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Menopause and Insomnia

In this article I will focus on the sleep disorder experienced by women when they reach menopause.

What is Menopause?

Menopause is also known as the ‘change of life‘. It is the end of the menstruation cycle (monthly periods) in women. What really happens is that a woman’s ovaries stop producing an egg every four weeks. She will no longer have a monthly period and, in all probabilities, be unable to have children.

Although women can experience the menopause in their 30s or 40s; the average age for a woman to reach the menopause is 52 years. If a woman experiences the menopause when she is under 45 years of age, it is known as a premature menopause.

Menstruation can sometimes stop suddenly when you reach the menopause. However, it is more likely that your periods will become less frequent, with longer intervals in between each one before they stop altogether.

Menopause Insomnia

What is Perimenopause?

During peri-menopause you may notice that something is different – you may not know what, but you know it is. Peri-menopause refers to the years before menopause; hormone fluctuations can occur anywhere from the 2 to 10 years before a woman stops having her period. If you are aged 35-55, and you are still having periods but something is different about them, you are probably in peri-menopause.

The first sign of peri-menopause is often a change to your periods in some way. The time between periods, or the number of days your period lasts, or how much you menstruate – any, some or all of these could be altered.

Menopause and Insomnia

Many women going through menopause often experience certain sleep disorders / insomnia. Insomnia is the inability to fall asleep or stay asleep at night or waking up too early. This is a normal side effect of menopause and it is usually caused by symptoms of menopause, such as hot flashes.

Insomnia is a common complaint during peri-menopause too.

If you are experiencing either peri-menopause or menopause, then your insomnia will takes the form of an inability to sleep through the night. You would often wake up in the very early hours of the morning, and would also experience great difficulty in getting back to sleep.

Sometimes, these awakenings might also immediately precede a night sweat or at least a warm period wherein you would wish to throw off the covers. Sometimes you might wake up with your heart pounding and in a state of anxiety for no evident reason.

Some of you might also wake up due to some very vivid dreams. You would find it too hard to arrive at some valid reason for waking up 2, 3 or 4 a.m. and then find yourself unable to fall back to sleep for 20 or 40 minutes or even longer.

During menopause you might experience insomnia in other forms too. Symptoms of insomnia can include one or more of the following:

  • Difficulty falling asleep
  • Waking up frequently during the night with difficulty returning to sleep
  • Waking up too early in the morning
  • Non-refreshing sleep (feeling tired upon waking, and then throughout the day)

Why does Menopause cause Insomnia?

Science has been trying to understand this, as women are complex and each of us is unique as well. There is a complicated and delicate balance of hormones in women, such as estrogen, progesterone, testosterone, DHEA and pregnenolone. What we know is that hormones start to change with the aging process and often fall far out of balance in peri-menopause. This mismatch of hormone activity can impact the feel-good chemistry of the brain in many women and cause extreme emotions, including perimenopausal rage. It can also trigger hot flashes, night sweats, hair loss and restless sleep – just to name a few other symptoms.

Menopause is the result of a change in the balance of hormones in your body; sex hormones to be more precise in this case. Sleep is possible only when the body reaches and maintains a certain temperature. During menopause your body is unable to maintain a consistent temperature due to the fluctuating hormone activity.

Menopause cause Insomnia

Even if a hot flash isn’t apparent to you, you may find that your body temperature has risen to the point where continued sleep is impossible. It will then take a period of time before body temperature falls again and this will make getting back to sleep difficult for you.

A number of factors gang up in menopause to disturb you sleep. Hormone levels, health issues, lifestyle and situational stressors all play a role in whether you are able to get to sleep and then stay asleep too.

Broadly speaking, once you reach the age of 40 (and sometimes even before that), as a woman you may have trouble getting or staying asleep because of the following:

  • Your declining hormone levels which impact your sleep/wake cycle.
  • Hot flashes and night sweats that wake you up and may require you to say awake to recover or change bedding.
  • Health issues that wake you including thyroid problems, pain, breathing difficulties or other reasons for waking or discomfort.
  • Sleep apnea, which is related to both changing levels of estrogen and to weight gain – and both of these are common in menopause.

Life stressors – now these could be anything and everything from your ailing parents to surly teenagers, a divorce, job worries, money problems and family issues. All of these have the potential to keep you awake once you are awakened in the night in between your sleep.

  • Depression and/or anxiety that may or may not be related to any of the above
  • Diet and use of substances such as caffeine, nicotine, alcohol or supplements
  • Medications, both prescription and over the counter, with side effects that keep you awake
  • Poor “sleep hygiene” that sets you up to be awake when you want to be asleep.

How to Take Control of and Cure Insomnia caused due to Menopause?

There are a number of things that you can try for getting a better night’s sleep. I would recommend the following remedies, which I am sure will definitely be able to control your insomnia and also provide you some comfort:

  • Herbal teas would help a lot of you women fall asleep more easily. You an also try sleeping potions such as Calms Forte, Snoozers, Easy Sleep, Valerian Root (a natural sedative), all of which are sold at health food stores.
  • Certain herbal teas, especially Chamomile and Peppermint are useful too for curing insomnia related to menopause. It contains no caffeine, is pleasant to the taste and also produces relaxing effects.
  • Taking melatonin supplements may also prove helpful to some of you. Melatonin is a substance that helps many older people get a better night’s sleep. As we mature, our bodies do not produce as much Melatonin as they once did. Hence, a supplement is helpful. But, you should always seek your doctor’s advice before taking this supplement.
  • You should definitely give a try to the product developed by internist, gastroenterologist, nutritionist; Stephen Hold, M.D. called Sleep Naturally TM. It is an excellent remedy for sleep disorders and insomnia which contains many of the natural herbs in a proprietary blend. It is also available in most of the health food stores across the country.
  • You should never try or even think of using alcohol for inducing sleep. Alcohol may help you relax and fall asleep, but it should not be used as a sleep aid because it has a rebound effect. It can disturb your sleep later and can cause you to awaken in the middle of the night due to frequent urination.
  • You can however try having a cup of warm milk just before your sleep time. Milk contain a substance called tryptophan. The body uses this tryptophan to make serotonin, a chemical in the brain. Serotonin helps control your sleep patterns, appetite, pain and other functions. Milk does not contain enough tryptophan to change sleep patterns, but drinking a glass of milk just before bedtime may help you relax.
  • I would however, not recommend over-the-counter tryptophan supplements, as they are susceptible of being associated with a rare condition called “eosinophilia myalgia syndrome”, and hence can result in more harm than good to you.
  • If your insomnia persists and is seriously affecting your quality of life, you may even need a prescription for a mild tranquilizer to help you fall asleep. However, you should make sure that you do not start depending on these. Sleeping pills are meant for short periods of sleeplessness due to an unusually stressful event. Many sleeping pills are quickly addictive and the rebound insomnia when you stop taking them is worse than the initial insomnia.
  • It is possible for some of you to simply get used to the idea that you will be awake many nights for some period of time. If you try to stay calm and do restful, relaxing things with/during that time, the resultant sleep loss may not be too dramatic. Some of you might even feel good about being grateful for the extra time to catch up with reading and have some quiet time to yourselves while the rest of the household sleeps oblivious to your blissful state!
  • When lifestyle changes such as these fail to remedy insomnia, talk to your doctor. He or she may be able to prescribe temporary medicine to help you sleep and get you sleeping regularly. Your doctor can also rule out other conditions that may be causing your sleep problem. If depression is causing your sleep problems, doctor may prescribe an antidepressant.
  • When your insomnia is a result of menopausal symptoms, you may also want to talk to your doctor about taking hormone therapy (HT). This therapy may help alleviate symptoms that are causing your sleep problem.
  • Good sleeping habits like making your bedroom comfortable (dark, cool, with minimal or no noise) and maintaining a regular sleep-wake up cycle (going to bed and getting up at a fixed time daily) also help to check and cure your insomnia.
  • As hormone levels even out on their own, your insomnia would also becomes less of a problem. You need to be aware of the fact that it is quite normal to have these early morning awakenings.

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Zoloft Insomnia

The word “Insomnia” originates the Latin dictionary where “in” means “No” and “somnus” means “Sleep“. Insomnia or sleeplessness is a condition wherein even after a hectic day you find it very hard to have a good, night long sleep and wake up refreshed the next morning. More simply, it is the difficulty in falling asleep or remaining asleep or awakening too frequently during the night, comprehensively affects today’s population.

Sleep Maintenance Insomnia

Depending on the duration of existence of this sleep disorder in our lives and the different factors responsible for bringing it in; Insomnia is classified in different types. Doctors commonly treat insomnia with the use of certain anxiety reducing and sleep inducing drugs known as anti – depressants.

However, sometimes insomnia is also caused due to some drugs used to cure anxiety. One such anti – depressant is Zoloft. Zoloft works well in treating the anxiety and suicidal tendencies but at the same time plays havoc with your sleep.

Zoloft is the trade name for Sertraline hydrochloride and it is an anti – depressant of the selective serotonin reuptake inhibitor (SSRI) class. It is also available in the market with another trade name of Lustral.

Zoloft was introduced to the market in 1991 by the pharmaceutical giant Pfizer.

Primarily, Zoloft is used to treat major depressive disorder in adults as well as obsessive compulsive, panic and social anxiety disorders in both adults and children. The demand and acceptability for this drug can easily be gauged from the fact that Zoloft was the second most prescribed anti – depressant in the U.S. retail market in 2011 with approximately about 37, 208,000 prescriptions being made for it!

Zoloft InsomniaZoloft is not meant to treat insomnia. However, both Zoloft and insomnia are known for relating to each other because insomnia is one of the more common side effects of Zoloft. This relationship between the two is even more pronounced for those people who are taking Zoloft as a medication for their obsessive compulsive disorder.

Based on clinical trials of Zoloft, insomnia occurred in as much as 28 percent of people taking the medicine. People have reported terrible insomnia while being on Zoloft. They find it too hard to fall asleep without a sleeping aid and even then they cannot stay asleep for more than an hour. Their bodies have also become too resistant for the sleeping aids to function properly.

A small percentage of people using Zoloft have also reported experiencing panic attacks. All day long tiredness, loss of appetite, increased sweating, burning sensation in the eyes are also some of the other side effects of Zoloft.

It is basically impossible to prevent insomnia while taking Zoloft. If you have been prescribed Zoloft by your doctor and you suffer from insomnia as its side effect, then you should try following some good sleep habits such as avoiding caffeine four to six hours before you go to bed; not exercising within two hours of bedtime, exercising five or six hours before bedtime might help you sleep more soundly; and not taking a nap later than 3 pm. Such things could definitely help you in improving your condition.

You should also maintain a regular sleep – wake cycle by going to bed and waking up at the same time each day. You should also not take large meals within two hours of bedtime. If you find yourself turning and tossing in bed even after 20 minutes into your usual bedtime, you should get out of bed and do something else like reading a book or any other quiet activity. You can then return to your bed when you again start feeling sleepy. You can also try winding down half an hour before bedtime with a relaxing pre – sleep ritual like taking a warm bath, or listening to soft music or reading something that interests you.

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Yoga for Insomnia

Insomnia or sleeplessness is the condition where you find it hard to fall asleep at night or experience frequent awakenings during the night. This results in your feeling tired the following morning. If you experience incessant or frequent insomnia could also result in several other disorders like hypertension, depression; heart related ailments and other physiological and social problems.

A majority of your sleep disorders can be corrected by bringing in positive changes in your attitude and also to your lifestyle. However, if your insomnia is a chronic one and such positive changes do not have any effect on your insomnia, then you are most likely to go for the use of certain drugs / medicines / sleep aids (under the supervision of a qualified sleep specialist).

Yoga for InsomniaAlthough such drugs / medicines / sleep aids, which are also known as anti – depressants, appear to provide you some relief from your insomnia, they have their own side effects. These aids or anti – depressants do not get back your sleep in the natural way. Instead they coerce your brain to decrease its activities when the pills are popped and induce sleep in you. Also, it is very hard to get yourself out of the medication cycle as they have long-lasting side effects too. And even if you somehow manage to stop your medication, you might find your sleep fading away again.

This is where the so – called alternative therapies come to your rescue and can definitely cure your sleep disorder. And one such alternative therapy is Yoga.

Insomnia is fast becoming a household problem affecting all ages in the present times due to the huge amount of stress being faced by us. School / college going children continuously face the stress of studies and competition; grown ups have to face work or relationship related stress and so on. Constant piling up of the stress is the major reason for the insomnia being faced by us.

Incorporating yoga in to your life can immensely help you in controlling and curing your stress related insomnia. Yoga has proven to be a great stress buster and can offer you different relaxation techniques, which also include breathing exercises and meditation. One such deep relaxation methodology known as Yoga Nidra (where Nidra means Sleep), can be particularly helpful if you have trouble sleeping.

The procedure of Yoga has a number of poses or postures which are known as Asanas. So, while there isn’t one specific pose that will automatically send you in to a deep sleep; still Yoga can be an effective sleep aid as part of your healthy lifestyle. Hence it would be a good idea to establish a regular Yoga practice, even if you can do only a few poses a day. Yoga includes a lot of stretching of your body. This regular stretching your body helps in releasing the stress and the accompanying tension.

Yoga postures also focus on your breath. This also encourages you to tune in to the present moment and allows you to stop worrying about things that have had happened in the past or which might happen in the future.

While practicing Yoga you may chose to include a few breathing exercises or gentle stretches in your regimen to relieve yourself of the tension and help you relax. The Yoga exercise “Three part Breath” is very helpful for clearing the mind of the day’s clutter and is a good choice at bed time.

You can start with some stronger poses that will help you let off the steam of stress that builds up when the mind gets to running and sleep seems miles away. You can then move in to postures that balance the adrenals thereby creating a mellower central nervous system. You can stretch the back body to relieve the itchy, restless leg syndrome that happens when stress hormones build up in the muscles tissues.

Yoga poses which can be done at bedtime and that too while lying in bed include “Happy Baby (Ananda Balasana). It releases the low back and hips, and you feel more relaxed.

The Goddess (Supta Baddha Konasana) pose, which opens your groins and the Legs up the Wall (Viparita Karani) pose are a few of some other good option to relax.

The Corpse (Savasana) pose ends every yoga class and the same is a good way to end your day too. In this pose you lie on your bed focusing on each part of your body and softening it before moving on. You begin with your toes, move up the legs and arms, through the torso to the neck, face and head. Then you spend a few minutes just breathing. If you find your mind wandering during this time, do not engage in your thoughts, instead you should bring your attention back to your breath.

Insomnia & Yoga

This exercise will help create a break from your active mind and allows you to relax for the sleep. This pose is a restorative and relaxing pose which will still your mind and cleanse and release you from the responsibilities of your day.

You can also try the following Yoga program to effectively control your insomnia and find your night long sleep:

  1. Step your right foot forward and your left leg back into a lunge stance. Your front knee should be over your heel, or behind it, and your back heel is over the ball of your foot. Inhale, and lift your arms up. Exhale a little more strongly, sweep fists into the side of your hips. Let the inhales bring more breath into your chest, and on the exhales, draw in the navel as you lengthen your tailbone down. Practice releasing more tension on every exhale.You should take five to 10 rounds of breath on one side, and then switch legs.
  2. After this, come to stand with feet hip distance apart. Bend your knees and fold forward, bringing your fists into opposite elbows. This helps to relax the large muscles of your back, shoulders and neck. Release your head completely, and let the jumble of thoughts drain out as you envision the space that’s left behind.You should repeat this for 15 to 20 breaths.
  3. Come to sit in Janu Sirsasana with your right leg extended and your left leg bent, foot into the right inner thigh or groin. Roll the flesh of your seat back, and ground your legs into the floor. Frame your long right leg with your hands (lifted onto fingertips), and fold forward with a long spine and open heart.You should take five to 10 breaths here, and then proceed to the next variation on the same side.
  4. Remain low in the pose, and walk your hands away from your straight leg toward center between your legs, or until you can feel a stretch along the groins and inner thighs. You may want to move your bent leg wider, until the foot rests in its own inner thigh. As you fold, keep your head lifted along a straight spine. Fold at your hip creases — not your lower or mid back — for the best possible stretch.You should take five to 10 breaths here, and then come slowly to sit, shake out your legs, and switch sides.
  5. Come to lie on your back, legs extended on the floor. Interlace your fingers behind your head, and lift the shoulders off the floor. Inhale at center, and exhale, draw your right knee into the chest, and twist so both your elbows are pointing at the knee. Inhales as both legs lengthen, and exhale, twist with the left knee in. Keep your feet on the ground, or for more action, lift them an inch off the ground. Exhales tone the navel toward the spine as your low back lengthens.You should take five to 10 rounds on each side, then relax the head, shoulders and feet to the floor, reach overhead and take a full body stretch to counter pose.After the above posture, cool it down and counter-stretch the front body by getting back into bed and placing a pillow or bolster beneath the heart. Let your arms rest to your sides, palms up to receive the blessing of calm that comes after a strong, breath-conscious practice.You should breathe here for one minute or more, and then come to the last pose.
  6. Now, this is the one which I told you earlier too. It is now here in detail. Move the pillows or bolster under your hips, and lift your legs up the wall or into the air. This is a full-body detox only when your legs and hips are higher than your heart, and the head is below the heart. Once you’re situated, keep your hands by the sides or clasp your elbows overhead, rest and breathe.Practice the slow breath here: Inhale, pause for a few seconds, exhale, and pause. Allow your breathing to slow, and follow the sound with your mind.

Know that as you cleanse and center from your day, the tools of yoga are always available to you. Practice often and you’ll master the ability to switch off the mind and rest easier.

Just make sure that you take slow but deep breaths through your nose during the entire period.

Yoga can be your effective snooze inducing ally. Yoga has been proven to calm the mind, relax your body and release all anxiety, which are all the crucial components for you to drift off in to a good quality night long sleep without the frequent awakenings.

For effective results you should include Yoga in your bedtime ritual. Experts have pointed out to the efficacy of creating a standard night time routine in order to signal your body that now is the time to prepare for sleep. Yoga does not have any of the ill side – effects which are associated with the use of anti – depressants.

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What is Anxiety?

Anxiety

Anxiety, in the simplest of terms, is a general name for several disorders that cause nervousness, fear, apprehension, worrying and typical conditions like these. Anxiety is also known as angst or worry.

Insomnia - What is AnxietyAll of us confront anxiety of varying degrees depending on the situation the anxiety is being caused of. Anxiety affects how you feel and behave. It is often a psychological and physiological state accompanied by various physical symptoms like reddening of cheeks/ears, sweating, shivering etc. Anxiety is also associated with feelings of restlessness, fatigue, problems in concentrating, and tension in the muscles. You would experience an ongoing worry and tension, have an unrealistic view of the problems and even feel edgy about anything.

Anxiety is a normal human emotion which every one of us experiences at certain times and in certain situations. Anxiety occurs when your reaction is out of proportion with what might be normally expected in a situation. We often experience a general state of worry or fear before confronting something challenging such as college examination, test, debate, public speaking, recital, job interview, problem at work, before making an important decision. These feelings are easily justified and are considered totally normal.

Is Anxiety and Fear the Same?

You should, however, not confuse anxiety with fear, as fear is more of a dreaded feeling about something, which appears intimidating and can overcome a person. Fear is concrete (a real danger of something), whereas anxiety is a paranoia of something in your environment that seems frightening but may not be such, and in many cases, may not even be present out there.

Moreover, your fear is related to the specific behaviors of escape and avoidance, whereas anxiety is related to situations which you perceive as out of control or inescapable.

When Anxiety does become a Dilemma?

While most of us, or rather all of us, experience anxiety on different occasions in our lives as a common reaction to real or perceived threats of all kinds, most of us do not develop long term problems with anxiety. When someone does develop chronic or severe problems with anxiety, such problems are usually classified as being one or more of the specific types of anxiety disorders.

Anxiety is considered a problem when these symptoms interfere with your ability to sleep or carry out other daily functions. Anxiety disorder is a serious mental illness. People who suffer from anxiety disorders consistently and overwhelmingly remain under crippling worry and fear.

All abnormal and pathological anxiety is classified under the blanket term “anxiety disorder“. These conditions come under the aegis of psychiatry. Studies and surveys reflect that more than 17% of the American population may be affected by either one or the other form of anxiety.

How does Anxiety affects your Body?

Anxiety can take several form viz. phobia, social anxiety, and obsessive–compulsive–post traumatic stress. This could result in heart palpitations, muscle weakness and tension, nausea, fatigue, headache; shortness of breath, stomach aches etc. Your heart rate, blood pressure and perspiration is also increased and your digestive functions and immune system of your body are also repressed.

Insomnia -  Anxiety affects your Body

You could also exhibit some external physical signs of anxiety that could include sweating and trembling. Even your pupils (eyes) would also appear to be dilated.

Anxiety can also have some emotional effects upon you. You may have feelings of apprehension or dread, trouble in concentrating, feeling tense, anticipating the worse, restlessness etc. You also might constantly be watching/waiting for the signs of danger and you may start to feel that your mind has gone totally blank.

Anxiety has some cognitive effects too upon you. These may include thoughts about suspected dangers, most common being the fear of dying. You may fear that your headache could be happening due to a tumor in your heart and the tumor might burst anytime causing death to you. Or you may start feeling the slight redness in your eyes could result in your losing your precious eyesight. When you suffer from acidity and burning sensation in your stomach and chest, you then might start thinking that this is happening due to some ulcer in your stomach which will ultimately take your life. During such situations you would feel intense fear of dying, and you would find it hard to pull such unwarranted fears out of your mind.

Anxiety could have some behavioral effects too, the commonest of which could be your withdrawal from situations which have resulted in provoking anxiety in you in the past.

Why Does Anxiety Happen?

A huge amount of research has been done on the condition of human anxiety. From these researches it has been explained that increased anxiety serves the purpose of increased vigilance regarding potential threats in our environment as well as the increased tendency to take proactive actions regarding such possible threats. Anxiety may cause false positive reactions in you, but due to these false reactions chances are that you may also be able to avoid real threats. You must have also noticed that people who are anxious to a great extent, are less likely to die due to accidents!

So, you can say that anxiety is a protective mechanism too, which has been designed to prevent us or any other organism on this planet, from engaging in potentially harmful behaviors/activities.

Anxiety can sometimes be caused due to some underlying health issues like heart failure, chronic obstructive pulmonary disease (COPD) etc.

Anxiety Types

Anxiety disorders can be classified into several specific types, which are being explained in brief here:

Test and Performance Anxiety: I can bet on this, that all readers of this article (and that includes me too) have experienced this commonest form of anxiety at some point of our lives. This type of anxiety is the uneasiness, apprehension or nervousness felt by us whenever we fear of failing an exam or a test. We fear that if we do not get good grades then we might face embarrassment by our teacher(s); we might be alienated from our parents and friends and such other feelings.

This kind of anxiety could also result from the time pressures of our work or when we have a feeling of a loss of control at work. Test and performance anxiety could cause sweating, dizziness, increased heart rate, drumming our desks etc. The fear of failing at a task and being negatively evaluated for failure also results in this kind of anxiety.

A lot of debate has been carried out of this kind of anxiety that since this anxiety type hinges on fear of negative evaluation, should it not be treated as a unique anxiety disorder or whether it is a specific type of social phobia.

Insomnia - Anxiety TypesStranger and Social Anxiety: This kind of anxiety is a common developmental stage in young people while meeting or interacting with unknown persons. I think you would now remember how you used to shy away whenever your mom or dad greeted their friends in the park or in the mall who you were not seeing too often or haven’t had seen before. Then your parents would coax you to say hello to the new person. And most of the times you would try to prevent yourself of such a situation of meeting someone you didn’t knew. Remember now!

This kind of anxiety happens because we as human beings are a social species who require social acceptance. And we also dread the disapproval of others. It is this apprehension of ours of being judged by others that is the basic cause of this kind of anxiety.

As we grow up this kind of anxiety wanes away on its own. However, for some of us it remains in varying degree and severity. In severe cases it can lead to a fear of interacting with unfamiliar people altogether. People can also restrict their lifestyles to accommodate the anxiety, minimizing social interactions whenever possible.

This kind of anxiety also forms the core aspect of certain personality disorders like Avoidant Personality Disorder etc.

Generalized Anxiety: It is also known as the Generalized Anxiety Disorder (GAD) this results from overwhelming anxiety and is identified by symptoms of exaggerated and excessive worry, chronic anxiety and constant irrational thoughts. These irrational thoughts are difficult to control and they can cause serious mental anguish interfering in your normal, daily functioning.

GAD is established when a person experiences chronic anxiety and excessive worry on daily basis, for at least six months. This anxiety could be due to a number of stress causing factors either at school/college, work and even home. The person also experiences 3 or more defined symptoms, including restlessness, being easily fatigued, mind going blank, irritability, sleep disturbance etc.

If you are suffering from GAD, you would often feel afraid and worry about health, money, family, work or school, but you will have trouble both identifying the specific fear and controlling the worries.

If the symptoms of chronic anxiety are not taken care of and treated during adolescence then the person significantly runs the risk of developing anxiety disorder in adulthood. This can even lead to depression.

GAD is treated through specialized therapies aimed at changing the thinking pattern of the affected person thereby reducing the anxiety producing behaviors.

Choice or Decision Anxiety: Hmmm… this is also one of the common anxieties being faced by us in these times. An endless number of choices are available to us for all our things, but we are short of time too to consider our options. This scenario results in anxiety not only for individuals but for organizations too. It is quite difficult to choose between similar options.

The first form refers to a choice in which there are multiple potential outcomes with known or calculable probabilities. The second form refers to the uncertainty and ambiguity related to a decision context in which there are multiple possible outcomes with unknown probabilities.

Paradoxical Anxiety: This kind of anxiety arises from the use of methods or techniques which are being used to reduce anxiety, like relaxation or meditation techniques or the use of certain medicines. You would worry about the effectiveness of your treatment on your anxiety. This anxiety type can be taken care of by controlling your mind and diligently following your treatment regimen.

How to Treat Anxiety Disorders?

Due to the ongoing research on anxiety disorders, much progress has been made in the last 2 decades in the treatment of people with anxiety disorders. Although the exact treatment approach depends on the type of disorder being faced, the treatment to cure anxiety disorders would include one or more of the following therapies:

Anti–depressants and anxiety reducing drugs are the are used to reduce the symptoms of anxiety.

To address the emotional response to mental illness, counseling like psychotherapy is also used. It is a process in which trained mental health professionals help you by talking through strategies for understanding and dealing with their disorder.

Insomnia - Anxiety Treatments

A type of psychotherapy, known as Cognitive Behavioral Therapy is also widely used to treat people suffering from chronic anxiety or anxiety disorders. In this you would learn to recognized and change his/her thought patterns and behaviors that lead to troublesome feelings.

Anxiety is also controlled through bringing–in changes to your dietary habits and to your lifestyle. You would be asked to limit or totally forgo your caffeine intake. You would also be directed towards more positive thinking.

Hypnotherapy has also proved quite helpful in the treatment of general anxiety, phobias and post–traumatic stress disorders.

Certain relaxation therapies like meditation, deep breathing and yoga are also helpful in treating your anxiety and they can make a world of difference to your life.

Aromatherapy is also very good at control your anxiety. Surrounding yourself with the right essences can really help reduce anxiety. Lavender is said to be the most effective, but other essential oils that can help with anxiety include jasmine, rose, sandalwood and melissa. You can enjoy aromatherapy either in a bath, or burn the oils while you rest and relax.

Many traditional herbal remedies are also available for anxiety. These remedies have been used for centuries in many parts of the world. Some of the common and widely used herbs to treat anxiety are Kava, Passion flower, Magnolia bark etc.

So, if you have been noticing yourself being too much anxious without any valid reason, it would be better to straightaway take the remedial course using some of the above mentioned alternative therapies. I am sure they would help you a lot in overcoming and controlling your anxiety. If they do not prove useful (which I think otherwise), then you should visit a doctor and seek professional advice.

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Trazodone for Insomnia

What is Trazodone?

What is TrazodoneTrazodone or Trazodone Hydrochloride is a common prescription drug used in the treatment of depression (which is also known as clinical or major depression). A number of conditions can be treated in an “off – label” fashion with Trazodone, insomnia being one of them. Here “Off Label” means that the drug is not purposely manufactured for those purposes; it is not FDA approved for the use; but it is commonly used regardless for its proven effectiveness.

Basically it is a sedating antidepressant, meaning that it will likely cause drowsiness. This drowsiness is in fact a side effect of Trazodone and is beneficial for people who have insomnia. While drowsiness can be bothersome for most of us, it is really beneficial if you are suffering from insomnia. Trazodone is usually taken in small doses just before bedtime. For this particular reason, Trazodone is also used for treating insomnia, although the drug has not been approved for this line of treatment. Trazodone is especially useful for treating people who are facing insomnia due to depression as the drug is effective for both conditions. Trazodone can even be used to treat insomnia caused by other antidepressant medications.

How Trazodone Works?

It is not precisely known how Trazodone works. However, the mechanism of antidepressant like Trazodone is very different from that of the straightforward sleep medications. Trazodone acts on neurotransmitters (chemical messengers within our brain. Serotonin provides mood stability and when in small supply creates depression symptoms including mood disorders and the symptoms associated with insomnia). The compounds in Trazodone stimulate serotonin (a neurotransmitter) in the brain, which is a part of the complex neurological process, to build up in spaces between the nerve cells by blocking its uptake in the nearby cells.

When Trazodone is used for curing depression, it is usually taken up to three times in a day. But, when it is used for treating insomnia, it is taken only once just before bedtime. The dosage is also lower for insomnia than for depression.

As a sleeping aid Trazodone can be used as a treatment for a longer period of time than many other popular sleep aids.

Trazodone’s has a half – life of 3 – 6 hours, which means that it is most likely to be used as a treatment for sleep onset insomnia or middle insomnia patients.

Common Side Effects of Trazodone

Many potential side effects are associated with the use of any drug. Although you would not be expected to experience most of these side effects, in fact you may not have even one of them; still the following side effects are common to Trazodone use:

Sleepiness, Dizziness, Lightheadedness, Dry Mouth, Headache, Blurred Vision, Nausea, Vomiting, Fatigue, Palpitations, Low Blood Pressure, Muscle Pain, Confusion, Diarrhea, Rash on Skin, Coordination Difficulties.

Trazodone Insomnia

In you are suffering from insomnia and have been advised Trazodone by your doctor then it’s so called side effects like sleepiness and dizziness would not be the side effects for you. You would in fact see those as a cure to your insomnia.

Trazodone use has some serious side effects too like abnormal heart rhythms; high blood pressure; hallucinations; seizures; anemia; hepatitis; stroke; and in rare cases even suicidal thoughts.

Issues with Trazodone

Many people who had been experiencing severe insomnia and were advised Trazodone by their doctors, have reported no side effects! For them it is their little bit of heaven and has been working great. Every night just before going to bed they take their recommended dose and happily turn off the light.

People have also reported going to sleep much quicker. They have started having deep and longer sleep periods than before.

At the same time, however, people have reported that after starting on Trazodone initially they slept well. It took them only around 10 minutes maximum to fall asleep. But when they used to get up they had balance issues and even felt a bit dizzy. After a year of their being on Trazodone, suddenly it (Trazodone) stopped working for them altogether. They even started experiencing the other side effects associated with the use of Trazodone and had to see their doctor who ultimately stopped the drug.

Precautions while using Trazodone

If you are thinking on using Trazodone you should use the drug with extreme caution. It is very important that you are monitored by your doctor as you begin with your medication and when any changes in its dose are made. Suicidal symptoms or unusual behavioral changes should be watched for. If you face any difficulty while taking Trazodone you should immediately contact your doctor.

Antidepressants are very powerful drugs. You should take Trazadone only under the advice and constant supervision of your doctor who is fully aware of your insomnia and the possibly associated depression. You should also consider the side effects of the drug use before actually going for it.

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Terminal Insomnia

What is Insomnia?

Insomnia, or sleep disorder, as it is commonly known, is the difficulty in falling asleep or remaining asleep or experiencing frequent awakenings during the night. During these faced paced and stressful times, insomnia has comprehensively affected today’s population all around the planet.

Understanding human sleep has been and will remain an unsolved mystery to the scientific fraternity. Some people have a tendency to fall asleep within no time of lying in bed while it is a real war for some of us. This could be due some genetic issues but it still remains unresolved.

Terminal Insomnia and Its Effects

Insomnia is of different types and of varying degrees. Depending on the duration of existence of this sleep disorder in our lives and the different factors responsible for bringing it in; Insomnia is classified in different types.

Terminal Insomnia

One such sleep disorder is Terminal Insomnia. This medical condition affects your sleep patterns and is also widely known as late insomnia. It is a frustrating condition in which you do not face any problem while falling asleep as soon as you hit your bed; but you wake up too early in the morning. You might wake up only in three-four hours into your sleep and no matter how hard you try; you find it impossible for you to fall asleep again. It also doesn’t help even if you go to bed earlier than your usual time or stay in bed for a longer time.

All this leaves you feeling exhausted, un-rested, and foggy when you get out of your bed to start your day. During the day too you would not feel refreshed, remain irritable, find it hard to concentrate on your work, and would find yourself being caught napping by your colleagues.

Why Terminal Insomnia Happens to Us?

The major factors and causes of inducing terminal insomnia are related to emotional stress, and physical pain and/or illness.

During these times stress is easily available to us. You won’t have to go searching for it. Our fast paced lives, work schedules et al all culminate in giving stress to our minds and bodies. This constant buildup of stress causes frustration and anxiety; and all of this anxiety plays havoc with our sleep patterns.

Some kind of physical illness or injury, which results in constant pain results in the increase of stress hormones in our bodies thereby affecting our sleep patterns and resulting in terminal insomnia.

If your digestive system is not working properly, then chances are that you may experience terminal insomnia too. If your body is unable to digest food normally and properly, then your body will take more time to digest food. The energy produced by late digestion would make you awake early during the night.

How to Treat Terminal Insomnia?

Terminal Insomnia TreatmentInsomnia, and it doesn’t matters of what kind, does not have just one cause or, for that matter, one solution.

I you really want to treat your terminal insomnia, and I am sure you really do, then the best way to do this is to simply cure the root cause(s) which is resulting in this condition. Once you determine the cause(s) of your insomnia, you can then easily determine the ways to effectively cure them.

You can also evaluate your circumstances and then try any, or a mix or even all of the following simple things to cure your sleep disorder:

  • Ensuring a daily bedtime routine prepares your mind and your body to sleep and wake-up at a fixed time daily. Experts have pointed out to the efficacy of creating a standard night time routine in order to signal your body that now is the time to prepare for sleep
  • You can also include Yoga and other relaxation techniques in your bedtime ritual. These are very effective in reducing your stress levels and in helping you achieve a normal sleep.
  • If your terminal insomnia is due to a bodily injury or some physical illness like joint-pain, then ask your doctor to prescribe medicine to alleviate the pain. This would also ultimately help you in sleeping properly.
  • Sometimes certain allergies are also responsible for playing with your sleep. If you are allergic to certain environments, like very early mornings, then you should seek a doctor’s advice to control your allergy. This would then help you in maintaining proper sleep as well.
  • You should also bring-in positive changes in your sleeping environment (your bedroom) and make sure that it isn’t too noisy or too lighted up when you go to sleep. Maintaining a normal room temperature is also an important factor for you to stay asleep through the night.
  • If you think that your terminal insomnia is being caused due to some emotional stress which you may be experiencing but are not fully aware of, then you should keep a diary along with you while sleeping. After you wake-up, the first thing you should do is, write down your thought and feelings. Since the emotional reasons, if any, might be in your subconscious mind; this record of your first thoughts will help you determine if there are any emotional reasons or any kind of fear, stress, worry or anxiety, which are hindering your sleep.

Every Short Sleeper is not a Terminal Insomniac

But don’t be too afraid to assume yourself suffering with terminal insomnia even if you sleep too little. You might be one of the “short sleepers“, who do not need as much sleep as most people do, and you can get along fine even with a few hours of sleep. If you feel well rested, refreshed and alert during the daytime even when you are sleeping around 5 hours every night, then you have no issue to worry about, my friend. That much amount of sleep is good for you and mark my words, most of the people around you would envy you for this fact!

If, however, if you never have been a short sleeper, and you are now finding yourself increasingly exhausted during the night, after sleep of short duration during the previous night, then you could very well be experiencing terminal insomnia. And then, it calls for some remedial action on your part.

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Sporadic Fatal Insomnia

What is Sporadic Fatal Insomnia?

Insomnia is a difficult condition for anyone to deal with at the best of times, but there is a variation of insomnia called sporadic fatal insomnia. It’s an extremely a rare condition which physically affects an individuals ability to sleep. It does this to such an extent that every known case has proven fatal.

Sporadic Fatal InsomniaSporadic Fatal Insomnia (SFI) is a rare genetic disease found in humans. It is a subtype of human prion disease, whose clinical and neuropathological phenotype is very similar to Familial Fatal Insomnia (FFI), which too is a genetic and also a hereditary sleep disorder.

Technically speaking, SFI patients reported until now were all homozygous for methionine (it is a protein based amino acid that helps with metabolic function), at codon (the sequence of genetic code) 129 of PRNP with deposition of type 2 PrPres (Parchi classification) in the brain.

Huhhh… such technical jargon always goes way above our heads. But do not worry, as I will now explain it to you in more simple terms. As you are aware, all living things are made up of minute structures called cells. A cell is said to be homozygous for a particular gene when identical alleles of the gene are present on both homologous chromosomes. The cell or organism in question is called a homozygote. True breeding organisms, like human beings, are always homozygous for the traits that are to be held constant.

Something about DNA and RNA

DNA (Deoxyribonucleic Acid) is a molecule that encodes the genetic instructions used in the development and functioning of all known living organisms and many viruses. Along with RNA (Ribonucleic Acid) and proteins, DNA is one of the three major macromolecules that are essential for all known forms of life.

In our bodies, and every other living creature, DNA is organized in large structures called chromosomes and these chromosomes are responsible for the different genetic traits that the living beings exhibit.

DNA is basically composed of proteins and when it mutates, a change in the structure of the proteins takes place. It might also happen that during this mutation a chromosome attaches a part of itself to some other chromosome.

The genetic code is the set of rules by which information encoded within genetic material (DNA or mRNA sequences) is translated into proteins (amino acid sequences) by living cells. Biological decoding is accomplished by the ribosome, which links amino acids in an order specified by mRNA, using transfer RNA (tRNA) molecules to carry amino acids and to read the mRNA three nucleotides at a time. The genetic code is highly similar among all organisms, and can be expressed in a simple table with 64 entries.

The genetic code defines how sequences of these nucleotide triplets, called codons, specify which amino acid will be added next during protein synthesis.

Unlike the more common type of insomnia that you or I may suffer from, Sporadic Fatal Isomnia is not caused by external influences such as stress, anxiety, diet or other difficulties. Rather, it is an internal condition caused by a deficient protein called prion.

Sporadic Fatal Insomnia (SFI) and Fatal Familial Insomnia (FFI) are very rare autosomal dominant inherited prion disease of the brain. It is almost always caused by a mutation to the protein but can also develop spontaneously in patients with a non-inherited mutation variant.

What is a Prion?

Sporadic Fatal InsomniaThe “Oxford Dictionary” defines a prion as “an infectious agent composed primarily of protein“. These prions build up in the brain and, over time, destroy the nerve cells. Creating what are best described as sponge-like holes in the brain; prions attack the thalamus – the region of the brain that is responsible for regulating your sleep.

In the unfortunate anybody suffering from Sporadic Fatal Insomnia, he/she will be robbed of the sleep and, usually in less than a year after the onset of SFI, conditions would be life threatening for them.

Are SFI and FFI Similar?

SFI is quite similar to the other inherited condition known as Fatal Familial Insomnia. However, SFI differs only in that it affects people who do not appear to carry the genetic mutation of FFI. Instead, true to its name; it is sporadic, striking random people without warning.

The mutated protein, called PrPSc, has been found in just 40 families worldwide, affecting about 100 people; if only one parent has the gene, the offspring have a 50% chance of inheriting it and developing the disease.

The first recorded victim was an Italian man, deceased in Venice in the year 1765. Only eight cases of SFI have ever been diagnosed. In SFI there is no mutation in PRNP-prion gene in D178N, but all have methionine homozygosity at codon 129.

Characteristics of SFI?

Insomnia SFIAlthough scientists had described a probable case of SFI in 1997, the disease was definitively established in 1999 by both Mastroianni et al and Parchi et al utilizing the term Sporadic Fatal Insomnia.

The age of onset of SFI is variable, ranging from 18 to 60 years, with an average of 50. However, the disease tends to prominently occur in later years. In women, SFI primarily occurs following delivery. The disease can be detected prior to its onset by genetic testing. The presentation of the disease varies considerably from person to person, even among patients from within the same family. Death usually occurs between 7 and 36 months from onset.

Parchi and colleagues reported five such cases in subjects between the ages of 36 and 70 years (mean 50) with duration of illness ranging from 15 to 24 months (mean 17.8). An additional ten patients have been reported in the literature as suffering from SFI, expanding the age range to 30-74 and the disease duration to 13-73 months.

Diagnosis of SFI

In patients with suspected prion disease, a characteristic, change in sleep pattern can be an important clinical clue for identifying SFI or FFI; polysomnography (PSG), genetic analyst and nuclear imaging may also aid in diagnosis.

Like FFI, SFI is characterized pathologically by thalamic atrophy and clinically by disrupted sleep, autonomic dysfunction and motor abnormalities; including myoclonus, ataxia, dysarthria, dysphagia and pyramidal signs. Other clinical features consist of peculiar behaviors that can be mistaken for psychotic signs. Since the people suffering from SFI are deprived of sleep they may display drowsiness during the day, which may be described as hypersomnolence (excessive sleep during the day), unless the abnormal nocturnal sleep pattern is recognized by electroencephalogram (EEG) and /or polysomnography (PSG).

It’s unlikely that sporadic fatal insomnia will be mistaken for common insomnia. The symptoms, whilst possibly similar at first, soon show their differences. Having said that, it’s speculated that cases of dementia may have been diagnosed incorrectly, supporting the theory that there have been more cases of sporadic fatal insomnia than have been reported.

An Example

The rarity of this disease makes the diagnosis of SFI quite challenging. To pronounce it more specifically, I present the following clinical and pathological details of a patient whose SFI diagnosis had not been considered before the patient’s actual death.

The patient developed trouble walking properly, and could not swallow properly. The patient started witnessing a loss of short term memory; and also a loss of power to distinguish between reality and his/her infrequent, troubled dreams.

Different Stages of Sporadic Fatal Insomnia

SFI has four stages and it usually take 7 to 18 months to run its full course:

  1. The patient suffers increasing insomnia, resulting in panic attacks, paranoia, and phobias. This stage lasts for about four months.
  2. Hallucinations and panic attacks become noticeable, continuing for about five months.
  3. Complete inability to sleep is followed by rapid loss of weight. This lasts for about three months.
  4. Dementia, during which the patient becomes unresponsive or mute over the course of six months. This is the final progression of the disease, after which death follows.
  5. Other symptoms include profuse sweating, pinpoint pupils; the sudden entrance into menopause for women and impotence for men; neck stiffness, and elevation of blood pressure and heart rate. Constipation is quite common as well.

As it would be clear from the above facts, prion diseases like SFI, have an unusual presentation. Hence, it is important to pursue a thorough sleep history when prion disease is being suspected/considered.

What Treatment Exists for SFI?

Treatment Insomnia SFIIn late 1983, Italian neurologist/sleep expert Dr Ignazio Roiter received a patient at the University of Bologna hospital’s sleep institute. The man, known only as Silvano, decided in a rare moment of consciousness to be recorded for future studies and to have his brain harvested for research in hopes of finding a cure for future victims.

As of 2013, no cure or treatment has yet been found for SFI. Gene therapy has been thus far unsuccessful. While it is not currently possible to reverse the underlying illness, there is some evidence that treatments that focus solely upon the symptoms may improve quality of life.

It has been proven that sleeping pills and barbiturates (drugs that act as central nervous system depressants, and can therefore produce a wide spectrum of effects, from mild sedation to total anesthesia) are unhelpful. However, on the contrary, in 74% of cases they have been found to worsen the clinical manifestations and hasten the course of the disease. And hence, a lot of debate exists on their efficacy.

It has been reported that one patient was able to exceed the average survival time by nearly one year with various strategies, including vitamin therapy and meditation, using different stimulants and narcoleptics and even complete sensory deprivation in an attempt to induce sleep at night and increase alertness during the day. He managed to write a book and drive hundreds of miles in this time but nonetheless, over the course of his trials, the patient too succumbed to the classic four-stage progression of the illness.

In the late 2000s, a mouse model was made for SFI. These mice expressed a humanized version of the PrP protein that also contains the D178N SFI mutation. These mice appear to have progressively fewer and shorter periods of uninterrupted sleep, damage in the thalamus, and early deaths, similar to humans with SFI.

Sporadic familial insomnia is a devastating neurological condition that invariably leads over just a few months to severe disability and death. Fortunately, sporadic fatal insomnia is an extremely rare condition. Just because you have some of the symptoms of this disease, you do not necessarily have sporadic fatal insomnia.

If you find yourself deprived of sleep constantly, try finding out the root causes. You should try to control your stress and reduce anxiety. You should also include positive lifestyle changes in your daily life. If these simple things do not help in alleviating your insomnia, then you should visit your primary health provider for further consultation and advice.

Always be positive.

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Sleep Terrors

I wished I never had to write on this particular topic; because believe it or not, I myself had been (what should I say), a victim (if I may say so), of sleep terrors. This phenomenon started just as I was about to say goodbye to my sweet teenage period and step into adulthood. I continued to experience these sleep terrors almost for a period of 5 years, and I know exactly what it feels to experience these.

Human Sleep

Sleep is divided into two categories of rapid eye movement (REM) and non-rapid eye movement (non-REM). Non–REM sleep is further divided into four stages, progressing from stages 1-4. Night terrors occur during the transition from stage 3 non-REM sleep to stage 4 non-REM sleep, beginning approximately 90 minutes after you fall asleep.

Insomnia Sleep Terrors

What is a Sleep Terror and Why does it Occur?

Sleep Terror is also known as night terrors or pavor nocturnes. It is basically a parasomnia disorder (something that is related to sleep and beyond). Sleep terror causes feelings of terror or dread. It typically occurs in the first few hours of your sleep. Technically speaking, this happens during stage 3 or 4 of your non-rapid eye movement NREM sleep.

Sleep terrors are caused by over-arousal of the central nervous system (CNS) during sleep. This may happen because the CNS (which regulates sleep and waking brain activity) is still maturing. Some kids may inherit a tendency for this over-arousal. About 80% who have sleep terrors have a family member who also experienced them or sleepwalking which is a similar type of sleep disturbance.

You would mostly find sleep terrors to occur to you during your periods of arousal from delta sleep. This delta sleep is also known as slow wave sleep. During the first half of your sleep cycle, delta sleep occurs most often. This indicates that if you are the one with more delta sleep activity, then you are more prone to experiencing night terrors. I think, I can say that I too belonged to this group of excess delta sleep activity.

Human beings have always known to be afflicted by sleep terrors ever since the ancient times. But, in those times as science had not progressed much in these fields, it was impossible to differentiate from nightmares until rapid eye movement was discovered.

The following reasons could be a broad classification of the reasons that are responsible for causing sleep terrors either in an adult or a child:

  • Stressful life events
  • Fever
  • Sleep deprivation
  • Certain medications that affect the central nervous system (the brain)
  • Recent anesthesia given for surgery
  • Children sleeping in a new environment or away from home
  • Children who suffer from sleep terror may also experience the following:
  • Tachycardia (increased heart rate)
  • Tachypnea (increased breathing rate)
  • Sweating during episodes
  • Are Sleep Terrors and Nightmares the Same?

No, no, no. You should not confuse sleep terrors with nightmares. Nightmares are only some bad dreams that cause feelings of horror or fear in you. While nightmares are relatively common during childhood, sleep terrors occur less frequently.

Sleep terrors are distinctly different from the common nightmares, which occur during REM sleep. Sleep/night terrors are characterized by frequent episodes of intense crying and fear during sleep, with difficulty arousing the person. Sleep terrors are frightening episodes that can even disrupt your family life.

Sleep Terror

Going by the available estimates around 1-6 percent of children and less than 1 percent of adults will experience a sleep terror episode with their lifetime. Sleep terrors can often be mistaken for the disorder of arousal from sleep in a state of confusion. Sleep terrors begin between ages 3 and 12 years and then usually dissipate during adolescence. In adults they most commonly occur between the ages of 20 to 30. Though the frequency and severity varies between individuals, the episodes can occur in intervals of days or weeks, but can also occur over consecutive nights or multiple times in one night.

Since sleep terrors are largely unknown to most of us, we tend to harbor the false notion that any type of nocturnal attacks or nightmare is a sleep terror; and most often than not we report all such happenings as sleep terror. But never mind, it surely is a lot confusing with such things.

Characteristics of Sleep Terror

If you ever experience a bout of sleep terror, you would reportedly be described by your family members or companions as ‘holding upright’ with your eyes wide open and a look of fear and panic on your face. You will often scream. You may also sweat excessively, exhibit rapid respiration and also have a rapid heart rate. These are some of the automatic signs of experiencing a sleep terror.

Some of you might even exhibit more elaborate motor activity, like thrashing of your limbs. This could include punching, swinging, or fleeing motions. This kind of activity results due to the notion in your mind that you are trying to protect yourself and/or escape from a possible threat which can lead to some kind of physical injury to you.

Sleep TerrorIf it is your child who is suffering from this condition, then it may appear to you that your child is awake during a sleep terror. The child will appear confused, be inconsolable and/or unresponsive to your attempts to communicate with him/her. During this period your child may not even recognize other family members familiar to him/her. The child may thrash around in bed and does not respond to comforting even by the parents.

You should be very careful while dealing with a situation like this because, if you try to awake your child or any other person when he/she is experiencing a sleep terror, he/she will lash out at you and this can be dangerous for both of you.

As a parent, you may have comforted your child after the occasional nightmare. But if your child has ever experienced what’s known as a sleep terror, his or her fear was likely inconsolable, no matter what you tried.

Most people who experience this disorder are amnesic or partially amnesic from the incident the next day. They usually do not remember the episode the next morning.

Most episodes of sleep terror last for about 1-2 minutes, but it may not be up to 30 minutes before the child relaxes and returns to normal sleep.

Sleepwalking is another predisposition of this disorder. Sleepwalking and sleep/night terrors are different manifestations of the same parasomnia disorder.

Who are at Risk?

Sleep terrors and other parasomnia disorders can be congenital. Sleep terrors in children are also more likely to occur in males that females. In adults, the ratio between the sexes is the same.

The disorder of sleep/night terror typically occurs in children aged 3-12 years, with a peak onset in children aged three and a half years.

The Precautions and Coping with Sleep Terrors

It may sound unfortunate, but it is a reality that no adequate treatment yet exists for curing sleep terrors. Management of sleep terrors primarily consists of educating the family about the disorder and reassuring them that the episodes are not harmful.

Sleep terrors can be very upsetting for any parent, as you might feel helpless at not being able to comfort or soothe your child.

If your child seems to be experiencing sleep terrors, an evaluation by the child’s pediatrician may be useful. During this evaluation, the pediatrician may also be able to exclude other possible disorders that might cause night terrors.

You can also try to interrupt your child’s sleep in order to prevent occurrence of sleep terror. This might sound weird, and is a bit difficult too, but it is something which you can do on your own and help your child. For this, you may follow the below given procedure:

Note how many minutes the sleep terror occurs from your child’s bedtime.

Then, awaken your child 15 minutes before the expected sleep terror, and keep her awake and out of bed for five minutes. You may want to take your child to the bathroom to see if he/she will urinate.

Continue this routine for a week.

However, you should also note that you should never awake your child while he/she is experiencing sleep terror.

Following this routine would take a toll on your sleep, but believe me that this is one of the effective ways to help your child control sleep terror. Your sleep is a very small sacrifice to be made to ensure your child’s well being.

As parents, you should also take the following precautions at your home:

  • You should make the child’s room safe, so as to prevent the child from being injured during an episode of sleep terror.
  • You should eliminate all sources of sleep disturbance in your child’s room.
  • You should strive and maintain a consistent bedtime routine and wake-up-time.
  • If your child is severely affected by sleep terrors and this is negatively interfering daily activities of your child, like school performance, and if peer or family relations are being affected, then certain tricyclic antidepressants (such as imipramine) may be used as a treatment. However, it has to be kept in mind that such treatments do not provide long-term help for your child; and these should only be used as a temporary treatment.
  • Frequent follow-up care with your doctor to provide support and reassurance helps alleviate their anxieties.

Most of the time, you would find sleep terrors simply disappearing on their own as the nervous system matures. Since nearly all children outgrow sleep terrors by adolescence, it is up to you that as a parent, how well you manage the situation and provide comfort to your child.

Understanding night terrors can reduce your worry and help you get a good night’s sleep yourself. But if night terrors happen repeatedly, talk to your doctor about whether a referral to a sleep specialist in needed.

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Sleep Maintenance Insomnia

What is it?

So, it is now nearing a full week since this strange thing started happening to you. It might have become even a routine now. You go to your bed normally and very soon enter your dreams but you have been continuously waking up in the middle of the night all of a sudden, due to no reason whatsoever, and then finding it very hard to go back to sleep again. The rest of the night is spent in rolling all over the bed trying different positions to get the sleep back. The sleep might be coming, but it would be too late and too little.

Sleep Maintenance Insomnia

They say ‘life begins at 40‘. Yes, it surely does. But for many it also brings along with it this sleep disorder which is termed as Sleep Maintenance Insomnia. It is a thing to definitely worry about but not too much, since this condition is experienced by most of the middle age individuals (40 and beyond). This condition is also termed as Sleep Interruption Insomnia by the specialists. If not checked early, this sleep disorder can have harmful effects on your health due to sleep deprivation.

The Major Symptoms

If you are suffering from any of the following sleep patterns, it would indicate that you are experiencing Sleep Maintenance Insomnia:

  • You are attaining instant or normal sleep as soon as hitting the bed but waking up after a few hours.
  • You wake up in the middle of the night without any valid reason and then find it very hard to fall asleep again.
  • You are sleeping being in a state where you think you are half awake. I mean you might be sleeping with your eyes closed but also constantly be aware of all the happenings around you, like the ticking of the clock or any other sounds, which could be nocturnal or anything.
  • You get up too early from the bed due to not being able to get back to sleep after awakening.
  • You keep waking up frequently, although briefly, throughout the night.

The Reasons behind It

This kind of sleep disorder is generally caused by anxiety and stress. Now, this stress and anxiety could be a result of a whole lot of problems or worries being faced by you on a daily basis.

Reasons Behind Sleep Maintenance InsomniaLike issues related to finance, yes; this could be one of the major worries for a majority of us. Worrying about the income and expenditure gap; paying off the debts; household expenses; children’s education; retirement plans; insurance; and what not. Such things create a very strong stress levels in our minds as we keep thinking about them; sometimes even dream about them, and then it all results in our sleep disorder.

And sometimes we simply get worried about our sleep after reading this kind of an article underlining the fact that not sleeping properly would make you sleepy during the day, or you would not be able to perform well. So, worrying about not being able to sleep, in fact makes you not able to sleep!

Depression is also responsible for your sleep disorder. Now, this depression could be due to any reason, whatsoever, and it will obviously differ from person to person. For some it could be due to some kind of a personal loss, like loss of a family member. For some others it could be due to some other factor.

Frequent and/or excessive use of alcohol or other drugs are also responsible for Sleep Maintenance Insomnia. Initially, you would find these agents helping you in attaining your sleep, but due to their dehydration and other hormonal effects you would soon find yourself in a pity with headache or full bladder resulting in frequent awakenings.

Women in particular, experience this sleep disorder while going through their menopause phase, as during this period a lot of hormonal changes / activities take place inside their bodies.

Certain medical conditions like chronic pain in the back pain, arthritis, restless legs syndrome (a neurological disorder characterized by an irresistible urge to keep moving the legs), snoring (by yourself or by your partner), asthma etc. also lead to acquiring this sleep disorder.

Some Remedies

  • If you really want to get over your sleep disorder, you should try to dwell upon the following tips in all your earnest:
  • Do regular exercise either in the morning or in the evening. But make sure you do not exercise when bed time is nearing. You can also try yoga and breathing exercises. These will help keep off the stress and tension by relaxing your muscles.
  • Reduce your intake of tea / coffee during the day. You would find it helping if you reduce your alcohol intake too. Make sure you don’t take any of these just before or a few hours before going to bed.
  • Keep anxiety and the resulting stress out of your mind. If you are worried about something talk about it to your partner or family members. If you can’t talk about it write it on a notebook. Pour it all out there and go to be bed with a mind minus the stress.
  • Do not go to your bed for the sake of it if you are not feeling sleepy. Do something else which would relax your mind. Like listen to soft music or read what you find interesting.
  • Clocks and television should be kept outside of your bedroom.
  • Wake up at the same time everyday. Even if on some days you go to bed late, then also get up at your regular time in the morning. This will help your body adapt to a sleep – awake schedule.
  • If after going to bed, you do not find yourself sleeping within the next 20 – 25 minutes, get out of the bed and read something or try any other activity which is boring enough to induce sleep in you!

If you still find it difficult to reign – in your sleep disorder, it would be advisable to visit the sleep specialist for counseling and medication. Just keep in mind that you should not become dependent on medication or sedatives to get your sleep. These have their side effects and withdrawing from their use is also difficult.

Positive changes to your lifestyle will definitely help you to overcome your sleep disorders and have a tight sleep all through the night.

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Sleep Apnea

Our Breathing

Insomnia Sleep ApneaThe word Apnea comes from the Greek dictionary and literally means “loss of wind”. We all are aware of the fact that breathing is what keeps us alive. We breathe in oxygen through our mouth into our lungs. The oxygen is then dissolved in our blood and then pumped to all parts of our body by our heart. During one breathing cycle we inhale oxygen and exhale carbon dioxide. This process continues even while we are sleeping. There are some sensors in a portion of our brain which control the amount of breathing throughout our sleep automatically and we don’t even have to worry about maintaining our breathing pattern while we take a sound sleep.

What Happens in Sleep Apnea?

During sleep every one of us has brief pauses in our breathing pattern, which usually is completely normal. However, if you are suffering from Sleep Apnea, then your breathing would be interrupted while sleeping. It might become shallow or totally stop. You may have one or more abnormal pauses in breathing or might have shallow breaths while you sleep. The pause could last for at least ten seconds to a minute and would make you breathless. The intermittent breathing will also result in decreased oxygen levels in your blood.

Insomnia Sleep Apnea

When you are experiencing Sleep Apnea you will often move out from deep sleep to a light one and a loud snort of a choking sound might also occur. If the pause is a long one then you may also awake feeling breathless and gasp for air. Typical breathing then again would start till the time Apnea is reached again.

Sleep Apnea is a common sleep disorder which results in the poor quality of your sleep, making you tired during the day. It is also a leading cause of excessive daytime sleepiness. If the condition is not too serious, it is possible that you may not even know that you have this problem of Sleep Apnea since it occurs during your sleep. Although your family members or your room / bed partner might know about it as they are the ones who too would be disturbed in their sleep because of your condition. Children too, sometimes experience this condition.

Types of Sleep Apnea

Based on its occurrence Sleep Apnea is classified into the following three major types:

Obstructive Apnea: It is the most common type of apnea in children. It is caused due to an obstruction caused in the airway (the region from the mouth or nose through the windpipe and into the lungs, through which our breathing action takes place). This obstruction is caused due to the enlarged tonsils (lymph nodes at the back of our throats), which is a common occurrence in growing children and it happens during sleep since that is when the soft tissue at the back of the throat is most relaxed.

The symptoms could include loud and chronic snoring followed by gasping; restless sleep and sleeping in unusual positions. This condition may also disturb the sleep of the children and hence they may feel sleepy and tired adversely affecting their activities at the school and other places.

Insomnia Obstructive Sleep Apnea

The most common symptom of Obstructive Apnea in children is their breathing from their mouths rather than from their noses during the day. They would breathe from their mouths even when they are sitting idle or just doing some activity in which there is no physical effort involved.
In children this condition usually wears off when the tonsils recover. If the tonsils are aggravated too much then a surgical removal of the same is necessary and with it the Obstructive Apnea also goes away.

Obstructive Apnea is also common in people who are obese and/or overweight (around fifty percent of the total affected ones), but it can affect anyone. You may experience this condition if your tongue and tonsils are large than the opening of your windpipe; your throat muscles and tongue relax more than normal; you have some extra soft fat tissue thickening the wall of your windpipe, making it narrower and harder to remain open; your nose, throat or mouth are too small, making the airway small.

The snoring is loudest when you sleep on your back. If you are sleeping tilted on your sides then it would be less noisy.

Central Apnea: It is the less common type of Sleep Apnea. In this condition your breathing repeatedly stops and starts during the sleep. This happens when the part of the brain that controls your breathing does not function properly and does not send proper signals to the muscles which control your breathing. As a result of this you might not breathe at all for brief periods.

This condition is generally also seen in premature babies since the respiratory centre in the brain of such infants hasn’t developed fully at the time of their premature birth.

Sometime this condition may also result while sleeping at a high altitude. A person suffering from a heart failure of heart attack may also experience this condition. Snoring typically is not witnessed in this kind of Apnea.

Central Apnea is treated by using a device to assist breathing and also by using supplemental oxygen.

Mixed Apnea: As its name sounds, this condition is a mix of the Obstructive and Central types. This condition is particularly seen in infants or children having an abnormal breathing control. Unlike its other forms Mixed Apnea could occur either when the child is awake or sleeping. This condition is treated with drugs that stimulate breathing. External oxygen through a mask is also provided to such patients.

How it is Diagnosed?

Your doctor will perform the diagnosis based on your medical and family histories. Physical examination and sleep study results would also be taken into consideration. This could be done your primary care doctor too and he would decide that whether or not you should see a sleep specialist.

What are the Remedial Measures?

Insomnia Sleep Apnea Remedial MeasuresThe doctor would definitely suggest some changes to your current lifestyle and daily activities like reducing alcohol intake; losing weight; sleeping on your side than on your back; and quitting smoking. He may also suggest some nasal sprays or medicines, if needed.

If your condition is severe the doctor may also initially suggest some mouthpieces or breathing devices, like the CPAP (Continuous Positive Airway Pressure) which uses a mask that fits over your mouth and nose. The CPAP gently blows air into your throat and the pressure from the air keeps your airway open while you sleep.

In rare cases, the doctor could even suggest you a surgery to widen your breathing passages and even for removing your tonsils if they are blocking your airway. These are done in a hospital and you may experience throat pain for a couple of weeks.

Better to Keep in Mind

Sleep Apnea can affect each and every one of us, at any age, even our children could get affected by this condition. Men are more likely to have this problem and the risk increases as you get older.

Sleep Apnea is a chronic condition requiring long term management. Sleep Apnea causes frequent drop of oxygen levels in your blood and this in turn trigger the release of stress hormones. If you let your Sleep Apnea untreated for a long time the increasing stress hormones could result in morning headaches, lack of concentration, mood swings, irritability, dry mouth or sore throat on waking up, high blood pressure, diabetes, heart stroke and other conditions related to irregular beating of your heart.

Many people do not think of snoring as a serious problem other can causing disturbance to the room / bed partner. It is also due to the fact that not everyone who snores while sleeping has Sleep Apnea or anybody who is suffering from Sleep Apnea snores! So, make sure you visit your doctor if your snoring is a loud one and punctuated by brief periods of silence.

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