Recurrent Breast Cancer

Friday, June 10, 2016

Insomnia is a condition of fragmented sleep. Those affected have early morning awakening that leads to poor concentration and irritability. It hampers job performance and slows reaction time.
Your doctor might have you complete a questionnaire to determine your sleep-wake pattern and daytime sleepiness. You may be asked to keep a sleep diary.
• How often do you have insomnia and when did it begin?
• How long does it take you to fall asleep?
• How many hours do you sleep?
• Do you snore or wake up choking for breath?
• How often do you awaken at night? How long does it take you to fall back to sleep?
• Are you refreshed when you wake up?
• Are you tired during the day?
• Do you doze off or have trouble staying awake while sitting or driving?
• Where do you sleep? What's the noise level, temperature and amount of lighting?
• Stressful life events?
• Alcohol and tobacco use?
• Family history of sleep issues?
• Recent travel and time changes?
• Long work hours, shift changes, and night shift?
Keep a current list of medications, vitamins, and herbal supplements, including doses. Have your sleep partner come along for your next doctor’s visit. The partner could provide observations that verify information. Your doctor could suggest an overnight sleep study. A blood test might be appropriate to rule out hypo or hyperthyroidism. .
Parkinson’s Disease and Alzheimer’s aggravate symptoms. Ritalin, prescribed for Attention Deficit Syndrome, inhibits sleep. Coffee, tea, and “energy drinks” are detrimental. Other sleep-related disorders include Sleep Apnea and Restless Legs Syndrome. Other disorders include depression, anxiety disorder, post traumatic stress disorder, and substance abuse.
If the cause isn't clear, or you have symptoms and signs of another sleep disorder, such as sleep apnea or restless legs syndrome, referral to an overnight sleep center is recommended. This study monitors brain waves, breathing, heartbeat, brain waves, eye movement, and body movement.
Behavior therapies are recommended as the first line of treatment for those with insomnia. They are equally or more effective than sleep medicines. Cognitive behavioral therapy helps or eliminates negative thoughts and worries that inhibit sleep, such as the concept, “a bad sleep night will make me sick.”.Muscle relaxation, biofeedback and deep breathing reduce anxiety. These modalities bolster breathing, heart function, muscle tension and mood.
“Stimulus control” is a technique that limits time spent awake in bed. The bed and bedroom should only be associated with sex and sleep. Sleep restriction decreases time spend in bed, causing partial sleep deprivation. This strategy creates fatigue the next night. When sleep quality has improved, time in bed is decreased. Other treatments include remaining awake. Also called “paradoxical intention,” this method reduces worry and anxiety about being able to sleep by getting in bed and trying to stay awake, rather than expecting to fall asleep.
If you fall asleep too early and awaken too early, you can use light to push back your internal clock. Go outside during times of the year when it's light outside in the evenings. Consider purchasing a medical-grade light box kept in your bedroom.
Prescription sleeping medicines, such as zolpidem (Ambien), zopiclone (Lunesta), zaleplon (Sonata) or ramelteon (Rozerem) can induce sleep. Physicians might not recommend “prescription sleeping pills” for more than a few weeks.
Over the counter nonprescription sleeping medicines contain antihistamines that cause drowsiness. These reduce sleep quality. Side effects include daytime sleepiness, urinary retention, dry mouth and confusion.
Antihistamines worsen urinary problems, causing urinary urgency during the night. Additional options include Melatonin. This over-the-counter (OTC) supplement could reduce insomnia.
Valerian is a dietary supplement sold as a sleep aid. It has a sedating effect, but hasn't been well studied. It is released into the bloodstream at dusk and tapers off in the morning. You might want to discuss it with your doctor. Those who take it at high doses or long term may develop liver inflammation (hepatitis). When it's time to stop, it should be tapered to prevent withdrawal symptoms.
Stick to a sleep schedule. Keep your bedtime and wake time consistent, including weekends.
Avoid large meals before bed. A light snack is fine. Drink less before bedtime so that you won't have to urinate as often.

Don’t work or eat in bed. Avoid TV, computers, video games, smart phones or other gadgets before bedtime.

The TV and an i-Pad may interfere with your sleep cycle.

Close the bedroom door or create a subtle background noise, such as a fan, to dampen noise sources. You might want to silence your cell phone and bedroom clocks.

A warm bath or massage can prepare you for sleep. Create a relaxing bedtime ritual, such as reading, soft music, breathing exercises, yoga or prayer. Avoid trying hard to sleep. The more you try, the more awake you’ll become.

Read in another room till you’re drowsy, then go to bed to sleep. If you can't sleep after twenty minutes, do something relaxing, such as reading. Try again.

Yoga and Tai-Chi help with sleep quality. Start slow and work with a coach or instructor who listens to your needs and limitations.
“Mindful Meditation” along with conventional treatment can improve sleep. Research suggests that regularly practicing meditation reduces stress and lowers blood pressure.


Famous quote: “The best cure for insomnia is to get a lot of sleep.” W.C. Fields