Insomnia

Insomnia is defined as a condition manifested by difficulty falling asleep and/or staying asleep. It needs to last for more than three (3) weeks at a time and is associated with negative daytime consequences of the disturbed nocturnal sleep. These daytime symptoms include fatigue, lethargy, impaired thought processes, mood disturbance and non-specific physical complaints including headache, gastrointestinal disturbance or multiple aches and pains. For the most part, insomnia is a symptom of an underlying medical and/or psychological problem; it is not a diagnosis by itself. Treatment is always more effective when the underlying problem is addressed rather than just treating the sleep complaints. An extremely useful regimen is for the person to maintain good sleep habits (see Guidelines for Better Sleep). Treatment can include behavioral therapy aimed at promoting mental relaxation as well as muscle tension release at bedtime. Therapy can be aimed at controlling the patient's physical as well as their emotional environment that they are contending with at the time of sleep onset, or in special cases the patient can be treated by restricting the number of hours that they spend in bed (time spent waiting to fall asleep as well as time spent asleep) and as the person's sleep improves the time in bed is increased. In some cases judicious use of sleeping medications are employed. This occurs when a temporary aid is needed to allow the person to get their sleep back on track. In most cases sleep will re-establish itself and in the long run regular use of sleeping pills will do more harm than good.