Ask Your Doctor: INSOMNIA

By anguillian April 24, 2017 11:11



Insomnia (in-SOM-ne-ah) is a common sleep disorder affecting many individuals in Anguilla. Persistent insomnia can have a significant impact on your quality of life. It can adversely affect how we spend our day, and affect our mood and lead to relationship problems with friends, family and colleagues.

What is insomnia?
Insomnia can be defined as difficulty getting to sleep or staying asleep for long enough to feel refreshed the next morning. Insomnia can be acute (short-term) or chronic (ongoing). Acute insomnia is common and often is brought on by situations such as stress at work, family pressures, or a traumatic event. Acute insomnia lasts for days or weeks.

Chronic insomnia lasts for a month or longer. Most cases of chronic insomnia are secondary, which means they are the symptom or side effect of some other problem. Certain medical conditions, medicines, sleep disorders, and substances can cause secondary insomnia.

Insomnia affects women more often than men. The disorder can occur at any age, but older adults are more likely to have insomnia than younger people.

How much sleep do you need?

There are no official guidelines about how much sleep you should get each night because everyone is different.
On average, a “normal” amount of sleep for an adult is around seven to nine hours a night. Children and babies may sleep for much longer than this, whereas older adults may sleep less. What is important is whether you feel you get enough sleep, and whether your sleep is good quality.
You are probably not getting enough good-quality sleep if you constantly feel tired throughout the day and it is affecting your everyday life.

What causes insomnia?

Secondary insomnia is the symptom or side effect of another problem. This type of insomnia is often a symptom of an emotional, neurological, or other medical or sleep disorder.

Emotional disorders that can cause insomnia include depression, anxiety, and posttraumatic stress disorder. Alzheimer’s disease and Parkinson’s disease are examples of neurological disorders that can cause insomnia.

Other disorders that can cause insomnia include the following:

• Conditions that cause chronic pain, such as arthritis and headache
• Conditions that make it hard to breathe, such as asthma and heart failure
• An overactive thyroid
• Gastrointestinal disorders, such as heartburn
• Stroke
• Menopause and hot flashes

Secondary insomnia can also be a side effect of some medicines. For example, certain asthma medicines, and some allergy and cold medicines can cause insomnia.

Some other substances can also cause insomnia and include caffeine and other stimulants, tobacco and other nicotine products, and alcohol and other sedatives.

Primary insomnia

Primary insomnia is not a symptom or side effect of another medical condition. Its cause is not well understood. Primary insomnia usually lasts for at least 1 month.
Many life changes can trigger primary insomnia. It may be due to major or long-lasting stress or emotional upset. Travel or other factors, such as work schedules that disrupt your sleep routine, may also trigger primary insomnia.

What are the signs and symptoms of insomnia?

The main symptom of insomnia is trouble falling or staying asleep, which leads to lack of sleep. If you have insomnia, you may:
• find it difficult to fall asleep
• lie awake for long periods at night
• wake up several times during the night
• wake up early in the morning and not be able to get back to sleep
• not feel refreshed when you get up
• find it hard to nap during the day, despite feeling tired
• feel tired and irritable during the day and have difficulty concentrating

Insomnia can also affect your daily activities and cause serious problems. For example, you may feel drowsy while driving. It is estimated that driver sleepiness (not related to alcohol) is responsible for almost 20 percent of all serious car crash injuries. Research also shows that insomnia raises older women’s risk of falling.
If insomnia is affecting your daily activities, talk with your doctor. Treatment may help you avoid symptoms and problems related to the disorder.

How is insomnia diagnosed?

Your doctor will likely diagnose insomnia based on your medical and sleep histories and a physical exam. Insomnia is not a disease, and no test can diagnose it. Your doctor would also try to rule out other medical disorders that can cause insomnia. For this, a variety of blood tests and other investigations might be required.

What you can do if you have insomnia?

There are several things you can try to help yourself get a good night’s sleep if you have insomnia. These include:
• setting regular times for going to bed and waking up
• relaxing before bed time – try taking a warm bath or listening to calming music
• using thick curtains or blinds, an eye mask and earplugs to stop you being woken up by light and noise
• avoiding caffeine, nicotine, alcohol, heavy meals – and exercise for a few hours before going to bed
• not watching TV or using phones, tablets or computers shortly before going to bed
• not napping during the day
Some people find over-the-counter sleeping tablets helpful, but they do not address the underlying problem and can have troublesome side effects. If your insomnia persists make an appointment to see your doctor.


Lifestyle changes often can help relieve acute (short-term) insomnia. These changes might make it easier to fall asleep and stay asleep.
A type of counseling called cognitive-behavioural therapy (CBT) can help relieve the anxiety linked to chronic insomnia. Your doctor may recommend a counselor if your symptoms point to a mental health problem, such as depression or anxiety.
Several medicines can also help relieve insomnia and re-establish a regular sleep schedule. However, if your insomnia is the symptom or side effect of another problem, it is important to treat the underlying cause.


Insomnia is a common sleep problem that can affect your quality of life. If you have insomnia, and have tried various things at home without success, it is time to make an appointment with your doctor for a complete evaluation and treatment of this problem.

Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.

Dr Brett Hodge MB BS DGO MRCOG, is an Obstetrician/Gynaecologist and Family Doctor who has over thirty-two years in clinical practice. Dr Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).ask your doctor

By anguillian April 24, 2017 11:11


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