The sleep deprivation which often results from anxiety and depressive disorders can result in prolonged physical and emotional agony. Sleep loss also affects ability to concentrate on driving and work activities, and has been estimated to be the cause of as many as 200 000 motor vehicle accidents each year. On a more devastating scale, the Exxon Valdez oil spill and Three Mile Island Nuclear plant accident have been attributed to lack of concentration by staff suffering from sleep disorders.
Insomnia affects almost one third of the population at some time in their lives, and may present symptomatically as trouble falling asleep, having trouble staying asleep or both. Men and women of all ages are affected, although sleep disorders are more common in old age. Care should be taken when attributing lack of sleep in old age to Insomnia : from about 20 years onwards, the amount of sleep required decreases with increasing age, but sleeping patterns normally adapt to sleep requirements and needs.
There are three typical forms of insomnia :
¨ Transient insomnia is very brief and lasts no longer than several nights. The insomnia is usually traceable to a specific event that recently caused distress.
¨ Short-term insomnia generally lasts for between two and three weeks, and is usually brought on by ongoing stress or aggravation, such as family tension, serious illness and financial concerns.
¨ Chronic insomnia is the form most often associated with patients suffering from extreme anxiety or severe depression (although depressed patients may actually sleep more than usual). For chronic insomnia to be diagnosed, poor sleep must be continuous for three weeks or more.
Sleep problems can be treated through the introduction of carefully-monitored sleeping schedules, changing sleeping habits and through the use of appropriate medication. There are several drugs available for insomnia, ranging from those with a relatively short half-life (ie those which are active for only a short period of time) and those with longer duration. Short half-life drugs are generally used when there is difficulty falling asleep, whereas the longer acting drugs are used to maintain sleep and bring about a more regular sleeping pattern. An important consideration in selecting an appropriate drug is that treatment should not be sought according to the number of nights when sleep is difficult, but according to the consequences the sleep disorder has the following day. Consult your doctor to discuss the best available option. Alternatively, the Depression and Anxiety Support Group can provide you with counselling and advice. They can be contacted on (011) 783-1474/6 or 884-1797, Monday to Friday from 8am to 7pm, and on Saturdays from 8am to 5pm.
Several key rules have been proven to improve sleeping habits and may help with transient and milder forms of insomnia :
· Sleep only for as long as you need to in order to feel rested and refreshed the following day
· Keep a regular sleep schedule by retiring to bed and waking up at the same time during the week and on weekends
· Do not focus energy on falling asleep, as this creates anxiety which keeps you awake
· Reduce unwanted light and noise, and maintain a comfortable temperature in the bedroom.
· Do not go to bed when hungry, or drink coffee or any substance containing caffeine
· Avoid smoking or drinking alcohol prior to going to bed – alcohol may cause grogginess and nicotine disturbs sleep
· Exercise every day and try to lead an active life