DO you struggle for hours to get to sleep, no matter how tired you are? Or do you wake up in the middle of the night and lie awake for hours, anxiously watching the clock? If so, you may be experiencing insomnia, a problem that is becoming increasingly common. Insomnia is a symptom rather than a medical condition in itself, which can accompany several sleep, medical and psychiatric disorders, characterized by persistent difficulty falling asleep and/or difficulty staying asleep. It is typically followed by functional impairment while awake. Most adults have experienced insomnia or sleeplessness at one time or another in their lives, though it is not defined by a specific number of hours of sleep that one gets, since individuals vary widely in their sleep needs and practices. Although most of us know what insomnia is and how we feel and perform after one or more sleepless nights, few seek medical advice. Many people remain unaware of the behavioral and medical options available to treat insomnia. There are two types of insomnia: Primary insomnia happens when a person has a sleep disorder that is not directly associated with any other health condition. Dr. Mohammed Al-Hammed, Head of the Psychiatry department at Bakhsh hospital, Jeddah, told Saudi Gazette that this type of insomnia arises from consciousness, which means there is a problem in sleeping. The second type is secondary insomnia, which happens when a person is sleep-deprived due to a physical condition like headaches and clinical depression. “In this case, a person must be treated in order to fall asleep and the insomnia goes away,” Dr. Al-Hammed said. Sometimes, insomnia only lasts a few days and goes away on its own. Other times, insomnia is stubbornly persistent. “A person with insomnia needs a doctor's attention if it lasts longer than three to four weeks or sooner if it interferes with a person's daytime activities and ability to function.” Dr. Al-Hammed advised. Insomnia may be caused by a host of different reasons (situational factors, medical or psychological conditions). The most common problems that may lead to insomnia include anxiety, stress, depression and certain medications that have been associated with insomnia, such as some anti-depressants. The other causes of insomnia are drinking large quantities of stimulants, smoking or exercising intensively before sleep. “You should consider not only restricting caffeine or nicotine intake in the hours immediately before bedtime, but also limiting your total daily intake,” Dr. Al-Hammed added. Insomnia is also associated with the type of food one consumes and the timing of meals. Dinner, for instance, should be taken three hours before bedtime so that there is enough time for the body to digest the food. However, Dr. Al-Hammed indicated that 99 percent of the causes of insomnia are often because of psychological problems, as compared to one percent for physical reasons. Depending on the medication taken to treat insomnia, the results may make matters worse. While treating underlying physical and mental issues is a good first step, it may not be enough to cure insomnia. We need to rectify our bad habits and adopt a new lifestyle that is conducive to getting a good nights' sleep every day. For example, we should make sure that the bedroom is quiet, dark and cool. Noise, light, and heat can interfere with sleep. We should also avoid drinking stimulants and doing exercise before bedtime and stick to a regular sleep schedule. Another important tip is to avoid napping. Taking naps during the day can make it more difficult to sleep at night. If you feel like you have to take a nap, limit it to 30 minutes before 3 P.M. Dr. Al-Hammed said that insomnia affects all age groups. Among adults, insomnia affects women more often men for many reasons like hormonal changes during pregnancy and childbirth as well as stress from handling the responsibility of the home and children. The sleep routine changes with age. From the age of 50 or 60, a person sleep less because of insomnia stemming from other physical problems. “These changes may also happen due to the use of older medication because of the multiplicity of organic disease they have. Moreover, some of these drugs cause insomnia accompanying sleep disorders in older adults,” Dr. Al
