Insomnia

What is it?

Insomnia or agrypnia is a disorder that involves the inability to fall asleep or stay asleep. In patients who suffer from it, the duration and quality of sleep are low and interfere with their daily lives. This disorder manifests itself with difficulty to initiate the dream, to maintain it or through a final awakening.

Causes

According to the Spanish Society of Neurology (SEN), the causes of insomnia can be established according to their origin:

Primary Causes

Are those that have to do with the maintenance of proper sleep hygiene or psychological aspects:

Physiological changes: aging produces changes in the sleep pattern. In older people, it is common to reduce the hours and quality of sleep and an increase in daytime sleepiness.
Lifestyle: constant changes in schedule, due to work or travel issues (jet-lag) cause circadian rhythm disorders.
Drugs: medicines and substances that can disturb sleep include antihypertensives, anticholinergics, hormones, stimulants, steroids, antidepressants, bronchodilators, decongestants, antineoplastics, caffeine, and levodopa.

Secondary causes

Insomnia sometimes occurs because of a pathology already existing in the patient or environmental factors.

Physical or psychological pathologies: some diseases or disorders associated with insomnia are the following:
Cardiovascular disorders: coronary insufficiency, left ventricular failure and cardiac arrhythmias.
Pulmonary complications: chronic obstructive pulmonary disease ( COPD ), asthma.
Eating Disorders (Eating Disorders ): anorexia nervosa.
Endocrine disorders: thyroid dysfunction.
Neurological disorders: headaches, Parkinson’s disease, lesions in the thalamus, dementia, etc.
Environmental factors: Extreme temperatures, changes in schedules or trips are factors that modify the sleep pattern and can cause insomnia.

Symptom

The symptoms of insomnia are easy to detect because the patient himself notices the difficulties to fall asleep or wakes up early. The lack of rest is manifested throughout the day causing fatigue, weakness and, in extreme cases, even slowness when processing information, irritability, and so on.

Prevention

In general, maintaining good sleep hygiene helps prevent insomnia and problems related to lack of rest. Here are some useful tips for falling asleep:

Avoid using the bedroom as a workplace or for other activities other than rest. This helps to associate the bed with sleep.
Condition the bedroom before sleeping so that it has the right temperature.
Create a relaxed and comfortable atmosphere in the room, modulating the intensity of light and avoiding noise.
Disconnect the cell phones and other electronic devices and remove them from the bedroom.
Always lie down at the same time so that the dream becomes a habit.
Perform relaxing activities one hour before bedtime.
Avoid intense exercise before going to sleep.
Avoid heavy dinners that can hinder digestion and make it more difficult to fall asleep.
Limit the intake of large amounts of fluids before sleep to prevent the need to urinate interrupt sleep.
In summer, it is important not to sleep with the windows open to avoid the noise of the street interrupting the sleep.
Lower the blinds so that the excess light does not wake us up at dawn.

Types

Transitory: lasts less than three weeks and in its origin involved many factors that can be modified, such as environmental and lifestyle-related, certain diseases and the drugs with which they are treated. About 90 percent of the population admits to having suffered an insomnia episode throughout their lives.
Chronic exceeds three weeks. It can be perceived as a pathology that interferes with the daily activity of the patient with severe physical and mental consequences.

Diagnosis

To diagnose insomnia, the doctor will assess the sleep pattern of the person, the use that this makes of drugs, alcohol and illegal drugs, the degree of psychological stress, the medical history and their level of physical activity.

In the first place, any pathology that may cause insomnia should be ruled out by physical examination and psychological examination. The correct treatment of this disorder is only possible if its origin is accurately determined. Sometimes insomnia masks an anxiety or depression problem.

Likewise, the hygiene of the patient’s sleep should be evaluated, such as the ingestion of alcoholic drinks or caffeine during the night, the drugs taken for other pathologies, the noisy, poorly oxygenated or extreme temperatures, and habits such as reading or watch television in bed. These customs must be corrected before starting the treatment. On the other hand, the possible psychological pathologies and family history should not be forgotten.