Health news blog » Anti Depressants-Sleeping Aid

DIFFICULTY FALLING OR STAYING ASLEEP: TYPES OF DIMS – TRANSIENT DIMS

admin — Sat, 18 Jun 2011 17:07:46 +0000

Let’s look now at one of the specific types of DIMS.
As I indicated earlier, the length of time a sleep disorder has persisted is an important element in understanding the nature of the problem and in prescribing treatment. Consequently, sleep problems in the DIMS category (and other categories, for that matter) are further classified as being transient (lasting only a few days), short-term (from one to three weeks), or long-term or persistent (a month or longer).
Transient DIMS is easily recognizable, even predictable, arising as it does from sudden or powerful—and, fortunately, relatively short-lived—emotional stress. The upheaval of such major life events as marriage, divorce, or the birth of a child can precipitate a sleep disturbance. Students facing exams are notorious victims. Other causes of transient DIMS include jet lag or hospitalization. As its name implies, transient DIMS lasts no more than a few days, perhaps a week.
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MANAGEMENT OF BED-WETTING

admin — Sun, 26 Dec 2010 15:34:58 +0000

Appropriate treatment of bed-wetting depends, of course, on the specific cause of the problem. In children perhaps the most important thing you can do is avoid overreacting to the situation. Children who wet the bed are not necessarily psychologically disturbed. Just the opposite: they are more likely to suffer psychological damage as a result of bed-wetting, due to the shame and embarrassment they experience among their family and friends. Your ability to deal patiently and rationally with the problem may be greatly enhanced by a simple tip: try double-layering the bed with regular and rubber sheets (one rubber sheet, followed by a regular sheet, followed by a rubber sheet, and topped off with a regular sheet). That way if bed-wetting occurs, you can quickly remove the top two sheets, return to sleep, and still feel confident that if the bed-wetting happens again you won’t have to confront a urine-soaked mattress. Your patience and understanding are the essential ingredients of any therapeutic approach.
Some management strategy is usually called for, however. The rate of spontaneous cure of bed-wetting is only about 15 percent per year in children over the age of six. The rest need some kind of thoughtful intervention in order to help remedy the situation.
As I often tell the concerned parents who seek my advice, correcting the unwanted behavior is only part of the goal. The other, and perhaps more critical, element is to demonstrate your awareness of, and sensitivity to, the needs of your children while they are awake.
Simply educating and reassuring both you and your bed-wetting child can work wonders. When parents are counseled to avoid harsh and punitive reactions that can create anxiety, guilt, or anger and may actually worsen the problem, they are then better able to try more productive strategies. Psychotherapeutic management is especially appropriate in cases of secondary enuresis, as it may reveal some stressful event in the child’s life that has caused bed-wetting behavior to develop.
Motivational counseling works to effect a cure in about one out of four bed-wetters. In this approach, children are encouraged to experience directly the consequences of their actions. If they are physically able, for example, they are asked to dress themselves in fresh pajamas and change their own wet bedsheets. Giving the child special rewards for staying dry—using a calendar marked with gold stars or serving favorite breakfast foods—may work.
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PSEUDO-INSOMNIA

admin — Fri, 08 May 2009 09:35:25 +0000

Insomnia is a subjective feeling and is influenced by many factors. The main component of insomnia is the distress felt as a result of not being able to sleep. People who say they are suffering from insomnia may in fact be getting enough sleep. But why do these people say they are not sleeping? It is because of the distress they feel when they are not able to fall asleep when they want to. These people who get enough sleep biologically and yet complain of insomnia, we call ‘pseudo-insomniacs’. ‘Pseudo’ means imposter.

(I) Feeling of distress. The difference between short sleepers and insomniacs is that the former sleep only a few hours at night, but feel well and function well the next day, whereas insomniacs invariably are miserable, feel distressed, became impatient of not sleeping, feel frustrated, and have little confidence in their innate ability to fall asleep even when they feel very sleepy. There are some people who can play cards all night without much sleep or attend wild parties well into the morning and yet feel no distress at all. However, these same people, when they are in bed and if they want to sleep and yet fail, will be so distressed and worried that they keep turning in bed and try all sorts of ways to make themselves sleep. Of course, the more they try to sleep, the more they cannot, which is the law of reverse effect. Hence they lose confidence in their innate ability to sleep and take sleeping pills.

(2) The expectation of more and better sleep. People are trained to sleep a certain number of hours a day when they are very young, and this magic number of hours stays in their subconscious, which has led them to think that a good sleep means sleeping eight hours or more. If they ever fall short of this, they become dissatisfied and distressed. They call themselves insomniacs.

(3) The facts of NREM sleep. During NREM sleep there are no thoughts and no memory. The only way to convince ourselves that we have in fact been sleeping is either to remember our dreams or to look at the clock before and after sleep. NREM sleep is like general anaesthesia—there is a blank in our continual awareness. These pseudo-insomniacs do not remember their dreams. They are not aware that they have slept as no one can ‘feel’ NREM sleep. It is difficult to convince them that they have had a normal sleep, as they expect to feel something when asleep.

(4) Frequent awakenings in the night. In the sleep laboratory it has been shown that we normally wake up many times in the night Most of the awakenings last only a few seconds and we fall back to sleep, not remembering them in the morning. If these awakenings last longer we feel distressed and, if they are all added up in the morning and remembered, we tell ourselves that we have had a bad night of broken sleep. The distress of lying awake in bed even for a few minutes will be remembered and exaggerated in the morning, even if there was actually many hours of sleep. This is the power of exaggeration when we are stressed.

(5) Natural insomnia sets in with age. As we grow older we need less sleep. Ian Oswald in Edinburgh reported an interview of 2500 people of different ages. Over 20 per cent of the elderly who were interviewed said they slept less than five hours each night As we grow older we need less and less sleep. However, even if we need less sleep, we are not contented, as the distress of lying in bed and not sleeping is unbearable to a lot of us. In contrast, there are a lot of older people who are completely satisfied with only three to four hours sleep at night They do not complain of insomnia and they do not take sleeping pills.

Hence a large proportion of people who think they have insomnia are in fact experiencing pseudo-insomnia. In fact these people are healthy, and if they are tested in the sleep laboratory they are found to have a normal sleep profile. They are imposters.

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HELPFUL TRAINS OF THOUGHT FOR SELF-MANAGEMENT OF ANXIETY: CONCENTRATE ON THE FEELING OF CALM

admin — Wed, 29 Apr 2009 10:25:24 +0000

Now we can consider more specific measures for the relief of the mental symptoms of anxiety. We include in this all the various forms of mental disquiet which anxiety brings to us: tension, apprehension, restlessness, and all the strange variations of feeling which bring us to know that all is not well with us.

We use trains of thought which are most appropriate to our own particular circumstances. But we must always remember that the procedure is effective only when we are first thoroughly relaxed, and have let ourselves regress into this primitive type of uncritical thinking.

Concentrate on the Feeling of Calm-If apprehension is a prominent symptom, as it often is, we can proceed like this:

Relaxed.

Whole of my body relaxed.

Relaxed and calm.

Calm all through me.

Calm in my face.

Calm in my mind.

Remember that it is not just a matter of repeating these ideas over to ourselves in our mind. We do it slowly, easily, comfortably, and really experience the feeling of each idea in turn.

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