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How to manage insomnia

Miss Evelyn had difficulty falling asleep at night for several months and was diagnosed with insomnia when she visited the hospital. According to a Consultant…

Miss Evelyn had difficulty falling asleep at night for several months and was diagnosed with insomnia when she visited the hospital.

According to a Consultant Family Physician, Department of Family Medicine, Central Hospital Benin, Dr. Egbe Enobakare, many  people are living daily with insomnia and it has become a way of life for so many that they think the condition is normal.

Expert says over 90 percent of adults at one time or the other in their lives suffer from insomnia.

Dr.  Enobakare described insomnia as repeated difficulty with falling asleep or staying asleep or poor quality sleep that occurs despite adequate time and opportunity for sleep resulting in some form of daytime impairment.

“Taking longer than 30 minutes to fall asleep, staying asleep for less than six hours, waking more than three times a night or poor quality sleep that is not relaxing can all be grouped under insomnia,” she said.

She said difficulties with falling asleep are common in young adults while difficulties in staying asleep is common in the middle-aged and elderly people.

Insomnia sometimes occurs over a short period, lasting up to one month, but in few cases it can be prolonged to more than one month, she said.

The physician said there are two types of insomnia, short term and prolonged.

Short term insomnia is commonly seen when adjusting to situational stress such as that which occurs during upcoming examinations or office deadline reports, while prolonged insomnia can be associated with a wide variety of medical conditions.

Dr.  Enobakare identified emotional discomfort, physical discomfort, illness, interferences in normal sleep schedule/routine (jetlag, switch from day job to night duty), situational stress (examination, job deadline, job loss, divorce, death of a loved one), drugs and environmental factors like noise, extreme temperatures and light, as the causes of insomnia.

She added that other significant causes are; use of tobacco, alcohol, caffeinated products, illegal drugs, depression, anxiety, long-term stress and discomfort at night.

She said insomnia is diagnosed by physicians through detailed medical history, sleep history and examination.

“The common symptoms of insomnia include: sleepiness during the day, poor concentration, forgetfulness, irritability, reduced work performance and general tiredness.

“Physicians may also ask patients questions to ascertain snoring, restless feelings in legs on lying down which may improve with sleep, bed sheets in disarray in the morning and periodic kicking during the night. In some cases, your bed partner may be questioned to ascertain your sleep quality and quantity,” Dr.  Enobakare also said.

According to her, it may not require treatment such as short-term situational stress like examination but mild insomnia may require education on the sleep problem and improvement in appropriate sleep hygiene measures.

She said: “Insomnia that is distressing enough to cause daytime impairment and as such decrease performance in daily activity may require prescription of sleeping pills for a very short time.

“Sleep hygiene measures address habits that are not compatible with sleep such as noise in the bedroom, extreme temperatures, watching TV in bed, alcohol or caffeine use.”

The physician added that more severe insomnia requires treating the underlying cause such as medical or psychiatric illness if any, and non-drug therapy like cognitive and behavioural therapy which are highly beneficial but can only be provided by healthcare workers trained in it.

She explained that in combating the condition, the following measures may be adhered to:

– Sleeping at the same time each night and getting up at the same time each morning.

– Avoid daytime naps and prolonged use of phones or reading devices (“e-books”) that give off light while in bed.

–  Avoid caffeinated drinks, tobacco, and alcohol late in the day as caffeine and nicotine are stimulants that can keep one from falling asleep.

–  Getting regular exercise but not close to bedtime, because it may stimulate you and make it hard to fall asleep. It is recommended that you should stop exercise for at least three to hours before bedtime.

– Don’t eat a heavy meal late in the day as light snack before bedtime, may help one sleep better.

– Make your bedroom comfortable. Be sure that it is dark, quiet, and not too warm or too cold. If light is a problem, try a sleeping mask. If noise is a problem, try earplugs

– Avoid using your bed for anything other than sleep or sex.

– If one can’t fall asleep and don’t feel drowsy, get up and read or do something that is not overly stimulating until you feel sleepy.

– If you find yourself lying awake worrying about things, try making a to-do list before you go to bed. This may help you to not focus on those worries overnight.

Dr Enobakare advised the public to avoid over-the-counter sleeping pills as they have rebound effects that are undesirable in the long run.


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