Dyssomnia
Dyssomnia is a disturbance of the body's natural resting and waking patterns.
Dyssomnias may be intrinsic i.e. having their cause in the body, or extrinsic i.e. having an external cause.
Person’s problems with a person's circadian rhythm, or internal clock may also cause dyssomnia.
Dyssomnia covers a range of specific sleep disorders, Insomnia, Sleeplessness, the Inability to Sleep, Wakefulness. Chronic and persistent difficulty in either; falling asleep, remaining asleep through the night, or waking up too early.
Daytime sleepiness, poor concentration, and the inability to feel refreshed and rested in the morning are caused due to all types of insomnia. Dyssomnias are disorders of the amount, quality, or timing of sleep.
Causes of Dyssomnia:
- Excessive sleep during the day
- Worry, anxiety or stress
- Depression or major depression
- Excessive physical or intellectual stimulation at bedtime
- Jet lag
- Abruptly stopping a medication
- Nicotine, alcohol, caffeine, food, or stimulants at bedtime
- Shift work
- Not getting enough bright-light exposure during waking hours
- Wake-sleep pattern disturbances
- Restless leg syndrome
- Aging
- Overactive thyroid
- Alcoholism or abruptly stopping alcohol after long-term use
- Side effect of a new medication
Associated Features of Dyssomnias:
- Obstructive Apnea Syndrome
- Central Apnea Syndrome
- Mixed Apnea Syndrome
- Narcolepsy
- Periodic Leg Movements and Leg-Related Syndrome
- Alveolar Hypoventilation
- Recurrent Hypersomnia
- Psycho-Physiologic Insomnia
- Idiopathic
Dyssomnia Treatment
Medical disorders, psychiatric disorders, and stress may precipitate or intensify parasomnias. A careful history of psychosocial stresses, alcohol or drug use, and symptoms of depression should be obtained.
Also, a detailed Mental Status Examination should be carried out. Patients found to have an underlying psychological or psychiatric disorder should be seen by a psychologist or psychiatrist, and appropriate therapy should be offered.
Drug treatment should only be opted to as a last alternative. You should practice good sleep hygiene; avoid using alcohol in the evening and to avoid caffeine before bedtime.
Counseling may be helpful for psychological disorders that lead to insomnia and the practice of relaxation methods may also be helpful.
Dyssomnia Medications
Medications are not being necessary in many cases. If everything else has failed your health care provider can investigate with you the possibility of using prescribed medications.
Benzodiazepines such as Valium (diazepam) or Ativan (lorazepam) are anti-anxiety medications that can also help induce sleep. Some antidepressants such as Elavil (amitriptyline) can be used at bedtime because they are sedating. They require a prescription.
Proper treatment of the depression with other appropriate medications or therapy should solve the problem, if insomnia is caused by depression. They must be used with caution because they can be addictive. They too require a prescription.
Newer medications called hypnotics are now available. They help reduce the time needed to fall asleep but are far less likely to be addictive than benzodiazepines. Ambien (zolpidem) and Sonata (zaleplon) are two examples.
Prevention Methods
Good sleep habits can prevent many cases from developing dyssomnias. Recommendations from sleep experts include:
- Don't go to bed unless you are tired.
- Have a comfortable, dark, quiet sleeping environment.
- Use the bed only for sex and sleep.
- Wake up at the same time every morning.
- Avoid alcohol, caffeine, and other drugs, especially after dinner.
- Avoid excessive daytime naps. A person should take only one nap a day, if any, and the nap should be less than 1 hour.
Treatment of any primary psychiatric condition may prevent some sleep problems from occurring. Avoidance of obesity may prevent some cases of sleep apnea. Some sleep disorders cannot be prevented.
