Insomnia in South Africa

How Is Insomnia Diagnosed?

The many potential causes of insomnia mentioned above can be determined by assessing lifestyle factors, by reviewing physical or psychiatric symptoms and by performing a physical examination. Certain laboratory tests and special investigations may be necessary. A sleep diary, which provides a record of how long and when you sleep, may also be helpful. In some patients an assessment at a sleep clinic may be necessary.

 

Treatment of Insomnia

Chronic or severe insomnia should be discussed with a doctor to rule out any medical or psychiatric condition.

Lifestyle changes: Regular moderate exercise, a balanced diet and avoiding excessive alcohol or caffeine will improve health and sleep. Reduce tension, promoting better sleep.

Behavioural therapies may also be used to treat some patients with insomnia. Relaxation therapy uses special techniques to calm the person and relax the muscles. Sleep restriction is a program that initially permits only a few hours of sleep per night, then gradually increases the nightly sleeping time. Reconditioning teaches the person to associate a bed with sleeping (and sexual activity), not daytime naps.

Drug treatment: If insomnia is transient or short-term, and sleep hygiene (see below) or non-medical treatments are not helpful, medication may be effective to prevent psycho physiological insomnia. In chronic insomnia, it is important to diagnose any underlying medical or psychiatric condition, and treat this effectively. Prolonged use of pills, without addressing the root cause may result in dependency. Hypnotic (sleep-inducing) medications, like the benzodiazepines, should be used for a few days at a time, to try to break a pattern of sleeplessness, while addressing any underlying problem. They should be used for short periods only, as they may become addictive. Antidepressants are effective in patients in whom depression has been diagnosed. Some Antihistamines have sedative effects and may be effective in the short-term. Melatonin may help insomnia by shifting the phases of the circadian rhythms, but is still undergoing further studies.

Sleep Hygiene is a holistic approach to sleeping. Good sleep hygiene prevents or relieves insomnia, and makes sleep more restful and pleasurable.

  • Establish a regular time for going to bed and waking up.

  • Use the bed for sleep or sexual activity only, not for reading, TV, or work.

  • Avoid naps, especially in the evening.

  • Exercise before dinner - exercising close to bedtime, however, may increase alertness.

  • Take a hot bath about an hour and a half before bedtime.

  • Do something relaxing in the half-hour before bed like reading or a walk.

  • Keep the bedroom cool and ventilated.

  • Do not look at the clock. Worrying about the time and "forcing" yourself to sleep makes it more difficult to sleep.

  • A light snack before bed can help sleep. A large meal may do the opposite.

  • Avoid fluids just before bedtime to reduce the need to urinate.

  • Avoid caffeine in the hours before sleep.

  • Quitting smoking eliminates the effects of nicotine on sleep loss.

  • People who can't sleep after 15 or 20 minutes should get up and go into another room, read or do a quiet activity using dim lighting until sleepy again.

  • If a person with insomnia is distracted by a sleeping bed partner, a couple of nights apart may be useful.

 

Click here for more information such as Types of insomnia, Causes of insomnia, Diagnosis of insomnia and Treatment of insomnia

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