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1 File is prepared by; Ahmed Abd El Hakim THIS FILE IS DOWNLADED FROM

2 What Is Insomnia? Insomnia is a sleep disorder in which a person experiences poor sleep or has trouble sleeping. Insomnia can involve: Difficulty falling asleep Difficulty staying asleep (that is, waking up many times during the night), without necessarily having had any difficulty falling asleep Waking up too early in the morning Not feeling refreshed after a night's sleep In any of these cases the person feels tired the next day, or feels as if he or she did not have enough sleep. Poor sleep for any length of time can lead to mood disturbances, lack of motivation, decreased attention span, trouble with concentration, low levels of energy, and increased fatigue. About one-third of the average person's life is spent sleeping. Healthy sleep is vital to the human body and important for the optimal functioning of the brain and other organs. There are three types of insomnia: Transient, or mild, insomnia - sleep difficulties that last for a few days; there is little or no evidence of impairment of functioning during the day Short-term, or moderate, insomnia - sleep difficulties that last for less than a month, that mildly affect functioning during the day, together with feelings of irritability and fatigue Chronic, or severe, insomnia - sleep difficulties that last for more than a month, that severely impair functioning during the day, and cause strong feelings of restlessness, irritability, anxiety, and fatigue Since everyone has different sleep needs, there is no "correct" amount of sleep. On average, most people need between seven and nine hours of good quality sleep each night in order to feel alert the next day. But some function perfectly well with only four or five hours a night. The key to healthy sleeping seems to be a consistent pattern, rather than the number of hours one sleeps. 2

Is Insomnia Serious? Insomnia can have physical and psychological effects. The consequences of insomnia include: Impaired mental functioning.

3 Is Insomnia Serious? Insomnia can have physical and psychological effects. The consequences of insomnia include: Impaired mental functioning. Insomnia can affect concentration and memory, and can affect one's ability to perform daily tasks. Accidents. Insomnia endangers public safety by contributing to traffic and industrial accidents. Various studies have shown that fatigue plays a major role in automobile and machinery accidents. As many as 100,000 automobile accidents, accounting for 1,500 deaths, are caused by sleepiness. Stress and depression. Insomnia increases the activity of the hormones and pathways in the brain that cause stress, and changes in sleeping patterns have been shown to have significant affects on mood. Ongoing insomnia may be a sign of anxiety and depression. Heart disease. One study reported that people with chronic insomnia had signs of heart and nervous system activity that might put them at risk for heart disease. Headaches. Headaches that occur during the night or early in the morning may be related to a sleep disorder. Economic effects. Insomnia costs the U.S. an estimated $100 billion each year in medical costs and decreased productivity. Normal Sleep Sleep is not a simple process. Many different parts of the brain control and influence sleep at different stages. There are two natural daily peak times for sleeping: at night and at mid-day, which in parts of the world is traditional "siesta" time. Here is how the body initiates sleep: As light fades, cells in the retina of the eye send a signal to a cluster of nerve cells located in the hypothalamus, in the center of the brain. These cells in turn send a message to the pineal gland in the brain to produce the hormone melatonin, which causes a drop in body temperature and sleepiness. At the same time, another cluster of nerve cells in the brain is believed to deactivate three major chemical messengers in the body, that keep us alert: histamine, norephinephrine, and serotonin. At the same time, another cluster of nerve cells in the brain is believed to deactivate three major chemical messengers in the body, that keep us alert: histamine, norephinephrine, and serotonin. 3

There are two distinct phases of sleep Non-rapid eye movement (Non REM) sleep - The quiet or restful phase of sleep, also referred to as "slow wave sleep"; it is divided into four stages of

4 There are two distinct phases of sleep Non-rapid eye movement (Non REM) sleep - The quiet or restful phase of sleep, also referred to as "slow wave sleep"; it is divided into four stages of progressively deepening sleep Rapid eye movement (REM) sleep - The phase of sleep in which the brain is active and dreaming occurs; it is also known as "dream sleep" What Are Sleep Disorders? An estimated 40 million Americans experience some type of sleep disorder, but 95 percent of them go undiagnosed and untreated, simply because they do not realize they have a problem or because they think that nothing can be done for them. Common sleep disorders include: Insomnia, an inability to sleep or to remain asleep throughout the night Obstructive sleep apnea, in which a person's breathing passages become temporarily blocked during the night; this condition is often marked by excessive snoring Chronic sleep apnea, a neurological condition in which the brain "forgets" to instruct the body to breathe Restless leg syndrome, in which a person has occasional movement and/or uncomfortable sensations in his or her legs, feet, or toes just before they fall asleep Hypersomnia, an increase in sleep by about one-fourth of a person's regular sleep patterns Narcolepsy, in which a person gets sudden attacks throughout the day and night of drowsiness and sleep that cannot be controlled Parasomnias, which are vivid dreams and physical activities that occur during sleep, such as sleepwalking (somnambulism) and episodes of screaming and flailing about (night terrors). Who Gets Insomnia? Over 90 percent of people experience some degree of insomnia at some point in their lives. Studies indicate that insomnia affects one in three adults every year in the United States. Several factors increase a person's chances of developing insomnia: Gender. In general, insomnia is more common in women than men. However, older men have more disrupted sleep than older women. Age. As a person ages, sleep becomes more fragmented. Complaints of insomnia are much 4

5 more frequent in people over age 65 than in younger individuals Medical conditions and medication. People who have arthritis, ulcers, urinary disorders, heart conditions, and other conditions that cause pain or discomfort, are more likely to get insomnia. In addition, insomnia is a side effect of many common medications, including over-the-counter medicines that contain caffeine. Childhood fears. One study found that people who had experienced longterm insomnia had been prone to nightmares and fear of the dark as children. Lifestyle. People who travel frequently and cross time zones, as well as night-shift workers, are at higher risk. Smoking, overuse of alcohol or other stimulants, and high caffeine intake also contribute. A new phenomenon that is contributing to insomnia is Internet addiction. Aging And Insomnia As people get older, they tend to sleep less, and their sleep stages also change. Though normal, these changes often make older people think they're not getting enough sleep. An early morning awakening pattern - in which people fall asleep normally but wake up several hours after and are unable to fall asleep again - is more common in the elderly. In some cases, early morning awakening may be a sign of depression. Experts believe a number of factors may influence sleep in the elderly, including: Naturally reduced levels of melatonin, the hormone that helps control sleep Sensitivity to environmental disruptions, such as noise Illnesses that cause pain or discomfort Neurological conditions such as Alzheimer's disease and Parkinson's disease For more detailed information about Parkinson's disease, go to Parkinson's Disease. Medication with side effects that include insomnia Grief, depression, and anxiety, to which the elderly are especially prone How Is Insomnia Treated? Sleep research has led to major advances in the treatment of insomnia. Many experts now consider sleeping pills to be overused, as well as dangerous because they can become addictive. They suggest that medication be used a last option, after other treatments have been tried. 5

Non-medicine treatment options include: Physical Relaxation If you are anxious about falling asleep, certain muscles in your body become tense and sometimes painful, interfering with sleep.

6 Non-medicine treatment options include: Physical Relaxation If you are anxious about falling asleep, certain muscles in your body become tense and sometimes painful, interfering with sleep. Physical relaxation techniques can help. Find a quiet, peaceful place in which to practice the following technique about 30 minutes a day: Lie perfectly still until you find the most comfortable position for yourself. Now deliberately tense up the muscles in your arms and legs as tightly as you can. Try to hold this tension for about a minute and then let the muscles relax gradually-first your legs, and then your arms. Now let your whole body feel as relaxed as it possibly can. Take a rest for five minutes and then repeat the procedure twice more. At the end of the session, try to concentrate on the feeling of your muscles and let them go as limp and relaxed as possible for the rest of the period. Try to make your breathing slow and steady as you relax. This technique is designed to teach individuals how their body relaxes and how to control relaxation and tension. Mental Relaxation Since stress and worry, including the worry about not being able to fall asleep, are often at the core of insomnia, many people have found that mental relaxation techniques can help them to feel less anxious and therefore sleep better. This method also requires finding a peaceful, quiet place to practice this technique for about 30 minutes a day: Try to relax your body first, by finding the most comfortable position for yourself. Then empty your mind of all thoughts by concentrating on one particular object in the room or a particular part of the room. After a minute, sit up, and then walk around for a bit. Then return to your position and repeat the exercise. Now think of a particularly happy time in your life that you really enjoyed. If you cannot immediately think of something, find a poster of some exotic place or beautiful scenery. Concentrate on imagining yourself in this place for about five minutes. Try to feel the sensations first in your neck muscles, and then in your arm and leg muscles, as they gradually become relaxed. After another few minutes, get up and walk around the room a bit. Then repeat the process. 6

7 This exercise differs from the physical technique in that it emphasizes controlling the psychological components of anxiety before attempting to relax your body. Other Techniques Other relaxation techniques to try include: Yoga or meditation Exercise (shown in studies to be an effective way to achieve a healthy sleep) Mind-body therapies such as guided imagery or hypnotherapy Reading while lying in a relaxed position Listening to music while lying in a relaxed position Having a soothing bath or shower before bed Massage, especially of the neck, shoulder, and leg muscles How Can I Avoid Insomnia? Prevention of sleeplessness is very much dependent on your ability to relax and learn techniques for sleeping well. Here are some tips to help improve your sleep: Learn to use physical and mental relaxation techniques. Establish a regular sleep schedule. This involves setting a regular bedtime and wakeup time and making every attempt to stick to it, including on the weekends. This will help to set the body's clock in a way that will make nighttime sleep deeper and more consistent. Avoid taking naps, especially in the afternoon. Exercise regularly during the day. Use the bed only for sleep and sex, not reading or watching television. If you do not fall asleep fairly quickly, get out of bed. Do not return until you are feeling drowsy. Try to reduce stress in your life, or find better ways to cope with stress. For more detailed information about coping with stress, go to Stress And How To Manage It. If it is noisy in your bedroom, introduce some form of "white noise" such as a rotating fan. Do not over-focus on falling asleep by watching the clock. Create a bedroom environment that is quiet, relaxing and peaceful. Set up a regular bedtime routine that revolves around an activity that helps you unwind. Avoid caffeine, and other stimulants, especially late in the day. Eliminate smoking. It has a detrimental effect on the lungs, heart, sinuses, and circulation, and it also interferes significantly with sleep, as nicotine is a stimulant that prevents the brain from resting. Cutting back on cigarette smoking may lead to nicotine withdrawal in the middle of the night, which can awaken you, so it is important to stop smoking completely. 7

8 For more detailed information about how to quit smoking, go to Smoking: How To Stop. Avoid alcohol. Even if it helps you fall asleep quicker, it actually worsens insomnia by causing shallow, unrefreshing sleep Frequently Asked Questions Here are some frequently asked questions related to insomnia. Q: What is the right amount of sleep I should get? A: Since everyone has different sleep needs, there is no "correct" amount of sleep. On average, most people need between seven and nine hours of good quality sleep each night in order to feel alert the next day. But some function perfectly well with only four or five hours a night. The key to healthy sleeping seems to be a consistent pattern, rather than the number of hours one sleeps. Q: How can I tell if I am getting enough sleep? A: Here are some simple questions to ask yourself to test for sleepiness: Do I need to set an alarm clock in order to wake up in the morning? If so, do I usually press the snooze button? Do I feel like I need a nap during the day? Do I fall asleep while watching TV? Does reading a book make me feel sleepy? If you answer yes to more than one of these questions, you are not getting enough quality sleep to meet your needs. Q: What can I do to avoid insomnia? A: Here are some rules to abide by: Don't exercise just before going to bed. Don't read or watch television in bed. Don't use alcohol to help you sleep. Don't take another person's sleeping pills. Don't partake in stimulating activities just before bed. Avoid all foods and drinks containing caffeine close to bedtime. Don't lie in bed fretting. If you can't sleep, get up and do some quiet activity. Only return to bed when you are sleepy. Do this as many times in a night as necessary. Q: Does insomnia ever go away on its own? A: Sometimes insomnia does go away on its own. Usually this happens with short-term insomnia that is due to some temporary stress in your life. When it persists, however, it may be a sign of another illness, such as anxiety or depression, and you should seek treatment. 8

9 Q: What is REM sleep and why is it important? A: REM sleep stands for rapid eye movement sleep. For most of the night, our eyes are still. However, every so often the eyeballs of a sleeping person will make rapid side-to-side movements under the lids. People woken up during these times report that they have been dreaming. During REM sleep the muscles of the body are very relaxed and movements are difficult. Some believe this semi-paralysis of the muscles stops us from walking around or otherwise acting out the scenes being played out in our dreams. Although adults spend only a fifth of the night in REM sleep, a newborn baby may spend half of its sleep in this stage. Some studies suggest that REM sleep is particularly useful for growth and repair of the brain itself, while the other type of deep, or slow-wave, sleep is useful for repair of the rest of the body. Q: Why is alcohol detrimental to sleep? A: After we have had a few drinks, alcohol often causes drowsiness and lets us get off to sleep quite easily. Later in the night, however, when the alcohol level in our blood decreases, our body's arousal mechanism is stimulated and our normal sleep pattern is impaired. In addition, one of the effects of alcohol is to stimulate the pouring of adrenalin into the bloodstream, causing arousal, sweating and palpitations. This can result in waking up halfway through the night, or earlier than normal, with the heart pounding, making it quite difficult to get to sleep again. SOURCE: File is PREPARED BY Ahmed Abd El-Hakim THE FILE IS DOWNLOADED FROM : 9

YOU REALLY NEED TO SLEEP: Several methods to improve your sleep

YOU REALLY NEED TO SLEEP: Several methods to improve your sleep Sleep is essential to our well-being. When humans fail to get good sleep over a period of time, numerous problems can occur. CAN T SLEEP!!