Sleeping difficulty
Alternative names:
dyssomnia; inability to sleep; insomnia; sleeplessness; wakefulness
Definition:
Chronic inability to sleep, remain asleep through the night, or feel refreshed by sleep.
Considerations:
Insomnia is not by itself a disease, but it is an occasional problem for as many as 25% of Americans and a chronic problem for about 10% of the population. It is the most common of the sleep disorders.
Everyone has sleepless nights occasionally, and it is nothing to worry about; however, there are some people who have chronic insomnia where the brain is not getting the rest it needs.
Most adults do best with about 8 hours of sleep a night until age 60, after which 6 hours may be adequate. Even though the elderly need less sleep, almost one-half of people over 60 experience some degree of insomnia.
The best measure of the amount of sleep needed is how the individual feels. If you awaken feeling refreshed, you are getting enough sleep.
The use of long-acting or high-dose sedatives as a cure for insomnia can increase daytime drowsiness and actually create the illusion that a sleep problem is getting worse rather than better. The use of antihistamines as a cure for insomnia can increase daytime drowsiness and also create the illusion that a sleep problem is getting worse rather than better. Chronic antihistamine usage may also lead to reversible memory impairment. Stronger tranquilizers, available by prescription, often induce drug tolerance and do not produce a natural, restful sleep. As a result, one may feel more dependent on the drug and may conclude that more of the drug is needed. The more drug used, the more side effects and tolerance develop. Upon discontinuation of these tranquilizers, rebound worsening of insomnia is very common.
A life-threatening disease is rarely the cause of problems with sleep. Typically, poor sleep habits are the cause.
Insomnia may cause a reduced energy level, irritability, disorientation, dark circles under the eyes, posture changes, and fatigue.
Counseling may be helpful for psychological disorders that lead to insomnia. Nightmares and dreams that interfere with sleep may respond to psychological interventions.
Common causes:
- jet lag
- shift work
- wake-sleep pattern disturbances
- grief
- depression or major depression
- worry
- anxiety or stress
- exhilaration or excitement
- bed or bedroom not conducive to sleep
- nicotine, alcohol, caffeine, food, or stimulants at bedtime
- aging
- excessive sleep during the day
- excessive physical or intellectual stimulation at bedtime
- overactive thyroid (hyperthyroidism)
- taking a new drug.
- alcoholism or abrupt cessation of alcohol after long-term use
- inadequate bright-light exposure during waking hours
- abruptly stopping a medication (such as sleeping pills).
- medications (for example, excessive thyroid replacement hormone, amphetamines, caffeine-containing beverages, cocaine, ephedrine, phenylpropanolamine, theophylline derivatives)
- withdrawal of medications (such as sedatives or hypnotics)
- interference with sleep by various diseases, including an enlarged prostate (men), cystitis (women), COPD, pain of arthritis, heartburn, and heart or lung problems
- restless leg syndrome
In infant's:
Most newborn babies wake several times during the night, but by the age of 6 months they typically sleep through the night. At one year, babies will sleep an average of about 16 hours in every 24. Two to three hours of this sleep will be during the day. Causes of sleeplessness in infants may include: Note: There may be other causes of sleeping difficulty. This list is not all inclusive, and the causes are not presented in order of likelihood. The causes of this symptom can include unlikely diseases and medications. Furthermore, the causes may vary based on age and gender of the affected person, as well as on the specific characteristics of the symptom such as quality, time course, aggravating factors, relieving factors, and associated complaints. Use the Symptom Analysis option to explore the possible explanations for sleeping difficulty, occurring alone or in combination with other problems.
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