Insomnia is a sleep disturbance--difficulty either falling asleep or remaining asleep. All body cells, especially the central nervous system--including the brain, the coverings of the brain (meninges), and the spinal cord -- and peripheral nerves are involved.
Appropriate health care includes:
Self-care after diagnosis.
Physician's monitoring of general condition and medications.
Psychotherapy or counseling, if the cause is psychological.
SIGNS & SYMPTOMSRestlessness when trying to fall asleep.
Brief sleep followed by wakefulness.
Normal sleep until very early in the morning (3 a.m. or 4 a.m.), then wakefulness (often with frightening thoughts).
Periods of sleeplessness, alternating with periods of excessive sleep or sleepiness at inconvenient times.
CAUSESDepression. This is usually characterized by early-morning wakefulness.
Overactivity of the thyroid gland.
Anxiety caused by stress.
Noisy environment (including a snoring sleeper sharing the room).
Allergies and early-morning wheezing.
Heart or lung conditions that cause shortness of breath when lying down.
Painful disorders, such as fibromyositis or arthritis.
Urinary or gastrointestinal problems that require urination or bowel movements during the night.
Consumption of stimulants, such as coffee, tea, or cola drinks.
Use of some medications, including dextroamphetamines or cortisone drugs.
Erratic work hours.
New environment or location.
Jet lag after travel.
Lack of physical exercise.
Drug abuse, including overuse of sleep-inducing drugs.
Withdrawal from addictive substances.
Stress; obesity; smoking.
PREVENTING COMPLICATIONS OR RECURRENCEEncourage your child to establish a lifestyle that fosters healthy sleep patterns (see HOME CARE).
MEDICAL TESTSYour own observation of symptoms; medical history and physical exam by a doctor; laboratory thyroid studies; EEG (See Glossary); tests in a sleep-study laboratory.
POSSIBLE COMPLICATIONSImpaired relationships; poor school work performance; lower resistance to disease; injury from falling asleep around machinery or while driving.
Most children can establish good sleep patterns if the underlying cause of insomnia is treated or eliminated.
Seek ways to minimize stress in your child's life. See Appendix 19.
Obtain medical treatment for any underlying medical disorder.
Urge your child not to use stimulants for several hours before bedtime.
Encourage the child to relax in a warm bath before bedtime.
MEDICATIONTemporary insomnia is interfering with your child's daily activities.
Your child has a medical disorder that regularly disturbs sleep.
Your child needs to establish regular sleep patterns.
Long-term use of sleep inducers may be counter-productive or addictive. Urge your child not to use sleeping pills given by friends, and not to take non-prescription sleeping pills.
Your doctor may prescribe sleep-inducing drugs for a short time if:
Your child should exercise regularly (See Appendix 36) to create healthy fatigue.
DIET & FLUIDS
No special diet, but your child should not eat within 3 hours of bedtime if indigestion has previously disturbed sleep. Drinking a glass of warm milk before bedtime helps some children.
OK TO GO TO SCHOOL?When appetite has returned and alertness, strength, and feeling of well-being will allow.
CALL YOUR DOCTOR IF
Your child has insomnia.
New, unexplained symptoms develop. Drugs used in treatment may produce side effects.