Colin Espie - An Introduction to Coping with Insomnia and Sleep Problems

You probably know all too well what insomnia is! Its a miserable experience when you dont sleep well at night, and having poor sleep affects how you feel during the day. So perhaps you dont really need me to tell you!

But then again, maybe its useful to confirm whether or not you have a clinical problem with your sleep. Heres a checklist of what insomnia is. By working through this list, youll be able to sum up the nature of your night-time sleep disturbance, its effects on your day- to-day life and, overall, how bad your problem is. Youll also be able to see what type of insomnia disorder youre suffering from.

To help you, the example shown here is of a mild but persistent sleep-maintenance insomnia with daytime effects of fatigue and mood disturbance (which means that the person has had trouble sleeping one or two nights a week for several months, and so feels tired and moody during the day).

Figure 1

Why dont you write down what kind of insomnia you have in this box?

Now, whatever type of insomnia you may have, try to remember this, as its quite important : insomnia is really a 24-hour disorder its not just about difficulty sleeping at night. Its also a daytime problem and, in fact, this is what drives many people to seek help. People can just about put up with not sleeping, but when theyre irritable or tired during the day, and perhaps not coping with work or relationships , as well as not sleeping, then thats quite a different matter.

So far so good. The next thing is to check to see if you might have any other forms of sleep disorder . Different types of sleep problems can go together, or we may think that we have one type when in fact we have another.

So heres another checklist! In each set of questions in the table opposite, youll see that theres a lead question in bold, and if you answer yes to that, you should then go on and look at the questions just beneath it. Do the same for each set of questions.

You can use Figure 2 as a kind of screening tool in case you may have difficulty with narcolepsy (which is a disorder of excessive daytime sleepiness), obstructive sleep apnoea (a sleep-related breathing disorder that also makes us really sleepy), or a sleep motor disorder (like periodic limb movement disorder or restless legs syndrome). There are also sections in Figure 2 on what we call parasomnias and circadian rhythm sleep disorders. Heres a brief word on each of these.

Parasomnias are divided into those sleep problems that happen during dreaming rapid-eye -movement (REM) sleep, such as nightmares, and those problems that occur during non-REM sleep (such as sleepwalking and night terrors). Circadian rhythm sleep disorders happen when the body-clock is out of sync with the clock on the wall. Common examples of these, which tend to be short lived, include jet lag and problems caused by shift work. In other words, the problem sorts itself out naturally over time. But there are some disorders of the body-clock which can be more long lasting.

If you answered yes to any of the five areas in Figure 2, you may wish to see your GP for further advice.

If you want to have another assessment of your sleep you can fill out the Great British Sleep Survey at www.sleepio.com. After you fill out the questions, the website will give you a report on your sleep. Sleepio is a new organization that is trying to find new ways to help people sleep better.