Insomnia and Other Adult Sleep Problems

157 Pages·2009·0.5 MB·English

by  Gregory Stores

thefacts
Insomnia and
other adult
sleep problems
06
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Insomnia and
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PROFESSOR GREGORY
STORES
1
1
Great Clarendon Street, Oxford OX2 6DP
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First published 2009
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British Library Cataloguing in Publication Data
Data available
Library of Congress Cataloging in Publication Data
Stores, Gregory.
Insomnia and other adult sleep problems / Gregory Stores.
p. cm. -- (The facts)
Includes index.
ISBN 978-0-19-956083-7
1. Insomnia. 2. Sleep disorders. I. Title.
RC548.S76 2009
616.8e'4982--dc22
2008041665
Typeset in Plantin
by Cepha Imaging Pvt. Ltd., Bangalore, India
Printed in China
through
Asia Pacifi c Offset Ltd.
ISBN 978–0–19–956083–7 (Pbk.)
1 3 5 7 9 10 8 6 4 2
While every effort has been made to ensure that the contents of this book are as complete,
accurate, and up-to-date as possible at the date of writing, Oxford University Press is not able
to give any guarantee or assurance that such is the case. Readers are urged to take appropriately
qualifi ed medical advice in all cases. The information in this book is intended to be useful to
the general reader, but should not be used as a means of self-diagnosis or for the prescription of
medication. The author and the publishers do not accept responsibility or legal liability for any
errors in the text or for the misuse or misapplication of material in this book.
Foreword
Insomnia and other sleep problems comprise a common but generally poorly
managed group of disorders. It is important to have some idea of what should
be regarded as normal sleep, in terms of both duration and quality. There is
great variation and what is normal for one individual is not for another.
Reference is made to 6–8 hours of sleep as normal for adults, but many
people—some well known, such as Margaret Thatcher and Winston
Churchill—can function with much less.
For the general public, disturbed sleep is often not something they like to
bother their doctor with, and yet, if persistent, it can have a devastating effect
on their lives and that of their family. Health professionals, on the whole,
are not always familiar with the large number of causes of disturbed sleep.
Reference may be made to sleep disturbance as a symptom of certain specifi c
diseases, but it is not often considered a topic in its own right. One hears, all
too often, of a visit to the doctor to discuss insomnia resulting in a prescrip-
tion for sleeping tablets. While on occasions this may be appropriate, generally
the prescription pad is reached for too quickly. It is perfectly understandable
for a busy GP with a shortage of time not to enquire more deeply into the
precise nature of the problem, but it may also be a result of insuffi cient knowl-
edge of the many causes of and reasons for sleep diffi culties.
This book, with its reader-friendly style and layout, will help the general pub-
lic to recognize the type of sleep problem that may be affecting them, or a
close relative or friend, and to realize that help is available, and to show them
how to fi nd that help.
T.P. Dudeney MB BS MRCGP
General Practitioner
v
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Contents
1 Introduction 1
2 Why is sleep so important? 5
3 What is sleep? 11
4 Changes in sleep with age 19
5 Signs of unsatisfactory sleep 25
6 Sleep problems and their underlying causes (sleep disorders) 29
7 Not sleeping well (insomnia) 39
8 Treatments for insomnia 51
9 Excessive sleepiness 67
10 Disturbed behaviour and strange experiences
at night (parasomnias) 83
11 Particular groups at special risk of sleep problems
and their consequences 103
12 Sleep disorders misinterpreted as other medical or
psychological conditions 125
13 Getting help with your sleep problem 131
Appendix 135
Glossary 137
Index 143
vii
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1
Introduction
06
Key points
◆ Sleep is an essential part of human existence.
◆ Disturbed sleep (which is common) can have various serious
consequences, especially concerning mood, behaviour, performance
at work or at school, and social relationships.
◆ It is essential, therefore, that people seek help for their sleep problems
and that effective treatment is provided.
Differing attitudes to sleep
Attitudes to sleep vary signifi cantly from one person to another. Some see it as
an enjoyable experience and even a relief from daytime pressures and cares—a
view expressed poetically by Sir Philip Sidney (1554–1586):
Come, Sleep! O Sleep, the certain knot of peace,
The baiting-place of wit, the balm of woe,
The poor man’s wealth, the prisoner’s release,
Th’indifferent judge between the high and low.
Astrophel and Stella (Certain Sonnets, Sonnet XXXIIX)
On the other hand, those who sleep badly can regard the night as a distressing
time, sometimes even to be dreaded, partly because of their inability to sleep
but also because things can generally seem much worse at night than during
the day. Literature again illustrates the point in Shakespeare’s Macbeth:
Good things of day begin to droop and drowse,
Whiles night’s black agents to their preys do rouse.
Macbeth, III, ii, 45
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