Insomnia 2

Insomnia 2

Category Health
By: Veronica Adesla, S.Psi
Jakarta, June 10, 2009

Definition

Almost everyone of all ages have experienced lack of sleep problems, such as: hard to sleep, quickly woke up from sleep and can not fall back asleep, repeatedly waking from sleep, sleep with uncomfortable or uneasy. There are many types of sleep disorders, but in scientific language, such as sleep disturbance is referred to as insomnia. The more we age, the more likely someone had experienced insomnia. Especially in the elderly (over 65 years) that most sleep disorders, although it is unknown whether this is a normal process of aging or due to other factors. Sleep disorders thereby making the person does not have the quality and quantity   (Amount of time) a good sleep.

Category

Insomnia can be distinguished according to the duration of the disturbances, as follows:

1.      Transient Insomnia, the insomnia that lasts less than a week.

2.      Short-term insomnia, which   insomnia that lasts one to three weeks.

3.      Chronic Insomnia, the insomnia that lasts more than three weeks.

The higher the level, the more impaired a person needs urgent medical consultation, either to a psychologist, psychiatrist, or a doctor. Especially in the case of Chronic Insomnia. But for Transient Insomnia still do self help or attempts to do its own to overcome.

Why is important to deal with insomnia? Because insomnia can decrease the totality / quality of a person in the activities and functioning (physical, emotional, and intellectual) in everyday life. So it can bring a lot of problems in daily life.

How could the quality and quantity of sleep a person can have an impact on the totality or quality of a person? This is because sleep is one of the processes that take an important role in human life. Humans spend a third of his life time to sleep. According to the info from   healthcommunities, the baby almost always sleep in all day, around 16 hours a day, teenagers usually takes 9 hours a day, while adults need less sleep 7-8 hours a day. This is a powerful mechanism in the human body that is natural. Just as animals also sleep at certain times. Research ever conducted by scientists on rats, they try to make the mice stayed awake, one with the constantly pour cold water on mice, this continues to be done eventually, after 14 days the mice even this die (Dr. Nick Carr, ABC). So sleep is one of the processes that are important in life. When a person sleeps, the body resting himself and proceeds to re-create balance in it, this is the most important factor for human health both physical and mental health.

Symptom

We talked about the importance of sleep in the process of human life. However,   not just any sleep   meant here. Because only quality sleep is to make the process work optimally in the body when the body is at rest. In patients with insomnia, sleep quality is not yet reached. The symptoms of people suffering from insomnia are among others:

·          Activities associated with sleep disorders such as trouble falling asleep, waking up too early, or frequently wake during the night and can not fall back asleep, feeling excited / fresh / feeling tired upon waking.

·          Having trouble in running daily activities due to insomnia, such as: declining productivity; often sleepy during the day; difficult / less able to concentrate and focus; hard to remember / often forget even the things that had just experienced; unable to think straight / objective - difficult to give consideration and assessment of the surrounding influence; impaired muscle coordination; less vigilant; impaired in socializing (having fewer social relationships, less active, irritability); experience in driving accidents due to fatigue or lack of sleep.

·          In some people, the problem gets worse everyday due to their own behavior that is not appropriate in an effort to calm down from insomnia disorders, such as: smoking, drinking alcoholic beverages and kafeine, as well as taking medication (tidut medications, sedatives ) without a prescription / drug addiction.

If you are experiencing the symptoms mentioned above then you have insomnia. To determine the level of insomnia that you experienced, you should   attention to the duration of the emergence of insomnia disorder and identify the causes of insomnia is to yourself. Know the causes of insomnia can also help you in determining the category you are experiencing insomnia.

Cause

According Saimak T. Nabili, causes of insomnia can be divided into two groups, namely the cause of transient and short-term insomnia, and the causes of chronic or long-term insomnia.

Causes or conditions that can lead to transient and short-term insomnia, among others:

Jet lag;

Changes in shift work;

Disturbing noises or unpleasant as: snoring;

An uncomfortable room temperature (too hot or too cold);

Stressful situations (exam preparation, loss of a loved one, being fired, divorce, separation);  

Suffering from intractable diseases or have undergone treatment in hospital;

Being in the medical healing process, such as the treatment of the use of drugs, alcohol, or substance addiction / drugs / certain materials;

Insomnia related to altitude, such as in the mountains.

While the causes or conditions that can lead to chronic or long-term insomnia, among others:

Psychological conditions: anxiety disorders, stress, schizophrenia, mania (bipolar disorder), and depression. Insomnia in some cases be an indicator of someone who is experiencing depression or mental problems.

Physiological conditions: chronic pain syndrome, chronic fatigue syndrome, heart blockage or heart failure, night time angina (chest pain) caused by heart disease, acid reflux disease (GERD), chronic obstructive pulmonary disease (COPD) / chronic obstructive pulmonary disease ( COPD), noctural asthma / asthma disturbance at night, obstructive sleep apnea / penyumpatan airways that occurs during sleep, degenerative disease (disease "setback") such as Parkinson's and Alzheimer's disease (in this case the insomnia is often used as a decision-making factor to put care homes ), brain tumor, stroke, or brain trauma.

Groups at high risk of insomnia: travelers / travelers, shift workers   the work shift change often, the elderly, youth or young adult learners, pregnant women, and women menopause.

Medical treatment associated with insomnia: asthma and certain cold medicines are freely available and which must be obtained by prescription; certain medications for high blood pressure   also associated with a lack of sleep, some medications used for treating depression, anxiety disorders, and schizophrenia.

Other Causes: Caffeine and nicotine are associated with less sleep; alcohol associated with sleep disorders and make sleeping was not refreshing when you wake up in the morning; disruption of bed partner who snores or can not be silent (such as twitching legs periodically during sleep ) can make you do not get a good night's sleep / quality.

So we already know the symptoms and the cause / trigger insomnia. Furthermore, as already mentioned above regarding the importance of addressing insomnia then we need to know what can be done to deal with insomnia. To deal with insomnia should first do is to figure out / find the cause of the insomnia. After knowing the cause   it is important to manage and control the problem. Because along with solved the problem then the problem would be resolved insomnia.

Handling

According Saimak T. Nabili, insomnia treatment can be done with two approaches, namely a non-pharmacologic / non-medical and pharmacologic approaches / medical. Non-pharmacologic approaches include: sleep hygiene, relaxation therapy, stimulus control and sleep restriction. These approaches refer to cognitive behavior therapy. And there are also nutritional therapy proposed by Prof.. DR. Ali Khomsan.

Sleep Hygiene: includes some simple steps to improve the quality and quantity of sleep, among other things:

-           Enough sleep, according to the time needed to rest: do not sleep over!

-           Exercise regularly at least 20 minutes each   day, best done 4-5 hours before bedtime. Avoid strenuous exercise before bed!

-           Avoid forcing yourself to sleep

-           Set a sleep schedule and wake up every day on a regular basis (eg, sleep at 10pm and wake up at 5 am)

-           Do not drink caffeinated beverages after the afternoon (tea, coffee, soft drinks, etc.) or stop drinking caffeinated beverages eight hours before bedtime. besides that reduce the use of caffeine.

-           Avoid "night caps" or drinking alcohol before bed

-           Do not smoke, especially at night. Smoking before bed can lead to insomnia. Additionally, it is good to reduce smoking.

-           Do not go to bed hungry, but also avoid heavy meals and excessive drinking before bed time - stop eating and mencamil 1 hour before bedtime

-           Adjust the atmosphere in the room to sleep (lighting, temperature, sounds, etc.)

-           Do not go to bed with your worries; try to finish it before you go to bed

Relaxation Therapy: This technique muscles and mind to relax in a way that is quite as simple as: meditation and muscle relaxation or reduce light illumination, and play soothing music right before you go to bed.

Stimulus Control: includes some simple steps that can help patients with chronic insomnia, among others:

-           Go to bed when you feel sleepy

-           Do not watch TV, read, eat, do chores, or think about your worries in bed. The bed should only be used for sleep and sexual activity.

-           If you are not asleep after 30 minutes went to bed, then wake up and go to another room and then go on your relaxation techniques.

-           Set your alarm clock to wake up at the time you specify every morning, do this even when weekends / weekends. Do not sleep over!

-           Avoid sleeping too much during the day. Limit your nap less than 15 hours except on doctor referrals. If possible, choose to avoid naps because it can improve the quality and quantity of your sleep at night. Except for the case of certain sleep disorders that can actually benefit from a nap - discuss this issue with your doctor.

Sleep Restriction: limit your time in bed only for sleep can improve your sleep quality. Set sleep and wake up in rigid and force yourself to wake up when it's time even if you are still sleepy. It will make you sleep better at night instead of sleep disturbances after you experienced the night before.

Handling other simple to do, among other things: Nutrition Therapy. According to Prof. DR. Ali Khomsan, food and drinks are recommended in order to deal with insomnia are:

Nutrition enough magnesium and calcium can counteract imsonia and reduce anxiety or stress;

Consumption of complex carbohydrates such as crackers, or bagel can stimulate drowsiness and help you sleep;

A glass of warm milk and honey can make sleep soundly;

Eating lettuce or lettuce in the evening can accelerate sleep.

Approach to pharmacologic / medical means insomnia treatment by the use of drugs and medical therapies. Several types of drugs that are used in dealing with insomnia include:

Benzodiazepine sedatives - to improve the quality and quantity of sleep while using this medication;

Nonbenzodiazepine sedatives; Ramelteon (Rozerem) - a drug used to stimulate melatonin receptors. Melatonin - released by the pineal gland in the body and begins to flow when the sun / light dim / dark, its function is to tell your body to rest;

Some antidepressant - in general is helpful for insomnia without depression;

Antihistamines - causes sleepiness but did not improve sleep and can not be used to treat chronic insomnia;

Valeriana officinalis (Valerian) - herbal medicine used in the United States, but there is no research   were able to show real benefits to patients with chronic insomnia.

About which one is better or effective in treating insomnia, whether it's using pharmacologic or non-pharmacologic approach? There is no rigid answer to this. In some cases of insomnia can indeed be handled without the need to involve the use of drugs it would be better if you just use a non-pharmacologic approach. Because then the patient can be spared from the side effects of drug use. However, for certain cases of insomnia (such as insomnia associated with severe psychological disorders (schizophrenic), severe medical problems (cancer), and drug abuse / drug) in which the most effective new or can be obtained with the combination of pharmacologic approaches involve the use of both approaches non-pharmacologic and pharmacologic be a good solution. Very vulnerable if pharmacologic approaches are not included with non-pharmacologic approach because it might appear to drug dependence patient while the patient is expected to not always have to rely on the use of drugs. Therefore, patients should also be prepared mentally (cognitive and behavior) to cope with insomnia regardless of drug use.

Healing insomnia vary depending on the severity of insomnia experienced, precise handling is done, medical conditions, and the active participation of the person to participate struggling to handle insomnia experienced.

Bibliography

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Carr, Nick. "The Function of Sleep." ABC. This Data retrieved June 09, 2009 from http://www.abc.net.au/dimensions/dimensions_health/Transcripts/s859047.htm

Healthcommunities. (January 2, 2000). "Sleep Disorders: Overview." Healthcommunities. This Data retrieved June 09, 2009 from http://www.neurologychannel.com/sleepdisorders/types.shtml

Healthcommunities. (January 2, 2000). "Sleep Disorders: Types of Sleep Disorders." Healthcommunities. This Data retrieved June 09, 2009 from http://www.neurologychannel.com/sleepdisorders/types.shtml

Iskandar, Yul. (2009). "Insomnia Therapy Consultation." Indonesia Business Online >> Consulting. This Data retrieved June 09, 2009 from http://web.bisnis.com/konsultasi/4id293.html

Khomsan, Ali. "Nutrition Therapy for Insomnia."   Ministry of Health of the Republic of Indonesia. This Data retrieved June 09, 2009 from http://www.depkes.go.id/index.php?option=articles&task=viewarticle&artid=51&Itemid=3

Nabili, Saimak T. "Insomnia." EMedicineHealth. This Data retrieved June 09, 2009 from http://www.emedicinehealth.com/insomnia/article_em.htm  

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