5% needs sleep disorder treatment with sleep medicine -foods and medicine alter chemicals in brain

SLEEP DIFFICULTY

PSYCHOPHYSIOLOGICAL INSOMNIA

commonly occur with functional,mood and center expend disorders, and when under stress.It can ofttimes be triggerd by one of these factors,but then become a habit on its own,driven by anticipation of insomnia and day-time naps.Insomnia causes day-time slepnes and fatigue,with consequences much as agency traffic accidents.assessment should pay particular attention to mood,life difficulties,and take intake (especially alcohol,nicotine and caffeine )

INITIAL INSOMNIA ( trouble getting soured to rest ).

is common in mania,anxiety ,depressive disorders and center misuse.

MIDDLE INSOMNIA ( waking up in the middle of the period ).

It occurs with scrutiny conditions, much as rest apnoea and prostatism.

LATE INSOMNIA ( primeval morning waking)

is caused by sad illness and malnutrition (anorexia nervosa ).

Habitual alcohol activity should be carefully estimated since even a small excess can be a multipotent drive of insomnia,as well as recent withdrawal.

CAFFEINE is perhaps the most commonly taken take in the UK,and its effects are primeval understimated.Six cups ( not mugs ) of real drink a day are likely to drive insomnia in the average healthy adult.

Caffeine is not only institute in tea and coffee,but is also institute in chocolate,cola drinks andsome analgesics.

Prescriptions drugs tat can either disturb slep or drive vivid dreams allow most appetite suppressants,glucocorticoids,dopamine agonists,lipid-soluble beta-blockers (e.g propranolol) and certain psychotropic drugs (especially when first prescribed:e.g fluoxetine,reboxetine,risperidone)

HYPERSOMNIA is not uncommon in adolescents with sad illness ,occurs in narcolepsy,and may temporarily follow infections much as infectious mononucleosis.

COMMON CAUSES OF INSOMNIA

PSYCHITRIC DISORDERS

Mood disorders ( mania sad and anxiousness disorders) Delirium and dementia.

DRUG USE AND MISUSE

Addictive take retraction ( alcohol ,benzodiazepines )

Stimulant drugs ( caffeine ,amfetamines )

Prescribed drugs ( steroids ,dopamine agonists)

PHYSICAL CONDITIONS

Pain ( classically with carpal delve syndrome )

Nocturia (e.g.from prostatism )

Malnutrition

PRIMARY SLEEP DISORDERS

Sleep apnoea

Restless legs syndrome

MANAGEMENT OF INSOMNIA

This is particularly determined by diagnosis .Where hour is directly manifest it is worth educating the patient about rest hygiene.Simple measures much as decreasing alcohol intake,having supper earlier,exercising regular ,having a bath prior to going to bottom and establishing a routine of going to bottom at the same instance should be tried.Relaxtion techniques and cognitive behavior therapy have a role in those with intractable insomnia.Short half-life benzodiazepines can be multipurpose for accent insomnia,but should be utilised for more than 2 weeks continuously to refrain dependence.Recently introduced non-benzodiazepine hypnotics ( zopiclone ,zolpidem ) are said not to drive dependence and tolrance, but behave on the same receptors,and sould ease be utilised with caution beyond 2 weeks.Certain antihistamines (e.g promethazine )and antidepressants (e.g amitriptyline ,trimipramine,trazodone ) are not addictive and can be utilised as hypnotics in low dose,with the added plus of improving slow gesture sleep.The commonest side effects are morning sedation and weight gain.

Melatonin is sometimes utilised to impact insomnia, especially in older people, who may have a baritone levels of melatonin. However, its use is controversial. Melatonin appears to be innocuous for short-term use (up to a few weeks), but the personalty of using it for a daylong time are unknown. Many other medicinal herbs and dietary supplements, such as skullcap and valerian, are available in health food stores, but their personalty on rest and lateral personalty are not substantially understood...... read more