INSOMNIA
Sleep is a normal periode of loss awareness which is used to restore the body condition both phisycally or psychologically
Sleep is one of the body defence to avoid all the side effect causing by lack of bed time.
Normally, the body needed to sleep about 6 – 8 hours depending on age, job activity, health condition and sleep habits. The older the less sleep we need. Babies need to sleep about 18 hours, adults about 8 hours, and older (above 50 years) need sleep time an average 5 - 6 hours. Sleep needs than specified quantity (number ) of sleep, but also by the depth (quality) of sleep. If someone have a short bedtime , but have enough depth of sleep, the recovery of body conditon work normally, so this one can wake up freshly with no health disturbance.
WHO data on 1993, there are about 18% of the world population who suffer with sleep difficult problem. This sleep disorder not only affect physical condition of the patient but also their psychological condition psikis that causes mental stress.
SLEEP PATTERN
The process begins with the normal sleep phase nod, a situation where the relationship between awareness with the environment become reduced. Excitative from the outside still can received and easily created awakened. Then, if the sleep process still continued then progessively decreased awareness and sensory excitement can still be accept but not the vague awareness. Next go to the sleep soundly in the phase where the sensory stimulation is not acceptable.
Brain activity during the sleep time can recorded in a graph with an EEG (Electro Encephalo Graph), so sleep patterns of a person can be observed
Referred to as non-REM sleep (Rapid Eye Movement). This phase, organs gradualy become less active, regular respiratory rate, decrase heart rate, muscle relaxation, eyes and face still quescent. This phase lasted for the approximately 1 hour, usualy a person still can hear the sound, so can easily to wake up.
- Paradoxal Sleep Pattern
Also known asa REM sleep. At this phase occur the rapid eyes movement , heart rate and respiratory become up and down, while the muscles going to total relaxation. Often, get a dream, talk in sleep, even snore. This phase last about 20 minutes.
In the sleep time that takes about 6-8 hours, both sleep patterns occurs alternately as 4 – 6 cycles
INSOMNIA
Insomnia or sleep difficult disorder to someone with lack of sleep quantity and sleep quality.
Symptoms the insomnia can be distinguished as follows :
- Difficulties start sleeping (initial insomnia)
- Wake up too early (early awakening)
According to WHO diagnostic classification, insomnia included in the DIMS (Disorder of Initiating and Maintainig Sleep) which in practice is classifed into 2 groups :
1. Primary Insomnia
Primary insomnia is a sleep disorder that its cause is not yet known exactly. Remedies still difficult and chronic. Often cause anxiety and depression complication, worsier the disorder. Most have a basic psychiatric disturbances, especially mild to moderate depression. Some of them is the alkoholic and drugs abuse. This last group require special handling in an integrated improvement of the conditon include sleep environments, medicines and psychoteraphy.
Cause of this sleep disorder is clear. Main causes is physical or psycological disorder. The treatment is relative easier, eradicate the main cause first. Secondary Insomnia is differentiated as follows :
- Temporary Insomnia (Transient Insomnia)
Occur to a person with normal sleep time but because of the temporary stress (e.g.: too noisy or bed exchange) come difficult to sleep. In this circumstances the hypnotic drugs maybe used, depending on adaptation ability to enviromental that cause the stress.
Occur in those who suffer physical illness (eg: cough, rheumatic pain , etc) or get a stress situasional (loss/death of close person, work change, etc). Usually this interference can be cured after adaptation, medicine and improving sleep atmosphere. Hypnotic drugs recommended for doesn't exceed 3 weeks (1 week is the best). Giving the medicine that criss-cross (intermittent) is more secure because it can avoid the occurence sedation effect that arise because of drug accumulation.
Treatment
- Find out and eradicate the major cause
- Make the patient clearly understand about the sleep important
- Develope sleep habit at the certain time in the night
- Try to reduce mental stress with funny and enjoyment activity
- Avoid food or drinks that contain with stimulant agent
- Hypnotic drugs, start with low dose, stopped when the desired effect is achieved
