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Insomnia

 

Difficulty in falling or staying asleep, the absence of restful sleep, or poor quality of sleep is called as Insomnia.

Causes :

Insomnia is not a disease, it is a symptom. The most common causes of insomnia are medications, psychological conditions (e.g., depression, anxiety), environmental changes (e.g., travel, jet lag, or altitude changes), and stressful events. Insomnia can also be caused by faulty sleeping habits such as excessive daytime naps or caffeine consumption.
It cane be classified by how long the symptoms are present. Transient insomnia usually is due to situational changes such as travel and stressful events. It can last for less than a week or until the stressful event is resolved.
Short-term insomnia lasts for 1-3 weeks, and long-term insomnia (chronic insomnia) continues for more than 3 weeks. Chronic insomnia often results from depression or substance abuse.
Transient insomnia may progress to short- term insomnia and without adequate treatment, short-term insomnia may become chronic insomnia.
Among the medications and substances that can contribute to insomnia are caffeine and coffee, tobacco, alcohol, decongestants (e.g., pseudoephedrine), diuretics (Lasix/furosemide, Dyazide/hydrochlorothiazide) given at bedtime, antidepressants, appetite suppressants, and amphetamines. Insomnia also may be the result of withdrawal from benzodiazepines, alcohol, antihistamines, amphetamines, cocaine, and marijuana.

Non-drug treatments for insomnia

Appropriate sleep habits are important in the management of insomnia. In some instances, changing sleep habits may correct the problem without the need for medications. Good sleep habits should include:
  • Regular sleep times;
  • A comfortable bed and quiet room at a comfortable temperature;
  • Appropriate lighting;
  • Regular exercise but not close to bedtime or late in the evening;
  • A bedroom that is not used for work or other activities that are not related to sleep;
  • Avoidance of stimulants (e.g. caffeine, tobacco), alcohol, and large meals close to bedtime;
  • Relaxation techniques such as breathing exercises; and
  • Avoidance of naps during the day.
over-the-counter medicines are there for insomnia

Self-treatment of insomnia with over-the-counter (OTC) drugs is advisable only for transient or short-term insomnia. OTC sleep aids should only be used for a short period of time in conjunction with changes in sleeping habits. Chronic use of these drugs may result in dependence on the them. This creates a situation in which sleep is not possible unless the drug is used. Chronic insomnia should be evaluated by a physician.
Persons with insomnia often suffer from fatigue as a result of sleep deprivation. Stimulant products are frequently used in an attempt to offset fatigue and other unpleasant side effects that can accompany a lack of sleep. However, the use of stimulant products can also cause insomnia, leading to a counterproductive effort to deal with sleep deprivation.

Caffeine

Caffeine is the sole active ingredient in most non-prescription stimulants. Caffeine is used for improving alertness and for staying awake. Caffeine is a powerful stimulant, but tolerance can be developed. Caffeine also is present in medications for menstrual cramps, headaches, and colds. Additionally, caffeine is found in coffee, tea, and chocolate.
Caffeine increases alertness by stimulating the nerves in the brain and spinal cord. It decreases muscle fatigue by stimulating muscle contraction. Caffeine also increases the heart rate and the force of contraction of the heart. The effect of caffeine varies among individuals and some people are only affected minimally.
Pregnancy and Lactation: Studies have shown that moderate caffeine intake does not cause low birth weights, miscarriages, or premature births. However, there are reports of birth problems in women who consume more than 300 milligrams per day of caffeine. Therefore, daily caffeine intake should probably be limited to less than 300 milligrams during pregnancy.
Caffeine is secreted into breast milk. The concentration of caffeine in breast milk is approximately 1% of the amount in the mother's blood. A lack of sleep and irritation may occur in breastfed infants whose mothers consume more than 600 milligrams of caffeine per day. No adverse effects have been noted in breastfed infants whose mothers consume between 200-336 milligrams per day of caffeine. A mother can limit the amount of caffeine her infant receives by limiting the amount of her caffeine intake and ingesting the caffeine after nursing.
Children: Caffeine is not recommended for children less than 12 years of age.
Caffeine decreases the absorption of iron tablets. Iron should be administered 1 hour before or 2 hours after the consumption of caffeine.
Caffeine decreases the effects of sedatives, and sedatives decrease the restlessness, alertness, and arousal that is caused by caffeine.
Adverse Effects: The most common adverse effects of caffeine are insomnia, nervousness, excitement, headaches, vomiting, diarrhea, and stomach pain. Caffeine also causes abnormal heartbeats and increases heart rate.
Dependence can occur from the regular use of caffeine. If caffeine intake is stopped suddenly, a withdrawal reaction that consists of fatigue, headaches, anxiety, vomiting, and restlessness may occur. Symptoms of withdrawal start 12-24 hours after the last consumption of caffeine and may last for a week.

 

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