Insomnia: Promoting a good night's sleep

摘要

Patients and practitioners can suffer from sleep disturbances. When problems persist, they can affect a person physically and psychologically. Often, by addressing lifestyle and sleeping habits, sleep problems can be alleviated. Most people have experienced disturbances of sleep. Adults need between seven to nine hours' sleep a night (NHS Choices, 2015a). The average total amount of nocturnal sleep decreases with age from about 8 hours at 15 years of age, to less than 6 hours at 80 years of age. The National Institute for Health and Care Excellence (NICE); 2015a) advise it can take up to 30 minutes for someone to fall asleep. Insomnia is difficulty in getting to sleep, difficulty staying asleep, early wakening, or non-restorative sleep, despite adequate time and opportunity to sleep (NICE, 2015a). It results in impaired daytime functioning, such as poor concentration, mood disturbance, and daytime tiredness (NICE, 2015a). A further distinction is made between short-term (up to four weeks) and longer-term (persistent) insomnia (NICE, 2015a). If the symptoms are mild, and of a short duration, problems should not interfere with a person's wellbeing and medical treatment may not be required. It is important to identify the factors causing insomnia, so that appropriate interventions and methods are used and difficulties overcome. Sleep disorders can have an underlying cause, which can be attributed to insomnia. NHS Choices (2015b) and NICE (2015b) provide a list of medical and psychiatric problems that can cause insomnia, and note several conditions that require medication, which in itself can cause sleep disturbances (Box 1). If problems persist after a month, and addressing issues have not worked, practitioners should encourage patients to consult their doctor.