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Copyright (c) 1991-92,1993   Tribune Media Services, Inc.


Are All Insomniacs Victims of the Same Disease?


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QUESTION:  As I stare at my ceiling, and sleep just will not come, I can't
help but wonder if this is a torment that comes in different varieties, or if
all insomniacs are victims of the same disease?  I hope you won't have to lose
any sleep looking up the answer to this question.

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ANSWER:  We've all felt it--the tossing, the turning, the staring at those all
too familiar walls.  And sleep seems never to come, to be as elusive as the
pot of gold or the winning lottery ticket.  If added to this scenario, you
fear even getting into bed, you must take some note of your whole life-style.
Because just as there are many insomniacs, so there are many varieties of
insomnia.
     Starting a sleep log, or more appropriately a wake log, will be helpful
to you and your physician.  Questions you will answer in this log will
include:  when you go to bed, when you wake up, things that hinder or help you
sleep, the number of sleepless nights you've spent.  And still more answers to
questions are needed.  Do you take any medication, do you smoke or drink
alcohol or beverages containing caffeine?  Do you nap during the day, do you
feel refreshed upon awakening?  Equipped with all this information, take
yourself to your family physician for treatment of your particular brand of
insomnia.
     And now a rundown of the many types:  insomnia can be of the
psychophysiologic variety, related to normal stress and anxiety.  This type of
sleeplessness is often compounded by a dread of going to sleep because of past
failure.  Another is related to drug and alcohol use.  These substances when
used initially as sleep inducers are defeatist, because they delay deeper
sleep.  Psychiatric disorders can also cause sleeplessness.  Another type is
caused by medical, toxic, or environmental conditions, such as pain, side
effects of medication, noise or uncomfortable temperature.  Restless leg
syndrome, accompanied by muscle spasm, can also be a culprit in the losing
battle with sleep.  A key to this type of insomnia is the state of the bed
clothes in the morning.
     Yet another kind is a sleep induced respiratory impairment.  Some of us
actually hold our breath during sleep and must wake up in order to breathe
again (sleep apnea).  More rare insomnias are of childhood onset;
sleeplessness that has been with us all our lives, REM (Rapid Eye Movement)
sleep arousers, those of us who flee from uncomfortable dreams by becoming
wide awake.  Any upset to our sleep/wake pattern can also precipitate
insomnia; for instance, jet lag or a sudden stint on the graveyard shift.
     No, you are not alone staring at the darkened ceiling.  The varieties of
insomnia seem infinite, and for any treatment to be effective, a diagnosis of
the type must be first accomplished, before effective treatment can start.
     And while I did not sleep particularly well last night, my wakefulness
was not provoked by this question, but rather a meal I enjoyed a bit too fully
last evening.  And that too, is just another frequently reported cause for a
disrupted, less than satisfactory sleep.  But as many people for whom sleep
problems are only occasional, I know I will do better tonight.

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The material contained here is "FOR INFORMATION ONLY" and should not replace
the counsel and advice of your personal physician.  Promptly consulting your
doctor is the best path to a quick and successful resolution of any medical
problem.