Dyssomnia covers
a range of specific sleep disorders, the Inability to Sleep, Insomnia,
Sleeplessness, Wakefulness. Chronic and persistent difficulty in either;
falling asleep, remaining asleep through the night, or waking up too
early. All types of insomnia can lead to daytime drowsiness, poor
concentration, and the inability to feel refreshed and rested in the
morning.
The Dyssomnias
are disorders of sleep or wakefulness they are not Parasomnias. Dysosomias
therefore include the following specific disorders:
Insomnia.
Apnea
Insomnia may be
divided into three groups: transient insomnias, which last for several
days; short-term insomnias, which can last up to three weeks; and
chronic insomnias, which continue for more than three weeks.
Associated
Features:
Psycho-Physiologic
Insomnia.
Idiopathic.
Narcolepsy.
Recurrent Hypersomnia.
Obstructive Apnea Syndrome.
Mixed Apnea Syndrome.
Central Apnea Syndrome.
Alveolar Hypoventilation.
Periodic Leg Movements and Leg-Related Syndrome.
Differential
Diagnosis:
Some disorders have similar symptoms. The clinician, therefore, in
his diagnostic attempt has to differentiate against the following
disorders which need to be ruled out to establish a precise diagnosis.
Nightmare
Disorder
Depression
Cause:
For many people,
poor sleep habits are the cause. However, because insomnia is a key
symptom of depression, you should
be evaluated for depression if you are having sleeping difficulties.
Generally transient insomnias may be caused by stress, changes in
sleeping patterns, related to shift working and jet lag. Short-term
insomnias may be caused by the effects of severe stressful events,
serious family or relationship problems and bereavement.
Finally the causes of chronic insomnia are more evasive and difficult
to identify. Some factors associated with Dyssomnia are therefore:
Jet Lag
Shift Work
Grief
Depression or Major Depression
Anxiety or Stress
Nicotine, Alcohol, Caffeine or other stimulants at bedtime
Natural Aging Process
Excessive Daytime Sleeping
Overactive thyroid (hyperthyroidism)
Medication side-effects
Abruptly Stopping a Medication (such as sleeping pills).
Treatment:
Drug treatment should only be
resorted to a as a last option. Practice good sleep hygiene:
avoid using alcohol in the evening and to avoid caffeine before bedtime.
Establish a regular
bedtime, but don't go to bed if you feel wide awake. Use the bedroom
for bedroom activities only. Once in bed, use creative imagery and
relaxation techniques to keep your mind off unrestful thoughts. Avoid
staying in bed for long periods of time while awake, or going to bed
because of boredom. Relax by reading, taking a bath, or listening
to soothing music before getting to bed.
Counseling
and Psychotherapy [ See
Therapy Section ]:
Counseling may
be helpful for psychological disorders that lead to insomnia and
the practice of relaxation techniques may also be helpful.
Pharmacotherapy
[ See Psychopharmacology
Section ] :
Antidepressants
can often help both the sleeping problem and the depression usually
associated with the disorder. As previously indicated medication
should be a last resort only.
