Dr. Irshaad Ebrahim, Consultant Neuropsychiatrist & Medical Director, The London Sleep Centre
As many as one-third of patients seen in the primary care setting may experience occasional difficulties in sleeping, and 10 percent of those may have chronic sleep problems.
About 30 to 40 percent of adults indicate some level of insomnia within any given year, and about 10 percent to 15 percent indicate that the insomnia is chronic and/or severe. The prevalence of insomnia increases with age and is more common in women.
Types of Insomnia
Periods of sleep difficulty lasting between one night and a few weeks are referred to as acute insomnia. Acute insomnia is often caused by emotional or physical discomfort. Some common examples include significant life stress; acute illness; and environmental disturbances such as noise, light, and temperature. Sleeping at a time inconsistent with the daily biological rhythm, such as occurs with jet lag, also can cause acute insomnia.
Chronic insomnia refers to sleep difficulty at least three nights per week for one month or more. Chronic insomnia can be caused by many different factors acting singly or in combination, and often occurs in conjunction with other health problems. In other cases, sleep disturbance is the major or sole complaint, and involves abnormal sleep-wake regulation or physiology during sleep.
Insomnia associated with psychiatric, medical and neurological disorders. Although psychiatric disorders are a common source of chronic insomnia, they account for less than 50 percent of cases. Mood and anxiety disorders are the most common psychiatric diagnoses associated with insomnia. Insomnia can also be associated with a wide variety of medical and neurological disorders. Factors that cause problems throughout the day such as pain, immobility, difficulty breathing, dementia, and hormonal changes associated with pregnancy, peri-menopause, and menopause can also cause insomnia. Many medical disorders worsen at night, either from sleep per se, circadian influence (e.g., asthma), or lying down (e.g. gastro-oesophageal reflux).
30 to 40% of adults indicate some level of insomnia within any given year.
Insomnia associated with medication and substance use. A variety of prescription drugs, non-prescription drugs, and drugs of abuse can lead to increased wakefulness and poor-quality sleep. The likelihood of any given drug contributing to insomnia is unpredictable and may be related to dose, lipid solubility, individual genomic differences, and other factors. Some drugs commonly related to insomnia are stimulating antidepressants, steroids, decongestants, beta blockers, caffeine, alcohol, nicotine, and recreational drugs.
Insomnia associated with specific sleep disorders. Insomnia can be associated with specific sleep disorders, including restless legs syndrome (RLS), periodic limb movement disorder (PLMD), sleep apnoea, and circadian rhythm sleep disorders.
Primary Insomnia. When other causes of insomnia are ruled out or treated, remaining difficulty with sleep may be classified as primary insomnia. Factors such as chronic stress, hyper-arousal, poor sleep hygiene, and behavioural conditioning may contribute to Primary Insomnia.
Here are 10 things to help you get a good night’s sleep
- Have and stick to a regular bedtime and wake up schedule Go to bed and get up about the same time each night and morning – even at weekends!
- Make sure the time that you set for your bedtime, is a time in which you are sleepy. Do not go to bed too soon or you may have trouble falling asleep or your sleep may be restless.
- Do not nap Napping can disrupt normal sleep cycles. Try skipping your nap and see if your regular sleep patterns improve.
- Make your bedroom a “quiet” room Do not watch television in your bedroom. Use it for sleeping or quiet reading.
- Establish relaxing before-bed routines Take a bath, a glass of warn milk, or do some light reading before bedtime.
- Develop relaxation techniques Learn yoga, deep breathing, quiet mediation or listen to soft music while trying to fall asleep.
- Avoid troubling news right before bed Violence in newspapers or on television may bother some people making it difficult to fall asleep. Try reading a book instead.
- Avoid stimulants Do not use stimulants or drink things that contain caffeine (tea, coffee, cola etc.) 6 hours before bedtime.
- Do not use alcohol or tobacco products close to bedtime Use of these products may calm you at the time of use, but they can have disrupting effects on your sleep during the night.
- Exercise regularly. Regular activity helps the body and mind healthy, but be sure to avoid vigorous exercise right before bedtime.
About the author
Dr. Irshaad Ebrahim established The London Sleep Centre in 2002 and is active internationally in developing Sleep Medicine Services and organizations.
His clinical interests include treatment of patients with Insomnia, Parasomnias (behaviors in sleep), Narcolepsy and Memory Disorders. He is committed towards research for new treatments for Insomnia, Depression, and Anxiety Disorders and has also conducted several studies on the Impact of ‘Sleepiness on Driving and Road Fatalities’.
He was also responsible for founding The Edinburgh Sleep Centre in 2005 and co-founded The South African Society of Sleep Medicine in 2011 where he is also its Vice President currently. An experienced practitioner who has served globally, Dr. Ebrahim pursued clinical practice at The Constantia Sleep Centre and The Pretoria Sleep Centre in South Africa before joining The London Sleep Centre in Dubai, UAE.
Having obtained his medical degree from the Nelson R. Mandela School of Medicine in South Africa, he went on to completing his research fellowship in Canada, trained in Psychiatry at University College in London and Guy’s King’s Hospital and St. Thomas’ Hospital where he also served as Consultant Neuropsychiatrist in Sleep Disorders in 2002. He further obtained a post graduate degree in Family Therapy, Neuropharmacology and the Neuropsychiatry of Sleep and Memory Disorders.