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Tools and Resources
Insomnia, Sleep Disorders
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| Introduction |
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Insomnia is a chronic inability to obtain or sustain sleep. While everyone occasionally experiences sleeplessness, chronic insomnia is an ongoing, often debilitating condition. After a night of inadequate sleep, those with insomnia report impaired mental and physical abilities, diminished memory, reduced alertness, and impaired reaction time.(1) Chronic lack of sleep threatens the well being, productivity, and safety of millions of Americans. Insomnia is not a disease but a condition associated with a number of physical and emotional disorders. The incidence of insomnia is higher among people with chronic illnesses, such as hyperthyroidism, renal insufficiency, multiple sclerosis, and Alzheimer's disease. Pregnancy, alcohol intake, stress, and depression are also leading causes of insomnia.
What determines sleep remains somewhat a mystery. Four stages of sleep have been identified by studies of brain wave patterns. Stage 1, the lightest sleep, is accompanied by muscle relaxation and a slowing of the heart rate. During stage 2 sleep, there is an increase in heart rate and eye movements, known as REM (rapid eye movements). During REM sleep, there is increased autonomic nervous system activity indicated by rapid breathing and increased stomach acid secretion. Muscle tone during REM sleep is inactive. Presumably, this is the period when dreaming takes place. During deep sleep (stages 3 and 4), there is no dreaming. During the sleep period, a person normally cycles from stage 1 to stage 4 in about 90 minutes.(2) Waking after a sleep cycle is complete is common among the elderly and small children.
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| Footnotes |
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1 Leger D, Stal V, Guilleminault C, Raffray T, Dib M, Paillard M. Diurnal consequence of insomnia: impact on quality of life. Rev Neurol (Paris). Oct2001;157(10):1270-8.
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2 Freeman Clark JB, Queener SF, Burke-Karb V. Pharmacologic Basis of Nursing Practice. St. Louis: Mosby; 1993.
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