Insomnia
Insomnia is defined as difficulty falling alseep, or staying asleep, or both. Up to 50% of the population are affected by insomnia at some time in their life. Women are affected more frequently than men, and people with psychological problems suffer from higher rates of insomnia. Insomnia or sleep disorders are not defined by a set number of hours of sleep. Each individual has different sleep requirements. Instead, sleep disorders are recognized by symptoms resulting from an inadequate quality or quantity of sleep.
Insomnia or sleep disturbance can be caused by many factors. Transient or short-term insomnia can be related to time changes (jet-lag, travel), altitude, change in medications, life-stress (loss of a loved one, job loss, divorce or separation), and poor sleep conditions (noise, light, disruptive bed partner). Substance abuse issues can also cause sleep problems, such as withdrawal from alcohol, drugs, or medications. Medical problems such as obesity (obstructive sleep apnea, snoring), chronic pain, chronic fatigue, acid reflux disease, asthma, coronary artery disease with chest pain, arthritis, smoking, and neurological problems can cause sleep disorders. Specific medical conditions which disrupt sleep include sleep apnea (obstructive or central), restless leg syndrome, period limb movement disorder, and disorders of circadian rhythms. Psychological issues such as depression, mania, bipolar disorder, anxiety disorders, or Post-traumatic stress disorder (PTSD) also go hand in hand with disordered sleep. Insomnia can be a prime indicator of underlying psychological difficulties.
Persons with sleep disorders may have difficulty staying awake during the day, feeling fatigued or exhausted . They may have difficulty concentrating at work or school. Due to disordered sleep patterns, they may have anxiety or feel irritable or angry during the day. Impaired motor coordination may result in difficulties operating equipment or driving a motor vehicle. Further daytime impairment may occur when a person with a sleep disorders takes stimulants during the day to stay awake.
How are Sleep Disorders diagnosed?
Sleep Disorders or insomnia should be evaluated by a mental health professional with a thorough evaluation. In severe cases sleep studies may be necessary. A thorough medical history is performed, to elicit problems related to airway obstruction (obstructive sleep apnea), or other medical conditions responsible for the sleep problems. Sleep studies can be done off-site, to characterize the specific type of sleep disorder. A full psychological and psychiatric evaluation is performed, to determine if underlying psychological issues are causing disordered sleep. Depression, Bipolar Disorder and anxiety disorders are frequently associated with sleep problems. The Client’s family history is also explored, as well as any history of drug or alcohol abuse, which can also disrupt sleep cycles.
What is the Prognosis for a Sleep Disorder?
Sleep Disorders can be effectively managed with psychological treatment and medication (if necessary), once the cause has been identified. In Clients with underlying psychological problems, effective psychotherapy, stress management, and psycho-education in conjunction with sleep therapy can significantly improve their wellness. Clients who receive effective treatment experience improvement in their ability to function normally during the day, including an increase in the number of days they feel well, and an improved ability to focus on and participate in their psychological treatment.
What Complications can Slow Recovery?
Persons with sleep disorders related to underlying psychological problems may lack the motivation to seek treatment or be compliant with therapy or medication. Substance abuse (especially alcohol, marijuana or cocaine) is common among persons with insomnia related to psychological problems. Concurrent substance abuse dramatically interferes with effective psychological and medical treatment.
When Should a Client enter a treatment center?
A person with disordered sleep and underlying psychological problems may require the assistance of family or a loved one to find the proper treatment. Family and friends can direct them to the appropriate mental health provider or treatment facility, providing important emotional support and financial resources. When sleep problems are negatively impacting daily school or work life and personal and family relationships, an intensive treatment program should be considered. Once per week psychotherapy or medication may be ineffective at managing psychological issues associated with insomnia or disordered sleep. A treatment facility, like PCH Treatment Center is a definitive option to help a family member recover and heal.
How does PCH Treatment Center treat Sleep Disorders?
Despite the fact that poor sleep is a central symptom of depressive, bipolar and anxiety disorders, psychological treatments have traditionally neglected the importance of healthy sleep. Recently however, psychologists have developed highly effective approaches for helping people fall asleep quicker, stay asleep longer and manage night-time racing thoughts that so often can disrupt restful sleep. These cognitive-behavioral approaches do not rely on traditional medications, but instead are based on three premises stating that insomnia is perpetuated by: 1) a set of poor sleep habits; 2) a poor sleep environment; 3) night-time worries, frustrations and despair. Cognitive-behavioral approaches have been so effective that the American Academy of Sleep Medicine describes them as the first line treatment for chronic primary insomnia.
At PCH Insomnia Treatment Center, our approach is unlike any other psychological program in that cognitive-behavioral approaches for insomnia are integrated into our treatment planning for each client under the supervision of Dr. Sarosh Motivala, an expert in sleep disorders. The secret to understanding why these approaches work while others do not is that cognitive-behavioral approaches are rooted in extensive neuroscience research. The foundation of this research is that there are two separate functional systems involved in generating and maintaining good sleep: one is based on sleep debt and the other is based on our internal body clock. When people experience insomnia, they are experiencing breakdowns in both of these systems. By using approaches that address inefficiencies in both these systems, cognitive-behavioral strategies can produce long-lasting improvements in sleep quality. In weekly meetings, individuals learn basic sleep facts versus myths, the triggers that elicit sleep and how to use these triggers to improve their sleep problems, two highly effective relaxation strategies to manage night-time mood and specific, individually tailored guidance on improving sleep. Sleep problems differ from person to person. Our approaches focus on the specific difficulties a person is experiencing including inability to relax at night, difficulty falling asleep, difficulty staying asleep, or waking too early.
