What is Insomnia and how can this affect you

Insomnia is the most common sleep disorder. Chronic insomnia is reported to affect up to 10% of the general populations.

Insomnia occurs when someone has persistent difficulties falling asleep or staying asleep. Insomnia can result in many forms of daytime impairment: fatigue, concentration or memory impairment, reduced motivation and energy. People with insomnia tend to be more irritable, anxious and having a low mood.

Insomnia causes much distress to sufferers and is associated with low quality of life, a high level of absenteeism from work and physical and mental illness. In the treatment of long-term insomnia, the most important factor to be addressed is anxiety and fear about the experience and maladaptive behavioural routines leading to a vicious insomnia cycle.

What treatments are available for Insomnia

There are many different types of sleep aids for Insomnia, including over-the-counter (non-prescription medications such as Nytol for example) and prescription medications.

The main sleeping pills prescribed in the UK by doctors include benzodiazepines (benzos) such as Diazepam and non- benzodiazepines (Z drugs) such as Zopiclone or Zolpidem.

Doctors also frequently prescribe antidepressants that also cause sedation to treat Insomnia and sometimes even small doses of antipsychotic medication with same sedative properties to improve sleep.

Sleeping pills, however, can have serious side effects and you can become dependent on them the longer you use them for. Often, prescriptions are limited to several days only because of this reason.

Some over-counter medications, herbal supplements and melatonin are advertised for treatment of insomnia.

Although melatonin can be very helpful medication in addressing sleep difficulties, it only works if taken correctly at individually specified time, at the correct doses and for correct indications.

Deciding which medication may be right for you depends on the type and duration of insomnia symptoms and many other different health factors. This is why it’s important to consult with a doctor before taking a sleep aid and to make sure that you have on-going medical monitoring reviewing medication effectiveness.

You need to remember that medication does not address the causes of Insomnia and for this reason, it is frequently ineffective in a long-term. Medication might be effective for acute insomnia symptoms but usually does not work in chronic insomnia.

I have tried all of the above; is there anything else?

At ROC Clinic we offer an integrative approach to treatment of insomnia.

This includes Cognitive Behavioural therapy, Light therapy with consideration of your circadian cycles, and medication management for the patients in whom medication is indicated.

Cognitive Behavioural Therapy although not widely used, is an effective treatment for insomnia leading to sustained improvement in sleep. It works by targeting the factors maintaining chronic insomnia and resulting in sustained changes in sleep behaviours and sleep-attitudes. Cognitive Behavioural Therapy is recommended by The American College of Physicians as a first line treatment for chronic Insomnia. Despite this, Cognitive Behavioural Therapy for sleep disorders is still to make its way into the UK management of Insomnia.

CBT Treatment protocol for Insomnia is much individualised, the number of sessions required for therapy varies between 6 and 8. Response to treatment largely depends on patient’s engagements and adherence to treatment recommendations.

If you have concerns and worries about your sleep, come and speak to our doctor, who will be able to assess your sleep difficulties and to suggest a treatment plan. Treatment of insomnia at ROC Clinic is provided by Dr Olga Runcie, Consultant Psychiatrist 22 years experience working in General Adult Mental Health and special interest in Sleep Medicine.

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