Insomnia

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Insomnia refers to a persistent difficulty with falling asleep, staying asleep, or waking up too early without being able to return to sleep. 

It can lead to daytime fatigue, difficulty concentrating, mood disturbances, and decreased performance in work or school.

The causes of insomnia can be complex, including:

• Psychological Factors: Stress, anxiety, and depression
• Lifestyle Choices: Alcohol, caffeine, or nicotine use, especially close to bedtime
• Environmental Factors: Noise, light, or an uncomfortable sleep environment
• Medical Conditions: Chronic pain, asthma, gastrointestinal issues
• Medication Side Effects: Certain medications may interfere with sleep

Symptoms of insomnia include:

• Difficulty falling asleep
• Waking up during the night
• Waking up too early
• Not feeling rested after sleep
• Daytime fatigue or sleepiness
• Irritability, depression, or anxiety
• Difficulty paying attention or focusing

• Benzodiazepines: temazepam, nitrazepam
• Non-Benzodiazepine Hypnotics: zolpidem, zopiclone
• Antidepressants: amitriptyline
• Melatonin

• Benzodiazepines: Dependency, dizziness, memory problems
• Non-Benzodiazepine Hypnotics: Sleepwalking, memory loss, daytime drowsiness
• Antidepressants: Dry mouth, constipation, urinary retention
• Melatonin: joint pain

It's estimated that around one-third of the adult population globally experiences some form of insomnia. 

In Australia, approximately 13-33% of the adult population is affected by insomnia to some extent.

• Mindfulness and Relaxation Techniques: Including meditation and deep breathing exercises.
• Herbal Remedies: Such as valerian root and lavender, though evidence is mixed.
• Sleep Hygiene Practices: Including regular sleep schedule, appropriate sleep environment, reducing blue light and excessive stimulation in the evening

De-prescribing in insomnia often involves transitioning from sleep medications to non-pharmacological strategies, ideally under the guidance of healthcare providers.

• Tapering Programs: Gradual reduction of medication while implementing behavioural strategies.
• Complementary medicines: dietary and lifestyle changes alongside herbal and nutritional medicines can help to improve sleep naturally 

Treating insomnia requires a multifaceted approach, and de-prescribing medications often necessitates replacing them with effective non-pharmacological strategies. Collaboration with healthcare providers skilled in sleep disorders is crucial for successful treatment.