Insomnia Essays (1492 words) - Sleep Disorders, Insomnia

Insomnia Lying among tousled sheets, eluded by sleep with thoughts racing, many people wrestle with the nightly demon named insomnia. Insomnia is defined as, the perception or complaint of inadequate or poor-quality sleep because of one or more of the following: difficulty falling asleep, waking up frequently during the night with difficulty returning to sleep, waking up too early in the morning, or unrefreshing sleep (Rajput 1431). Because the definition of poor-quality sleep is not the same for every person, it is not easy to determine the frequency and severity of its occurrence (Holbrook 216). To add to the complexity of this problem, there is not even one universal treatment that can be used effectively in all cases. Many effective treatments have been discovered, but there is no cure-all. The two most popularly used treatment methods are pharmocological treatment and behavioral-cognitive treatment . Each of these treatments has its pros and cons and is recommended for different types of patients. Although taking a pill every day would appear to be the simplest way of overcoming insomnia, it is, at best a temporary solution, and in recent years, use of drugs as a treatment has declined rapidly. Medical records show that the yearly number of prescriptions for sleeping pills peaked in 1972 and were cut in half by 1982. The reason for this decline is that a large amount of cases, insomnia has been proven to be a symptom of an underlying . . . problem (Sweeney 231). Drugs can be a good solution for a short period of time, but their long term use is discouraged, because a tolerance can develop after four weeks of regular use (Espie (?) 115-116). There are three main types of drugs used for treatment--benzodiapine hypnotics, sedating antidepressants, and antihistamines. Benzodiapine hypnotics are the most prescribed drugs for treating insomnia. They are most useful when treating short term problems and have relatively few side effects when used correctly. They reduce the time for sleep onset and increase sleep efficiency. Long-term use can lead to physical and psychological dependence and abruptly discontinuing their use may cause symptoms of withdraw. (Zammit 132-135). Gradually tapering off the drug is recommended to prevent rebound insomnia. The possible side-effects of benzodiapines include inducing anterograde amnesia, excitability, agression, and symptoms of depression. (Longo 2121). Benzodiapines can be especially harmful for the elderly. They can heighten the symptoms of demensia related disorders. Pregnant women are also discouraged from taking benzodiapines because they are considered teratogens (substances that can reach a fetus and cause harm) (Myers 118). A secondary option to benzodiapines is sedating antidepressants. These drugs can promote sleep onset and maintain sleep (Zammit 136), but they have not been scientifically proven to treat insomnia. There is no risk of dependence on antidepressants but it is possible for them to become ineffective after a very short time. The third drug option is antihistamines, which besides helping with allergies, are said to decrease sleep onset and reduce time in REM sleep. Many antihistamines are available without a prescription. They are not recommended for treating insomnia because they are not sedatives and very few studies have been done to show their effectiveness. There are also side effects such as dry mouth and urinary retention associated with antihistamines (Walbroehl 1911). In addition to drugs, there are other sleeping pills available. These natural remedies are not regulated by the FDA and it is difficult to accurately jusdge their effectiveness and safety. One of these remedies, which has gained a lot of attention recently, is melatonin. This hormone, naturally secreted by the pineal gland, helps control the sleep-wake cycle. It is now sold as a dietery supplement which aids in sleep. It is still in the process of being tested as an accepted treatment for insomnia. Many results of these tests are coming back favorably, but there are still many questions about its safety to be answered. (Cupp ?) An alternative to sleeping pills, cognitive-behavior therapy can sometimes be used effectively as a treatment. This therapy focuses on encouraging the patient to eliminate behavior incompatible with sleep (Rajput 1431). This treatment has many components, which include stimulus control, sleep restriction, relaxation techniques, and cognitive therapy (GN 103). According to _____, all