Dear bjdog123-ga,
Wow, you must be feeling pretty desperate by now. However, don’t
give up. A positive and determined attitude is going to get you a lot
farther in licking this problem than giving up. So, let’s give this a
try.
As you know, we are not doctors here at Google Answers. The best I
can do, in terms of answering your question, is to find as many
references as possible to chronic insomnia and let you peruse them to
try to make some sense of your situation, and then decide on some
other directions you might want to pursue. Unfortunately, doctors
often don’t have an easy answer, and often the patient has to continue
to fight with extreme diligence to find an answer. Therefore, in your
case, let’s see if you can try to overcome this by looking at the
following resources and analyzing them according to your own, unique
condition.
First of all, a lengthy article published by the American Academy of
Family Physicians covers chronic insomnia in great detail. The article
stresses that “insomnia is essentially a symptom and not a diagnosis”;
therefore, it may change your thinking a bit in how you might look at
this problem. Chronic insomnia is considered complex because it is
normally caused by a number of factors concurrently, rather that one,
isolated reason, “including medical conditions, medications,
psychiatric disorders and poor sleep hygiene.” Causes of insomnia may
include “a prodromal (sort of a forerunner) indication of psychiatric
illness (particularly depression),12 a sleep-related breathing
disorder such as sleep apnea,13,14 a movement-related disorder such as
restless leg syndrome15-17 or a circadian rhythm disorder. Other
causes listed include:
Menopause
Gastroesophageal reflux disease
Benign prostatic hyperplasia
Incontinence
Congestive heart failure
Chronic obstructive pulmonary disease
Peptic ulcer disease
Allergic rhinitis (nasal obstruction)
Seizure disorder
Medical conditions that cause pain, such as
arthritis,bursitis,fibromyalgia and reflex sympathetic dystrophy.
I imagine the Mayo Clinic would certainly have identified some of
the other causes mentioned, such as sleep apnea, excessive snoring and
excessive movement during sleep. However, the other possiblities in
the article may not have been considered. Interestingly, fibromyalgia
is mentioned as a cause of insomnia, so the two may be linked, and the
insomnia may have been a precursor to the fibromyalgia diagnosis.
Please refer to the article for a wealth of information on
medications, causes, types of insomnia and numerous references to
articles you may want to read further. “Chronic Insomnia: A Practical
Review.” American Academy of Family Physicians (10/1/1999)
http://www.aafp.org/afp/991001ap/1431.html
Rest assured that physicians admit that chronic insomnia is not easy
to treat. However, be hopeful, because “the bottom line is that once
the underlying problems are identified and worked through, a
successful treatment plan can be implemented," according to Dr. David
Kupfer of the University of Pittsburgh Medical Center's Western
Psychiatric Institute and Clinic (WPIC). Options include behavioural
modification often accompanied by a short-term dosage of medication,
until more normal sleep patterns are learned and established.
“Importance of Proper Diagnosis of Chronic Insomnia Stressed.”
(1/29/97) http://www.pslgroup.com/dg/1981e.htm
Now, before you get frustrated over that term, “behaviour
modification,” please realize that there is a good deal of merit to
it. Even with the fibromyalgia or possible other causes linked to the
insomnia, behavioural patterns can be changed, so that you may be able
to work on de-railing the stress of not being able to fall asleep,
which just continues to feed on itself.
An extremely good article written by Donald B. Weaver, Ph.D.,
Director Insomnia Program Sleep Medicine Associates of Texas, covers
the psychological aspects of treating insomnia. Please read it
through, and let it sink in. As I said, even with actual medical
problems occurring along with the insomnia, behavioural modifications
can be a great help. After you read the article, you will notice that
Dr. Weaver offers an audio-tape program which you can use at home. As
he states in the article, “My role is to help people change those red
stoplights back to green lights that signal "GO to sleep," and replace
their nighttime anxiety with genuine, positive expectations of good
sleep and replace their nighttime body tension with deep physical
relaxation. It's really fulfilling to empower people to regain control
of their sleep process, in a way that works.” Sound corny? Don’t be
too skeptical. I have used tapes for chronic anxiety problems and
found them to alleviate a majority of symptoms.
“Guide for Chronic Insomnia: Questions and Answers” by Donald Weaver
can be accessed at http://www.sleepmed.com/insomnia.html
One common thread I have seen in all the articles I have read in
researching your question is the existence of depression.....not as a
result of insomnia, (though that would certainly be understandable),
but as a cause of insomnia. Have you ever been treated for depression?
It may be an avenue to explore.
“One of the most common causes of chronic insomnia is depression.
Other underlying causes include arthritis, kidney disease, heart
failure, asthma, sleep apnea, narcolepsy, restless legs syndrome,
Parkinson's disease, and hyperthyroidism. However, chronic insomnia
may also be due to behavioral factors, including the misuse of
caffeine, alcohol, or other substances; disrupted sleep/wake cycles as
may occur with shift work or other nighttime activity schedules; and
chronic stress.” “Insomnia.” The National Women’s Health Information
Center. http://www.4woman.gov/faq/insomnia.htm
One last, very interesting article describes another cause of
chronic insomnia entirely. The August 2001 issue of the Journal of
Clinical Endocrinology and Metabolism describes research finding that
“persons suffering from chronic insomnia have increased levels of
stress hormones in the blood, suggesting that these persons have an
abnormal, hyperactive body reaction to stress.” Again, the
psychological factor enters in to the equation! “When the body stress
response system is activated, the "stress hormone" cortisol is
increased as a result of a rise in the so-called "releasing" hormone
ACTH which stimulates stress hormone secretion into the bloodstream.
Since this system, when activated, leads to arousal and sleeplessness,
a research team at the Sleep Research and Treatment Center of the
Pennsylvania State University College of Medicine hypothesized that
these stress hormones would be increased in chronic insomniacs.” The
article further states that “This new information should be important
for doctors treating persons suffering from chronic insomnia. Rather
than medications to promote sleepiness, drugs (such as some
antidepressants) or techniques that reduce the activity of the stress
system might be more useful in treatment of chronic insomnia.” (Once
again, the reference to antidepressant medication!) The article,
titled “Chronic Insomnia = Chronic Stress” can be found at
http://stress.about.com/library/weekly/aa082101a.htm
Instead of going downhill, I encourage you start climbing uphill by
researching all that you can. Read these articles, consider the common
link of depression (if you think it is viable) and think about
ordering the behavioural tapes from Dr. Weaver’s clinic if they spark
an interest. I have faith that even if you can’t entirely beat your
chronic insomnia, you can at least alleviate it to a great degree and
finally get some decent night’s rest.
All the best to you!
umiat-ga
Google search strategy
chronic insomnia |
