Dr Fiona McAndrew of Bupa Cromwell Hospital
Insomnia is one of the most common conditions seen by GPs.
In this article, Dr Fiona McAndrew discusses the different types of insomnia
and what can be done about the problem..
Difficulty in sleeping is a common problem
If you’ve ever had trouble sleeping, you know the
frustration it can cause – tiredness, irritability, difficulty concentrating –
and you’re hardly alone.
Insomnia is one of the most common conditions seen by GPs,
affecting about one-third of the population at some point in their lifetime.
Most people sleep between seven to nine hours a night, but many people
experience difficulty falling asleep, trouble staying asleep, frequent waking,
early morning waking and difficulty getting back to sleep.
Primary and secondary causes of insomnia
There are two main types of insomnia: primary and secondary.
Primary insomnia has no obvious cause. Secondary insomnia is caused by an
underlying problem, such as a medical condition or psychological problem, such
as grief or depression. In fact, approximately half of all cases of insomnia
are caused by psychological problems. Some other common secondary causes
include obstructive sleep apnoea, excess alcohol, illicit drug use, delayed
sleep phase disorders, and parasomnias (conditions such as restless leg
syndrome, sleep talking/walking, teeth grinding, etc).
Obstructive sleep apnoea is often associated with obesity
and is caused by upper airway obstruction. This obstruction reduces oxygen
intake, causing you to wake. Symptoms include snoring, waking up gasping for
breath, episodes of breathing pauses and excessive daytime sleepiness. You will
often find your partner is the one who sends you to the doctor for this.
Luckily, obstructive sleep apnoea responds well to a machine called a CPAP
(continuous positive airway pressure). Your GP will need to refer you to a
sleep specialist to confirm a diagnosis of obstructive sleep apnoea.