness of medicine remains uncertain. It is unclear whether medicine has profound improvements in sleep or whether residual symptoms may hinder functioning more. The presence of residual symptoms has shown an association with an additional day of unrestful sleep.15 Yet, medicine has shown improvements in sleep and functioning, although weaker in comparison to CBT15 and Mongolian medical acupuncture.11 Bo et al. directly studied the relationship between acupuncture and medicine,11 while Morin et al. used the relationship between CBT alone or with medicine.13 Morin et al. lacked a medicine only group, but instead furthered their study to examine whether further treatment or no treatment in both groups were effective or not.13 Conflicting with Fitzgerald et al., Morin et al. showed tapering medicine in the extension group to show less improvement in functioning.13 Cancelation of medicine and continuation of CBT would have stopped the presence of residual symptoms and therefore would have shown improvement, but was not the case. Although both CBT and medicine were both effective in improving sleep and daytime functioning, only CBT showed significant reductions in anxiety, depression, and

Sleep has a major function in the physical and mental health of an individual. It is important to assess elements of sleep disorders when evaluating for any mental health condition. According to Perese (2012), “Psychiatric disorders characterized by sleep disturbances include anxiety disorders, depression, bipolar disorders, schizophrenia, and Alzheimer’s disease” (pp 222-223). Normal sleep length should be at least 7 or 7.5 hours per night and when poor sleep pattern exists, it could affect alertness, memory, cognition, creativity and quality of life (Perese, 2012). Sleep-wake disorders can be described as any problem with sleeping including; difficulty falling or staying asleep, sleeping too much, sleeping at the wrong time and abnormal behaviors during sleep (MedlinePlus, 2015). According to DSM-5 (2013), “Sleep-wake disorders encompasses 10 disorders or disorder groups: insomnia disorder, hypersomnolence disorder, narcolepsy, breathing-related sleep disorders, circadian rhythm sleep-wake disorders, non-rapid eye movement (NREM) sleep arousal disorders, nightmare disorder, rapid eye movement (REM) sleep behavior disorder, restless leg syndrome, and substance/medication-induced sleep disorder” (p. 361).

     According to different resources, there are many different kinds of treatments for insomnia. The first is a change in behavior. This therapy is used to re-establish healthy sleep patterns by helping an individual deal with his/her sleep problem. For this method a physician is not needed. A patient can try this on his/her own.

Hypnotic drugs produce sleeping effects on individuals. There are different groups of these sleeping aids. The most common of these groups are the barbiturates, benzodiazepines and non-benzodiazepines. Here, aim to take a look at these three groups and find which group is better for patients who are suffering from insomnia.

One implication of this research is that it has the potential to change treatment towards sleep disorders and insomnia for both patients and doctors/therapist. “Demand for sleep treatment often exceeds the availability

Many people around the world experience sleep disorders at some point in their lives. Insomnia is one of the common sleep disorders that defined as an inability to fall or stay asleep a result there are five million patients per year in the US alone. Because having sleep problems can have serious consequences such as affecting the mood, weight, and memory, it is important to know how to treat it accurately. The non drug strategies are the best way to control insomnia (1). Cognitive behavioral therapy is a type of non drug strategies that have many steps to treat insomnia, but the most common steps are a sleep restriction therapy, sleep hygiene education, and relaxation.

“In the 1970s, benzodiazepines came to the forefront in treating insomnia and are still widely prescribed” (Asnis, Thomas & Henderson, 2016). They are proven to work quickly to help with anxiety and sleep but caution should be taken to avoid dependency or other unwanted side effects.

A few of the articles that were used in studying this disorder agreed that sleeping more at night could help those people lose weight. One article that was used said that sleeping pills and tranquilizers could increase a person’s risk of death, (#4, 2010) while another article used in this research said that prescription pills could be used to prevent insomnia. (MediLexicon, Intl., 2012) With the research that is currently being put towards this disorder, researchers should start to agree more on insomnia and ways to prevent or cure it.