INSOMNIA AND ANXIETY
Insomnia and anxiety are one of the commonset complaints in psychiatric, medical and generalclinical practice.
CAUSES:
Insomnia refers to difficulty in falling asleep or staying asleep, or lack of refreshment from sleep.In addition stress,psychiatric illness like depression and anxiety disorders, pain in any body part or substances abuse.
EDEMIOLOGY:
The overall female to male ratio is nearly 2:1.The age of onset of most anxiety and insomnia disorders is in young adult (twenties and thirties), although the maximum prevalence of generalized anxiety and agoraphobia-panic in the general population is in the 50-65 year age group.
SALIENT FEATURES:
Frequent awakenings from sleep, early morning insomnia or non-restorative sleep.
Difficulty in initiating sleep, the physiological reduction in numbers of hours of sleep does not amount to insomnia .
Stress situation leading to insomnia or the symptoms of the causative illness can be elicited on careful enquiry.
Treatment- Treat the underlying cause.In bothe primary insomnia (where no cause is identifiable)and insomnia due to other cause management includes introducing good sleep hygiene.
PHARMACOLOGICAL:
Diazepam 5-10 mg
or
Nitrazepam 5-10 mg at bedtime.
Insomnia and anxiety are one of the commonset complaints in psychiatric, medical and generalclinical practice.
CAUSES:
Insomnia refers to difficulty in falling asleep or staying asleep, or lack of refreshment from sleep.In addition stress,psychiatric illness like depression and anxiety disorders, pain in any body part or substances abuse.
EDEMIOLOGY:
The overall female to male ratio is nearly 2:1.The age of onset of most anxiety and insomnia disorders is in young adult (twenties and thirties), although the maximum prevalence of generalized anxiety and agoraphobia-panic in the general population is in the 50-65 year age group.
SALIENT FEATURES:
Frequent awakenings from sleep, early morning insomnia or non-restorative sleep.
Difficulty in initiating sleep, the physiological reduction in numbers of hours of sleep does not amount to insomnia .
Stress situation leading to insomnia or the symptoms of the causative illness can be elicited on careful enquiry.
Treatment- Treat the underlying cause.In bothe primary insomnia (where no cause is identifiable)and insomnia due to other cause management includes introducing good sleep hygiene.
PHARMACOLOGICAL:
Diazepam 5-10 mg
or
Nitrazepam 5-10 mg at bedtime.
Sleep hygiene--
- Set a schedule: Go to bed at a set time each night and get up at the same time each morning .Avoid day time naps.Limit daily inbedtime to the usual amount present before the sleep disturbance.
- Avoid large meals near bed time; eat at regular times daily.No stimulant medication or food beverages (caffeine, nicotine, alcohol, etc) especially in the evenings.
- Mild to moderate physical exercise in the morning.
- Relax before going to bed : a warm bath, reading, or another relaxing routine can make it easier to fall sleep. Avoid evening stimulation : substitute television by radio.
- Practice evening relaxation routines , such as progressive muscular relaxation or medication.
- Maintain comfortable sleeping conditions : avoid extreme temperatures.
need to care the insomnia patients
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