Insomnia and its management

Eamonn Brady is a pharmacist and the owner of Whelehans Pharmacy, Pearse St, Mullingar. Check www.whelehans.ie for more information. If you have any health questions e-mail them to info@whelehans.ie

This is a quick summary of insomnia and how to prevent and ease it; for a more detailed article on insomnia and how to tackle it, ask a Whelehans Pharmacy staff member for a free copy or check www.whelehans.ie.  One in three people suffer from insomnia at some stage in their life while one in ten suffers from chronic insomnia. Half the elderly population complains of suffering from insomnia.

How much sleep do we need?
This varies greatly from person to person. The amount of sleep needed varies from four hours to over ten hours. It also depends on level of activity. A person who is retired may undertake less activity than when they were working and less sleep is needed. On the other hand, a person with a young family and constantly on the go will require more sleep to recuperate. The amount of sleep needed reduces as we get older. A baby needs 16 to 17 hours sleep; by the age of five, sleep requirement reduces to 8 to 9 hours and teenagers generally need less than 8 hours sleep. Even less sleep is needed as we enter adulthood.

Reasons for insomnia

The main reasons for sleep problems include ageing as we need less sleep as we get older (so for example an older people may wake up at something like 5am as the body has enough sleep but it is considered too early to actually get up). Medical conditions can be a reason. Pain is often a problem.  Needing to get up to go to the toilet can disturb sleep. It is estimated that over 60% of men and women over 60 need to get up at least once during the night to go to the toilet. However urinary frequency can easily be treated by your doctor. It could be a medical problem such as unstable bladder which can be rectified with medication. Not drinking tea or coffee late and not taking certain blood pressure tablets late at night can alleviate this. Emotional upset from bereavement can be a cause. Some prescription and over the counter medication including decongestants can disturb sleep. Anxiety, worry and stress can be a factor. Sleep disturbance is a common symptom of depression and low mood.  Change in sleep routine such a shift work can affect sleep. Surroundings can be a reason for poor sleep, for example, a room is too hot or cold, too bright or too noisy.

Recent research

In 2008, research by the German Institute for Quality and Efficiency in Health Care showed that good bedtime habits are more effective than sleeping pills to help insomnia.  The institute found that going to bed when tired, avoiding caffeinated drinks like tea and coffee at night, and not reading or watching television in bed can help people who suffer from sleeping problems. They showed that learning relaxation techniques can help people switch off and make it easier to get to sleep. Getting up at the same time each morning can help your sleep pattern.

Self Help

Avoiding cat naps during the day can help ensure a good night’s sleep. Nicotine can have a negative impact on sleep so stopping smoking can improve your sleep pattern. A warm bath before going to bed can relax you and help you sleep. Many people consider alcohol as an aid to sleep, however alcohol actually disturbs sleep so it should be avoided if you have difficulty sleeping. Regular exercise helps sleep but do not exercise in the late evening. You should avoid watching TV, eating and talking on the phone in bed. If you feel restless in bed you may try getting up and try reading or listening to relaxing music for a while until you get tired again. If you still feel you don’t get a sufficient night’s sleep, it is possible that you don’t need as much sleep as you think you need. We don’t need as much sleep when we were older. Many people in their seventies only need less than 6 hours sleep.

Treatment

Quite often sleep disturbance is due to a medical condition. Examples include depression, asthma, ADHD or pain. Treating the medical is often the key to solving the sleep problem. There are many natural products available on the market with varying degrees of success. Their effectiveness is questionable but they may help if suffering from mild insomnia. Sleeping tablets are only available on prescription and should be used for short term use only. It is easy to become dependent on them and they become less effective if used long term (more than 5 days). The newer non benzodiazepine sleeping tablets such as zopiclone are less addictive than older varieties but it is still easy to become dependant on them. They are best avoided in the elderly as they cause confusion and increase the likelihood of falls. Your GP will generally try to rule out other medical problems such as depression before prescribing sleeping tablets.

I’ll discuss sleeping tablets in this blog in the coming days.

 

Upcoming talk on depression and mental health

Whelehans Pharmacy Mullingar has organised an expert panel to discuss depression and mental health. The information evening is being held in The Greville Arms Hotel on Tuesday February 10^th at 7pm. Speakers will include Consultant Psychiatrist from St Lomans Mental Health Service, Dr Ciaran Corcoran; Specialist Psychiatric Nurse Colette Moriarty and Pharmacist Eamonn Brady.  This talk is open to all and is free of charge. You can turn up on the night or incase it is booked out you can put your name down in advance by calling Whelehans at 04493 34591.

Disclaimer: Consult a healthcare professional before making any changes recommended