Insufficient sleep has several severe health consequences, including high rates of exhaustion (a more prevalent sign of a sleep disturbance than drowsiness), cardiac and vascular difficulties, and increased risk of driving accidents, weakened immunological function and decreased cognition.
General practitioners should pay attention to how sleep disorders affect the pathophysiology of other medical ailments because treating sleep disorders provides a window of opportunity for treating the comorbid medical condition. Treatments like, Modalert 200 (Modafinil) for conditions such as hypertension, heart failure, mood disorders and epilepsy may be less effective if sleep disturbances are present in the patient.
To treat patients with persistent insomnia, if online resources are ineffective for them, give them CBT-I and recommend them to a competent therapist, such as a psychologist, for treatment.
Despite the fact that more than 80 different sleep disorders have been identified, a simple classification system has been developed. There are four categories of sleep disorders in this system: insomnia, hypersomnia, circadian rhythm issues, and “things that go bump in the night” insomnia (parasomnias).
The term “insomnia” refers to a condition in which a person has a hard time falling asleep or remaining asleep, and then wakes up sooner than expected. Daytime symptoms, such as exhaustion, mood swings, difficulties concentrating or remembering, and behavioural issues, must be present to qualify for a diagnosis.
Over the course of more than three months, a person with chronic insomnia will have difficulties sleeping more than three times a week (American Academy of Sleep Medicine, 2014). Chronic insomnia, if untreated, may linger for years or even decades.
People who suffer from excessive daytime drowsiness report feeling constantly or often sleepy, and this is generally accompanied with inappropriate sleep occurrences.
It can be due to:
Scheduling Your Sleep and Maintaining Good Sleep Hygiene
Make a note of bedtimes, how long it takes for patients to fall asleep, the number and length of nocturnal wakeups, how long it takes for patients to wake up on weekends, and the difference between weekday and weekend sleep patterns and sleep quality.
The patient’s beliefs and coping or compensating behaviours, such as spending too much time in bed or using hypnotics, should be explored. Make an effort to learn more about the patient’s nighttime routine and the things that could be bothering him or her when he or she is trying to sleep.
At Night, Worry or Anxiety
Before sleep or while lying awake at night, inquire about the patient’s feelings of anxiousness, irritability, and a reluctance to “turn off.”
Functioning During the Daytime
Inquire about drowsiness throughout the day, as well as mental and physical exhaustion, difficulty concentrating and remembering things, and a bad mood or irritation. Insomnia sufferers are more likely to complain of mental tiredness and an inability to sleep throughout the day than they are of daytime drowsiness.
People with mental and physical health issues
The “Insomnia” section on the next page provides further information on insomnia and the circumstances that may contribute to it.
Investigate any prescriptions that affect the central nervous system (CNS) or cause sleep problems (e.g., diuretics).
Addiction to Drugs
Ask about caffeine and other drug usage, and think about how alcohol withdrawal might affect your ability to sleep.
Excessive drowsiness throughout the day should be checked for. Daytime drowsiness and weariness are the most prevalent nighttime symptoms of sleep problems.
A thorough evaluation of all patients with excessive daytime drowsiness should include a review of any accidents or near-misses that may have been caused by driver inattention or tiredness. It is important to check all patients who are weary, drowsy, or exhausted for signs of apnea.
Various Sleep Disorders That Cause Insomnia
When a patient arrives with insomnia symptoms, it is important to rule out sleep disorders that may be causing the symptoms.
Insomnia may be caused by restless leg syndrome or a lack of sleep-wake cycles.
People with mental and physical health issues
Chronic insomnia may be triggered or exacerbated by psychiatric and physical problems. People suffering from depression and anxiety or post-traumatic stress disorder, for example, typically wake up sooner than they used to.
As a result, acute pain or physical disorders that produce discomfort might worsen sleeplessness. It’s critical to remember that chronic insomnia detaches from these underlying causes and is instead sustained by insomnia-specific psychological elements.
The comorbid disorders and insomnia are commonly linked by overlapping behavioural pathways that increase the symptoms of both.
Insomnia may be caused by a variety of drugs, including antidepressants, CNS stimulants, CVS antihypertensive medications, including beta blockers, over-the-counter decongestants, GI irritants, and corticosteroids. The rebound impact of drug and alcohol withdrawal, particularly from sedatives like alcohol and short-acting hypnotics, should also be taken into account.
- excessive drowsiness throughout the day
- Restriction of Sleep Time
- Excessive daytime drowsiness in healthy adults is most often caused by sleep restriction or inadequate sleep.
- Abrupt cessation of breathing during sleep is known as apnea
Sleep apnea is divided into two basic categories: obstructive and
Hypopneic. Hypopnea, or lack of breathing, occurs at least five times an hour in people with obstructive sleep apnea (OSA). This causes a 50% reduction in airflow (hypopnea) or no airflow at all (apnea).
Insomnia and other sleep problems may be effectively treated with sleep education. Involve patients in the following discussions:
- Sleep requirements for the typical person and the range of individual differences
- circadian rhythm and the relevance it plays in the patient’s desired regular sleep routine as they become older
- napping’s importance in making up for sleep deprivation as well as its impact on the development of chronic insomnia
- The repercussions of sleep deprivation and the impact of coffee, nicotine, pharmaceuticals, and alcohol on sleep are critical.
- Counseling based on the principles of cognitive behaviour (CBT)
Adopting behavioural techniques and cultivating sleep-related anxiety, driven by unhelpful sleep-related cognitions are the hallmarks of acute insomnia, according to the cognitive-behavioural model. In spite of the absence of the triggering factor, the condition continues to exist.