Insomnia
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| Insomnia |
Definition of Insomnia
The term insomnia comes from the Latin in- which means "not" or "without" and somnus which means "sleep" (Nevid et al., 2005:61).
Insomnia or sleep disturbance is a condition of a person with poor sleep quality and quantity (Lanywati, 2001: 15).
Insomnia can also be defined as a sleep disorder or a noticeable change in sleep patterns (Ibrahim, 2001:68).
Symptoms of Insomnia
According to Rafknowledge (2004:57), insomniacs generally begin with symptoms such as the following:
1). Difficulty falling asleep or not achieving deep sleep that can last through the night and last for days, weeks or more
2). Feeling tired when you wake up and not feeling refreshed. Those who experience insomnia often feel like they never fall asleep at all.
3). Headache in the morning which is often referred to as the "hangover effect", when in fact the person did not drink that night,
4). difficulty concentrating,
5). Easy to get angry,
6). Bloodshot eyes,
7). Sleepy during the day.
Then according to Laniwaty (2001:13), the symptoms of insomnia are:
1). Difficulty initiating sleep (initial insomnia), usually caused by emotional disturbances, tension or physical disturbances, (eg, excessive fatigue or a disease that interferes with organ function),
2). Waking up too early (early awakening), which is able to start sleeping normally, but sleep is easily interrupted and or wakes up earlier than usual bedtime, and then can't go back to sleep again. These symptoms often appear as a person ages or because of depression and so on.
Classification of Insomnia
According to the WHO diagnostic classification in 1990 (Laniwaty, 2001:13), insomnia is included in the DIMS (Disorder of Initiating and Maintaining Sleep) class. Practically, insomnia is classified into two groups, namely: primary insomnia and secondary insomnia.
Primary insomnia is a sleep disorder whose cause is not known for certain and usually lasts a long time or is chronic (long term insomnia). Primary insomnia often causes complications of anxiety and depression, which can actually make the insomnia worse.
Taruna (2007) explained that in primary insomnia, there is a hyperarousal state (increased alertness) where there is excessive activity of the ascending reticular activating system (metabolic activity in the brain). The patient can sleep but does not feel asleep. The period of REM sleep is very less, while the period of NREM sleep is sufficient, the period of sleep is reduced and awakening is more frequent. Primary insomnia is not related to psychiatric conditions, neurological problems, other medical problems, or the use of certain medications.
Secondary insomnia is a sleep disorder whose cause can be identified with certainty. The cause can be in the form of physical pain disorders or mental disorders (psychic). Secondary insomnia can be divided into two, namely temporary insomnia (transient insomnia) and short-term insomnia (short term insomnia). Temporary insomnia (transient insomnia) occurs in someone who is included in the group can sleep normally, but due to temporary stress or tension, it causes a person to have difficulty sleeping. Short term insomnia is a sleep disorder that occurs in people who are physically ill or under situational stress.
According to Taruna (2007), secondary insomnia is caused by circadian rhythm disturbances, psychiatric, neurological or other medical problems, or drug reactions. Insomnia is very common in the elderly. This insomnia can occur due to psychoneurotic and organic diseases. In people with insomnia due to psychoneurosis, non-organic complaints are often found, such as headaches, bloating, body aches that interfere with sleep. This situation will be worse if the person is experiencing tension due to life problems. In insomnia secondary to organic disease, the patient cannot sleep or the continuity of sleep is disturbed due to organic pain, for example, arthritis sufferers who are easily awakened by pain caused by changes in body posture.
Causes of Insomnia
The causative factors according to Ibrahim (2001:68), are:
1). Situational problems such as stress, work pressure, and marital discord,
2). Age,
3). unavoidable medical disorders such as pain and physical discomfort,
4). Attacks related to drug use, such as withdrawal symptoms from drugs, alcohol, or sedatives,
5). Psychological conditions, especially severe mental disorders such as schizophrenia and affective disorders.
Taruna (2007) explained that there are several risk factors for insomnia, namely:
1). Emotions (psychological factors). Holding on to anger, anxiety, or depression can lead to insomnia,
2). Habit. Caffeine use, excessive alcohol, excessive sleep, smoking before bed and chronic stress can cause insomnia. Environmental factors such as noise, extreme temperatures, and environmental changes (jet lag) can cause transient insomnia (temporary insomnia) and recurrent insomnia (permanent insomnia).
3). Age above 50 years old,
4). Gender. Insomnia affects more women (20-50% higher than men). Women suffer from insomnia more often because of their menstrual cycle. 50% of women reported suffering from bloating that interfered with their sleep 2-3 days in each cycle. Increased levels of progesterone cause fatigue at the start of the cycle.
Effects of Insomnia
According to Turana (2007) the effects of insomnia are physiological effects, psychological effects, physical effects, social effects, and death.
Physiologically, most insomnia is caused by stress, there is an increase in serum noradrenaline, an increase in Adrenocorticotropic hormone (ACTH or adrenal hormone) and cortisol, as well as a decrease in melatonin production.
Psychological effects of insomnia can be in the form of memory problems, impaired concentration, loss of motivation, depression, and so on. While the physical effects of insomnia can be fatigue, muscle pain, hypertension, and so on.
Social effects of insomnia can be in the form of a disturbed quality of life, such as difficulty getting promotions in the work environment, less able to enjoy social and family relationships.
People who sleep less than 5 hours a night have a lower life expectancy than people who sleep 7-8 hours a night. This may be because the disease that induces insomnia shortens life expectancy or because the high arousal state present in insomnia increases mortality or reduces the likelihood of recovery from illness. In addition, people who suffer from insomnia are 2 times more likely to have a traffic accident when compared to normal people.
