Dr Nikhil Juneja

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An regular inability to fall asleep or stay asleep, leading to excessive fatigue is termed to be insomnia. It’s a symptom not the disease in itself. Insomnia is "difficulty initiating or maintaining sleep or both" and it may be due to inadequate quality or quantity of sleep.
Insomnia can be classified in terms of its duration: transient, short-term, and chronic. Transient and short-term insomnia are caused by similar factors, but short-term insomnia usually requires a greater disturbance.
Types of Insomnia
Although there are several different degrees of insomnia, three types of insomnia have been clearly identified: transient, acute, and chronic.
1. Transient insomnia lasts from days to weeks. It can be caused by another disorder, by changes in the sleep environment (eg.hotel), by the timing of sleep. Its consequences - sleepiness and impaired psychomotor performance - are similar to those of sleep deprivation.
2. Short time insomnia or acute insomnia is the inability to consistently sleep well for a period of between three weeks to six months. It needs a greater disturbance like worry, tension or some emotional disturbance.
3. Chronic insomnia lasts for years at a time. It can be caused by another disorder, or it can be a primary disorder. Its effects can vary according to its causes. They might include sleepiness, muscular fatigue, hallucinations, and/or mental fatigue; but people with chronic insomnia often show increased alertness. Some people that live with this disorder see things as though they were happening in slow motion, whereas moving objects seem to blend together. Can cause double vision
Chronic medical illnesses - Certain medical illness can interfere with sleep, especially disorders of the heart and lungs. Other important physical causes include heartburn, menopause, diabetes, arthritis, hyperthyroidism and hypoglycemia.
Sleep disordered breathing (sleep apnea) - Disorders of sleep that cause one to stop breathing while asleep may fragment sleep and cause frequent awakenings during the night.
Restless leg syndrome (RLS) – Recurrent movements of the legs during sleep that may cause arousals from sleep.
Psychophysiologic ("learned") insomnia - Many people go to bed worrying about insomnia because of previous episodes. This creates an anxiety about going to sleep, which usually leads to greater difficulty sleeping.
Biological factors - As we age, sleep becomes lighter and more fragmented. Older people often struggle with frequent nighttime awakenings and the inability to sleep past the very early morning. Also, during our life spans, the internal biological "clock" that regulates sleep creeps slightly forward, compelling most older people to go to sleep earlier and to wake earlier.
Lifestyle factors - Excessive caffeine consumption, alcohol and drug abuse, smoking, and poor sleeping habits are often overlooked as cause of chronically disturbance.
What Causes Insomnia?
Insomnia can be caused by:
• Chronic stress and anxiety.
• Certain type of drugs and antibiotics associated with more severe and chronic types of insomnia.
• Hormone shifts such as those that precede menstruation and those during menopause.
• Life problems like fear, anxiety, emotional or mental tension, work problems, stress, unsatisfactory sex life.
• Environmental factors like noise, light, or extreme temperatures that interfere with sleep.
• Certain Mental disorders also may cause insomania.
• Disturbances of the circadian rhythm.
• Estrogen is considered to play a significant role in women’s mental health (including insomnia). The sudden estrogen withdrawal could also cause insomania.
• Brain lesions, or a history of traumatic brain injury.
• A rare genetic condition or family background could also be responsible.
• Parasites can cause intestinal disturbances while sleeping.
• An overactive mind or physical pain may also be causes.
Symptoms of insomnia
• Trouble falling asleep
• Experiencing restless sleep, in which you wake frequently throughout the night and then have trouble falling back asleep
• Waking too early in the morning
• Feeling tired and un-refreshed upon waking in the morning
• Difficulty falling asleep
• Waking up often during the night and having trouble going back to sleep
• Waking up too early in the morning
• Feeling tired upon waking
• Sleepiness during the day
• Irritability and problems with concentration or memory
Its very useful in cases of sleeplessness when the mind is overactive and excieted. Shows inability to relax due to the overexcitement caused by good news or ideas. The mind seems to be overexcited, as if from drinking too much coffee.
A person needing Belladonna is extremely restless. Frightful images when drifting off to sleep cause the patient to dread sleep. They are awakened by nightmares, or they can experience a throbbing in the brain that prevents sleep.
Used for acute insomnia caused by shock, fright, bad news, or grief. Wake up due to nightmares. For those who panic with insomania.
Good for physical overwork and when the bed feels too hard and uncomfortable.
Kali phos
Right terrors, or waking with a sinking feeling in the stomach. Caused by excitement or mental strain. Also for anxiety, irritability, and muscle fatigue Exhausted by stress or overwork.
Arsenicum album
feels sleepy during the day but anxious at night. Restless in bed with anxious dreams and nightmares.
If the person is feeling sleepy but unable to get to sleep, if the bed is too hot, or else sleep comes but it is so heavy that the person snores and cannot be roused.
Bedwetting in the early part of the night. Over-sensitive child easily upset and tearful. Afraid of the dark.
Calcerea phosphorica
This remedy is often helpful to children with growing pains, and also to adults who have aching in the joints and bones, or neck and shoulder tension that make it hard to fall asleep. The person lies awake for many hours, feeling upset and irritable—then has trouble waking in the morning, feeling deeply tired and weak
Irritable baby who refuses to be calmed. Sleeplessness caused by teething, anger, or Colic. Moaning when asleep, eyes are half open when asleep. For the person who exhibits irritability, peevishness, and restlessness.
Bed wetting during dreams. Nervous-system immaturity.
For overtiredness and exhaustion or due to night working.
Sleeplessness caused by shock, emotional stress, or grief with frequent yawning. Jerking of limbs while asleep. Due to anger and tension.
Nux vomica: People who have insomnia after over-indulgence in stimulants, food, and drink—or after overexertion, either physically or mentally. On getting up, they are tense, impatient, and irritable, with a feeling that they sorely need more sleep.
Sleep problems during the menopause. Waking anxious and feeling unwell.
Muriaticum acidum
Insomania due to emotional problems.
Early waking with an overactive mind and/or recurrent thoughts. person feels too hot and throws covers off, then feels too cold and lies with arms above head. If the insomnia is worse after tking rich food.
Zincum metallicum: Insomania due to nervousness. Their legs and arms often feel extremely restless, and lying still in bed may be impossible.
Difficulty falling asleep. Waking early feeling unrefreshed. Exhausted and depressed by over work and mental stress. Feels irritable and sleepy during the day.
Insomnia that comes from itching or feeling of heat in bed, especially in the feet. The person is irritable and anxious, and often feels a need to throw the covers off. Insomnia due to lack of exercise.