Sleeping Disorders & Daytime Sleepiness


Insomnia is a sleep disorder in which people have trouble falling asleep or staying asleep, early awakening, or a sensation of insufficient sleep. You may still feel sleepy and unrest when you wake up. Insomnia not only take a toll on your energy level and mood but also your overall health, work performance and life quality. How much sleep is enough varies from person to person, but most adults need seven to eight hours a night. Insomnia can impair mental focus therefore increases the risks of accidents.

Insomnia usually accompanies with excessive daytime sleepiness. Short term (acute) insomnia usually lasts for days or weeks, usually associated with stress or a traumatic event. Long term (chronic) insomnia may last for a month and beyond, which may be associated with other medical conditions or medications. The U.S. National Institutes of Health estimates that around 30 percent of the U.S. population complains of sleep disruption, with around 10 percent having symptoms of daytime functional impairment.

Treatment includes lifestyle modification (diet, nutrition, exercise, and behaviour), and medications.

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Insufficient Sleep Hygiene

Factors that can contribute to sleeping disorders include consumption of neuroexcitatory substances such as but not limited to caffeine commonly found in tea, coffee, glutamic acid (E620), monosodium glutamate (E621), wheat, barley, or other stimulant drugs near bedtime, or even in the morning for people who are hypersensitive to them. Other factors include elevated sympathetic nervous system due to late evening exercise, anticipation of an event, irregular sleep-wake hours, and afternoon napping.

Emotional Related Insomnia

Acute emotional stressors such as demise of a love one, loss of job, financial loses, chronic worries can cause insomnia. Symptoms usually remit shortly after the stressors subside. However, if daytime sleepiness and fatigue develop, particularly if they interfere with daytime functioning, short term treatment with hypnotics is warranted. Chronic anxiety may require specific treatment.

Physical Related Insomnia

Physical disorders may affect sleep and contribute to insomnia and excessive day time sleepiness. Physical pain and discomfort such as injuries, cancer, arthritis, herniated disks, back pain, particularly those worsen with movement can cause intermittent awakening leading to poor sleep quality. Sleep apnea and nocturnal seizures can also affect sleep.

Drug Related Insomnia

Insomnia and excessive daytime sleepiness can cause by repetitive use of CNS stimulants such as caffeine, amphetamines, hypnotics such as benzodiazepines, other sedatives, oral contraceptives, antimetabolite chemotherapy, anticonvulsants such as phenytoin, methyldopa, propranolol, alcohol, and thyroid hormone preparations. Most psychoactive drugs can induce abnormal movements during sleep.

Insomnia can develop upon withdrawal of CNS depressants such as sedatives, opioids, barbiturates, monoamine oxidase inhibitors, tricyclic antidepressants, or illicit drugs such as marijuana, phencyclidine, cocaine, and heroin. Abrupt withdrawal of sedatives or hypnotics can induce nervousness, tremors, and seizures.