Sleep is not an abnormal condition but a normal protective function, having for its purpose the prevention of excessive fatigue. But like every other function of the human organism, it does not always work smoothly. Many people find it difficult to obtain a proper amount of sleep; and even among those to whom sleep comes readily, its processes often are strangely disturbed.
Everyone has an occasional sleepless night, and this is not a problem for most people. However, as many as 25% of Americans report occasional sleeping problems, and insomnia is a chronic problem for about 10% of people.
The lack of restful sleep can affect your ability to carry out daily responsibilities because you are too tired or have trouble concentrating. All types of insomnia can lead to daytime drowsiness, poor concentration, and the inability to feel refreshed and rested in the morning.
Most adults do best with about 8 hours of sleep each night until age 60, after which 6 hours may be enough. Even though the elderly need less sleep, almost one half of people over 60 experience some degree of insomnia.
The best measure of the amount of sleep needed is how you feel. If you awaken feeling refreshed, you are getting enough sleep. For some people, this may take only 4 hours. Others can need up to 10 hours to feel rested.
Using long-acting or high-dose sedatives as a “cure” for insomnia can make the problem worse, not better, over time. Antihistamines (the main ingredient in over-the-counter sleeping pills) can lead to similar difficulties. Using antihistamines over time may also affect your memory.
Strong, prescription sedatives do not produce a natural, restful sleep. In addition, you can become dependent on or tolerant of these drugs. In this case, the same dose of the drug no longer produces sleep, which may lead you to try a higher dose. Higher doses worsen the chance of dependence, tolerance, and side effects. Stopping these medications can cause a rebound insomnia and withdrawal.
A life-threatening disease is rarely the cause of problems with sleep. For many people, poor sleep habits are the cause. However, because insomnia is a key symptom of depression, you should be checked for depression if you are having trouble sleeping.
Insomnia may cause:
Dark circles under the eyes
Reduced energy level
It may help to see a psychiatrist, doctor, or another mental health provider to evaluate psychiatric disorders that can lead to insomnia. If you are depressed, antidepressants can help both the sleeping problem and the depression. These medications do not carry the same concerns about tolerance and dependence as sedatives.
Counseling may help with nightmares and dreams that interfere with sleep.
Tips for reducing evening agitation and nighttime sleeplessness:
• Plan more active days. A person who rests most of the day is likely to be awake at night. Discourage afternoon napping and plan activities, such as taking a walk, throughout the day.
• Monitor diet. Restrict sweets and caffeine consumption to the morning hours. Serve dinner early, and offer only a light meal before bedtime.
• Seek medical advice. Physical ailments, such as bladder or incontinence problems, could be making it difficult to sleep. Your doctor may also be able to prescribe medication to help the person relax at night.
• Change sleeping arrangements. Allow the person to sleep in a different bedroom, in a favorite chair or wherever it’s most comfortable. Also, keep the room partially lit to reduce agitation that occurs when surroundings are dark or unfamiliar.
• Nighttime restlessness doesn’t last forever. It typically peaks in the middle stages, then diminishes as the disease progresses.