INSOMNIA
Man’s best
escape from the stresses of life is provided by sleep – and the rest and
recuperation which it affords. Sleep occupies one-third of our lives and turns
out to involve the basic biological states of the brain and body. But sleep –
and getting enough of it is not a simple problem. Insomnia is the most common
of sleep related symptoms.
Various
studies have shown that up to 30 percent of the adult population complaint of
serious insomnia at least once during the course of a year. About a third of
all U.S. adults experience some type of sleep disorders during their lifetimes.
A recent estimate says sleep disorders cost the U.S. economy $45 billion a
year.
Our natural
sleep patterns are controlled by an internal body clock called a “circadian
clock”. It regulates body temperature, hormone levels, heart level and other
vital body functions. If someone is suffering chronic loss of sleep, these
important functions soon become impaired, overall health is usually affected as
is a person’s memory and mood. It is estimated that over the past century a
person’s average nightly sleeping time has been reduced by two hours.
Though, the
use of hypnotic medication as a treatment for insomnia is correspondingly high,
most of us, including doctors, are unaware about such problems.
Day Time Consequences Of Sleep Disorders :
While the
experience of disrupted nocturnal sleep may be the most prominent symptom for
patients with sleep disorders, particularly those with insomnia, the impact of
this sleep disruption on day time function is arguably the more important
aspect from both clinical and public health perspectives. Sleepiness-related
automobile accidents, for example, constitute an important health risk for the
patient with disrupted sleep. In fact, industrial catastrophes like Bhopal and
Chernobyl have happened because of errors on part of their sleep-deprived
staff.
Sleep
deprived people will go from feeling tired to feeling a heavy sense of
exhaustion, as if it’s a chore just to get out of bed in the morning. They will
have trouble waking up. The individual’s reactions are slowed, and
concentration is broken. When the body is not properly rested, it can’t
function in top shape. The body’s defenses are lowered because it has to focus
on staying awake and keeping up with the person who refuses to give in and
sleep. This leads the individual to be more susceptible to illness, and to get
sicker and for a longer period of time when an illness is contracted. The body
cannot fight the bacteria or virus until it can stop focusing so much energy on
everyday life processes.
Once
sleep deprivation has set in, the lost sleep can never be made up. Research has
also shown that by being chronically sleep deprived, one is shortening their
life. Since the effects of sleep deprivation can be quite harmful, one should
make an effort to take care of him or herself.
Day
time impairment due to loss of sleep may be difficult to quantify in the
clinical setting. In assessing sleepiness, specific questioning about the
occurrence of sleep episodes during normal waking hours, both intentional and
unintentional, can overcome the inconsistencies among subjective
characterization and will simultaneously provide an index of the adverse impact
of sleepiness on day time function. Specific areas to be addressed include the
occurrence of inadvertent sleep episodes while driving or in other safety
related settings, sleepiness while at work or school, and the effect of
sleepiness on social and family life.
While
clinical evaluation of the complaint of excessive sleepiness is usually
adequate, objective quantification is sometimes necessary for diagnostic
purposes or for the evaluation of treatment response. Assessment of day time
functioning as an index of the adequacy of sleep can be made with the multiple
sleep latency test (MSLT), which involves repeated measurement of sleep latency
(time to onset of sleep) under standardized conditions during a day following
quantified nocturnal sleep. The average latency across four to six tests is taken
as an objective measure of day time and sleep tendency. Disorders of sleep that
result in pathological day time somnolence can be reliably distinguished with
the MSLT.
