Today's article in the Daily Mirror is about Insomnia, but it's interesting to note all the 6 points highlighted are also related to Sleep Apnoea - yes even asthma - and there was some research claiming 40% of people with asthma have OSA http://www.snoring.ie/asthma_and_sleepapnoea.php

I have lost count of the people who have told me they thought it was insomnia they were suffering from, until they got diagnosed with sleep apnoea.  I realise insomnia is also a very real sleep disorder, but people with this should also check for the likelihood of undiagnosed sleep apnoea too.

Tackling insomnia: Six reasons why you might not be sleeping well... and what you can do about them

Senior woman sitting in bed and suffering from insomnia

Millions of us are simply desperate for a good night’s sleep.

With as many as 15 million prescriptions for sleeping pills written each year, new research by the Royal Pharmaceutical Society has found that over half of insomniacs are risking their health by buying over-the-counter sleep remedies without getting some medical advice first.

But with the study finding that 80% of those suffering insomnia had underlying problems, such as heart disease, depression, or asthma, could self-medicating pose an even more serious health risk as conditions go undiagnosed?

To make matters worse, an increasing amount of clinical evidence suggests sleeping pills aren’t even an effective way to banish insomnia.

In fact, a recent Great British Sleep Survey polled 20,000 UK adults and found that nearly half of those taking sleeping pills had had poor sleep for over a decade, despite using medication.

So why don’t the drugs work?

Sleeping pills aren’t useful for treating anything but very short-term insomnia.

Professor Colin Espie, founder of The Sleep Centre, at the University of Glasgow, explains: “These pills knock you out rather than send you into a natural or deep sleep, so the  longer you take them the worse you’ll feel.”

Indeed, the official guidelines from the National Institute for Health and Clinical Excellence only recommend sleeping pills after other drug-free treatments are tried.

And on top of their questionable effectiveness is the issue of side effects, as Professor Espie points out. “Daytime concentration levels of people who take sleeping pills are depleted by around one third, and fatigue symptoms are actually 25% higher.”

So whatever the cause of your sleep problems, you’re unlikely to find sedating yourself on a nightly basis a satisfactory long-term solution.

What is insomnia?

Sleep is one of life’s great certainties. You can’t escape or fight it – it just happens subconsciously, which is why those who are dubbed ‘good sleepers’ never give it a second thought.

Recurrent insomniacs, on the other hand, are not so fortunate.

“For a variety of reasons they have become overly aware of their need to sleep,” explains Professor Espie.

“This might be because they’re feeling stressed, which puts the whole body into a state of hyper-alertness, or because a medical problem, such as heartburn, has disrupted their sleep, making it become a new focus.”

Many experts now believe the trick to beating insomnia is finding a way to make the falling asleep process fade into the background again.

This means dealing with whatever emotional or medical trigger has created the issues in the first place.

Some temporary triggers, like pressure at work, are well known, but there are other surprisingly common causes that you need to be especially watchful for.

Indeed, according to the Royal Pharmaceutical Society, if your insomnia lasts for longer than a month, there may be an underlying medical condition.

Here are some of the less obvious issues and what can you can do about them.

1) Sleep apnoea

Warning signs: Snoring and extreme daytime tiredness are major signs of this breathing disorder, which occurs when the muscles and soft tissue in the throat relax, blocking your airways.

How it stops sleep: When blood oxygen levels dip too low, the brain wakes you up to restore normal breathing.

This can happen many times in one night.

In most cases, the sufferer has no recollection of it happening, but feels exhausted the next day.

Some specialists believe the condition is a sign of underlying heart disease. “The poor sleep it causes does seem to raise blood pressure and increase heart rhythm problems,”agrees Dr Mark Dayer, consultant cardiologist at Nuffield Health Taunton. “And by treating sleep apnoea, heart symptoms generally improve.”

Treat it: Not all snoring is a sign of trouble, but if you suspect you have apnoea, talk to your GP.

Apart from losing weight, the most effective treatment for this condition is continuous positive airway pressure (CPAP) – a ventilator mask worn at night that keeps the airways open by continuously pumping air.

2) Depression

Warning signs: Early waking, low mood and energy, loss of appetite and general apathy.

How it stops sleep: Our state of mental health is intrinsically linked to how we sleep – whether it’s anxiety preventing us from nodding off, or lack of sleep lowering our daytime mood.

“Research shows that people with disrupted sleep are twice as likely to suffer from depression,” points out Professor Espie.

“In fact, just as we see conditions such as high blood pressure or cholesterol as risk factors for heart disease, doctors should see sleep problems are putting someone at a higher risk of depression and other mental illness.”

Treat it: One therapy that has a high success rate for treating both depression and insomnia is cognitive behavioural therapy (CBT).

But while CBT is commonly prescribed for depression, it’s seldom thought of as an option for sleeplessness – despite clinical trials showing it is the most effective long-term solution for insomniacs.

Because this therapy can be hard to access through your doctor, experts have come up with Sleepio – a six-week online CBT course designed to help you develop a healthier relationship with sleep.

In trials it helped 75% of chronic insomnia sufferers (£49.99, www.boots.com).

3) Night-time peeing

Warning signs: Waking up with a desperate need to empty your bladder.

But it can also affect you in a less obvious way, so you sleep fitfully without waking fully, as your body tries to send a signal to the brain that it needs the loo.

How it stops sleep: Nocturia – the medical name for waking up in the night to wee, tends to occur during pregnancy and as we get older.

Some research suggests that up to 65% of older adults are sleep deprived as a result of frequent night-time urination.

Normally, our bodies produce anti-diuretic hormones that concentrate urine while we sleep so we can last the night without waking.

But as we get older, these hormones decline so we’re less able to hold fluids for long periods of time.

Treat it: See your GP to check for urinary infections, prostate problems, and undiagnosed diabetes, as all can cause frequent urination.

Certain drugs, such as diuretics and heart medications, can also be triggers.

If medical problems are ruled out, it can help to avoid drinking anything for three hours before bedtime, especially coffee, tea or alcohol.

4) Asthma

Warning signs: An irritating cough that only occurs at night and comes and goes can be the first sign of undiagnosed asthma – especially in children – and can cause chronic sleep problems.

How it stops sleep: Asthma causes airway irritation, which triggers mucus production and subsequent coughing to try to clear it away.

Lying down makes symptoms worse, which is why it only occurs at night for some people.

“Symptoms can also start soon after people are in bed because of high levels of allergens in their beds and bedrooms, which trigger asthma and other allergy problems,” explains Allergy UK.

Treat it: See your GP if an intermittent night-time cough is keeping you awake.

If you’ve already been diagnosed with asthma, disturbed sleep can be a sign it’s getting worse so it’s vital to review your treatment plan with your GP, as you may need to use your inhaler more often.

5) Restless legs syndrome

Warning signs: An uncontrollable urge to move your legs, which worsens at night.

How it stops sleep: Doctors don’t know exactly what causes restless legs syndrome, but the need to twitch can prevent sufferers from falling asleep, while muscle jerks can also wake or partially rouse you from deep sleep.

This means many of the UK’s 10 million sufferers wake up exhausted in the morning without realising the cause.

Treat it: Make sure you’re getting enough iron and folic acid, as deficiencies in both have been linked to restless leg syndrome.

Red meat, spinach, and other leafy greens are good sources of both nutrients.

Leg massages to boost circulation and calf-stretching exercises before bed can help, while medication, including anticonvulsants and dopamine agonists (normally used for Parkinson’s disease in much higher doses), can help severe cases.

6) Acid reflux

Warning signs: Waking up with a nasty taste in your mouth after a night of a disturbed sleep.

How it stops sleep: Acid reflux causes the body to partially awaken from sleep, even when there are no obvious symptoms of heartburn.

The result of this “silent reflux” is fitful, uneven sleep, but when you wake up digestion is complete and you can’t tell why you slept poorly.

US research suggests that that up to 25% of people who report bad sleep without a diagnosed cause have sleep-related acid reflux.

Treat it: Lifestyle changes can make a huge difference, especially stopping smoking and losing weight.

Don’t eat for at least two hours before bedtime.

Steer clear of trigger foods in your evening meals – alcohol, chocolate, spices and caffeine.

Sleeping on your left side can ease symptoms, as it reduces the backflow of stomach acid.

Elevating your head and shoulders with extra pillows can also help.

Over-the-counter antacids, or those prescribed by your GP, offer temporary relief.

http://www.mirror.co.uk/lifestyle/health/insomnia-six-reasons-why-y...