Many people who experience episodes of insomnia turn to prescription sleeping pills to solve the problem—and often this is just fine; there’s typically no harm in taking sleeping pills for a few nights, or on the occasional night when sleep won’t come.
For some people, however, medications just aren’t a good option. There are many reasons why this might be the case; some people find that sleeping pills don’t provide them with the restful sleep they need, while for others it’s more about trying to avoid using pills altogether. This is of particular concern for people in recovery from substance addiction, who must be careful to avoid the use of potentially habit-forming medications.
Luckily, there are lots of effective non-pharmaceutical options for treating insomnia and other sleep disorders. For example, dietary supplements such as magnesium and melatonin, taken before bedtime, can help make it easier to get to sleep. And improving your sleep “hygiene” by going to bed and getting up at the same times, and avoiding things like working or watching TV while in bed, can help too.
For more great information about non-pharmaceutical options for improving your sleeping habits, check out this article, aimed at people who are recovering from substance addiction, but full of useful information that might help others too.
If you’re like most Americans, you probably haven’t spent much time thinking about the benefits of napping lately. In fact, the last time most of us took a nap regularly was in kindergarten.
There’s a persistent idea that napping makes you lazy or unproductive, and that it’s only for small children and people too old to work. People even pride themselves on how little sleep they get.
Science, however, shows that the stigma against napping is misplaced and inaccurate. Carefully used, naps are a great way to boost your intelligence and productivity, ensure better health, and even work toward self improvement.
The Unnatural Full Night’s Sleep
Modern humans are among the few creatures that sleep all at once. Almost every other type of animal, from cats to canaries, gets polyphasic sleep. This consists of a series of sleeping and waking cycles during every 24 hour time period.
Even ancient humans tended to break up sleep. In ancient Rome, sexta or noon was considered the best time for a mid-day nap. The same practice was traditional in Spain, Mexico and many other countries, but it’s dying off due to the increasing use of American and Northern European business hours.
Since most people have extreme difficulty getting enough hours of sleep every night, the resulting sleep deprivation causes many health problem. Loss of sleep makes us less accurate, more irritable and more susceptible to disease. We have trouble feeling happy and healthy and our work often suffers significantly.
Advantages of Napping
Greater alertness – If you feel like you’re about to nod off at any moment, you’re not doing good work. Making time to get a nap could improve things significantly. According to one study performed by NASA, a 40 minute nap provides an alertness increase of up to 100 percent. Just 20 minutes produces greater improvement than either exercise or taking 200 milligrams of caffeine.
Better memory and learning capacity – Naps also help to boost your working memory, which is required for managing complex tasks. Sleeping for short periods is also good for longer-term memory, since you transfer information out of your short term memory and into permanent storage in the neocortex while you’re asleep.
Increased creativity and sensitivity – By taking a nap, you can boost your sensory perception abilities significantly. Being tired reduces your ability to taste food, enjoy beautiful things and process other sensations. It also cuts into your creativity; if you’re having trouble on a project, just take a nap and it may all come together.
Better health – When you deprive yourself of sleep, you boost your levels of cortisol, a stress hormone. An increase in cortisol makes you feel anxious and irritable. It also increases your risk of abdominal fat gain and glucose intolerance, reduces your ability to learn, creates hormone imbalances and causes a wide range of other problems that can damage your health. Sleep provides an antidote to this stress hormone, giving your body a chance to heal and rebuild.
Better mood – Serotonin is a neurotransmitter responsible for regulating appetite, sleep and mood. It helps us feel contented and happy. Unfortunately, high levels of stress hormones result in lower levels of serotonin. Sleeping regularly helps us rebuild levels of this important neurotransmitter and feel happier overall.
Monetary savings – One of the lesser known advantages of napping is saving money. Think of what you spend on coffee and energy boosters every week. By getting just a few minutes of sleep, you could cut out all those stimulants and enjoy the natural boost that comes with napping.
You may not have considered the possibility of using acupuncture for insomnia, but this alternative therapy could be a big help. Most people who have insomnia for more than a few days quickly turn to medications, but many sleep drugs come with serious side effects.
They’re also usually only temporarily effective and can even result in dependencies. Acupuncture is much safer and produces few to no side effects. Plus, it’s impossible to become dependent on it.
Acupuncture is a common practice in Chinese traditional medicine. It works by redirecting the flow of energy, known as qi, in the human body. This redirection is accomplished by inserting long needles at specific points, known as meridians. Since acupuncture often produces calming effects, it makes an excellent treatment for insomnia.
How Acupuncture Works for Insomnia
Standard acupuncture practice divides insomnia up into several different categories. The acupuncturist can only provide correct treatment when he or she knows which qi flows need to be redirected.
Difficulty falling asleep – Yang qi has been blocked from yin portions of the body, preventing complete relaxation.
Waking up during the night – This problem occurs when your body traps internal “heat.” When this energy can’t dissipate, insomnia occurs.
Waking too early – This is associated with poor yin energy from the kidneys. It’s often associated with lifestyle problems.
Vivid and disturbing dreams – This is attributed to “heart fire” or “liver deficiency heat,” problems that prevent you from relaxing and keep your brain too active.
Complete inability to sleep – Acupuncturists say that this problem is caused by problems in the spleen or liver, which reduce the quantity and quality of blood in the body.
Each different type of insomnia receives different acupuncture treatment, but the overall goal is the same. Your acupuncturist will work to unravel stress and put your internal energies back into balance, helping you calm down.
Some people even fall asleep during treatment!
In many cases, the best sleep occurs right after receiving a treatment. You may continue to sleep soundly after that, or you may experience symptoms again just a few days or weeks later.
In these instances, you have a more serious imbalance that will need multiple treatments. In either case, using acupuncture for insomnia provides an effective alternative to potentially-addicting drugs.
Pregnancy insomnia can occur at any point during pregnancy, but it’s more common during the last few months, when changes to the body are at their most extreme. As much as 80 percent of patients suffer from this problem at some point during their pregnancies.
While doctors don’t distinguish this form of insomnia from conventional sleeplessness, pregnant insomnia sufferers tend to have a number of causes in common. They can also use many of the same treatments to get relief.
All insomnia is characterized by an inability to get good quality sleep or enough hours of sleep total. The specifics vary from person to person, however, even in pregnancy.
Some people have trouble falling asleep, while others find themselves waking up regularly during the night.
It may be hard to get back to sleep if noise, light, or the need to go to the bathroom wake patients up during the night. The sleep that they do get may be of poor quality and leave them feeling tired and moody.
Insomnia during pregnancy is caused by a wide range of common factors. These are all based on physical and hormonal changes that occur during the pregnancy, so insomnia tends to be at its worst when patients are nearing term and those changes are most severe.
Here are a few of the potential causes for this kind of insomnia:
Abdominal discomfort – Changes in the size and shape of the abdomen may be uncomfortable enough to keep patients awake or cause them to sleep poorly.
Back pain – Many people suffer from back pain due to the difference in weight distribution and posture that occurs during pregnancy. This can cause unrestful sleep, difficulty getting to sleep, or frequent wakeups.
Heartburn – During pregnancy, the uterus expands and compresses the stomach and esophagus, making painful acid reflux more common. This is especially likely when patients lie flat on their backs.
Anxiety – The hormonal changes that occur during pregnancy can cause a significant increase in the brain chemicals responsible for anxiety and depression.
Frequent, vivid dreams – Many pregnant patients find that changes in their hormones also cause them to dream vividly. These dreams may wake them up throughout the night.
Frequent urination – Uterine expansion can also compress the bladder and kidneys, causing pregnant patients to wake repeatedly in the night to use the bathroom.
Anticipation – With a baby on the way, many new parents experience excitement, worry and other strong emotions that may cause nighttime wakeups and poor sleep quality.
Leg cramps – Painful cramps caused by hormonal and nutritional changes often occur at night.
Treatment for this form of insomnia usually focuses on easing discomfort and targeting the symptoms, since the causes are difficult to treat. Some of the commonly-used options include:
Pre-bed calming rituals such as tea, soft music or meditation
A dark, quiet sleeping environment
Changes in sleeping positions
Daily physical exercise
Changes in eating habits to prevent heartburn
Reducing caffeine consumption
Reducing fluid intake close to bedtime
Mild sedatives when behavioral and environmental methods fail
Pregnancy insomnia is fundamentally a short-term disorder. Most patients recover within a relatively short period after birth, though new babies may also complicate sleep.
OVERVIEW: Hypopnea syndrome refers to episodes of extremely shallow or slow breathing during sleep. These episode interfere with the body’s ability to get enough oxygen. They may induce repeated waking up during sleep, though the sleeper is not always aware that this happens.
This disrupted sleep cycle causes symptoms similar to those of sleep apnea, in which the sufferer has trouble feeling rested during the day and may be depressed or forgetful.
This sleep disorder is not identical to sleep apnea, however, since some air is flowing through the respiratory system at all times.
Up to a quarter of men between 30 and 60 years old and about 9 percent of women in this age group suffer from this problem, but it can be hard to estimate the true number because most people never get diagnosed.
While this problem isn’t as serious as sleep apnea, it can still worsen over time and increases a person’s risk of a heart attack or stroke.
This condition tends to disrupt sleep patterns during the night, causing patients to get poor quality sleep and to miss vital deep and REM sleep stages.
That leads to a number of unpleasant symptoms:
Ease of fatigue
Lethargy and low energy levels
Reduced ability to concentrate
Headaches upon waking
Strong mood swings
Loud snoring and snorting
People who suffer from hypopnea often spend a lot of time asleep, but they wake feeling unrested. They may also find themselves sleeping at unusual hours or suffering from insomnia due to unusual sleep patterns.
Their loud snoring, punctuated by periods of silence, can be an irritation for partners and family members and may cause serious strain on relationships.
A person may suffer from hypopnea syndrome for a number of reasons, including:
Congenital defects of the throat and nose
Obesity or high weight
Weakened respiratory muscles
Alcohol or sedative use
Like sleep apnea, hypopnea happens more often in people who are overweight or obese. It can also happen in some people who have relatively low levels of body fat, but who naturally have thick necks or who have a high body weight due to muscle gain.
Many of the same factors that influence sleep apnea and snoring are also causes of hypopnea syndrome.
The treatments for hypopnea syndrome are similar to those used for sleep apnea. All of them involve reducing airway obstruction or changing the shape of the airway to increase airflow and reduce the risk of low-oxygen states. They include:
CPAP treatment with a mask and externally-enforced air pressure
BPAP treatment, a muscle and nerve-stimulating drug for people with neuromuscular problems
Oral appliances made by a dentist
Changes in sleep position
Avoiding drugs, alcohol and sleep medication
Surgery on the soft palate, tonsils, uvula, tongue or adenoids
While it may be easier to deal with having hypopnea than sleep apnea, this disorder should never go untreated. Getting treatment for this problem can greatly reduce daytime tiredness and improve mental health.
It also decreases the risk of eventual heart and other cardiovascular problems, which can be aggravated by the low oxygen states associated with hypopnea syndrome.
Millions of people in the U.S. suffer from sleep debt or sleep deficit, which is the result of sleep deprivation or insufficient amount of sleep over a period of days, weeks or longer.
Sleep debt happens when the amount of sleep you are actually getting is less than the amount of sleep you should be getting. It’s a deficit that increases every time you short-change yourself from obtaining those essential minutes of nightly slumber.
In advanced cases, a sleep deficit can cause physical and mental health problems.
Is Sleep Deprivation Serious?
Studies show that severe sleep deprivation can lead to:
Lack of performance ability
A recent study at the University of Chicago restricted a group of healthy young men to only 4 hours of sleep for six nights in a row. Afterwards, their blood tests showed results that nearly match individuals who have diabetes.
A tremendous drop in insulin due to a reduced ability to process blood sugar, elevated levels of cortisol. High levels of this stress hormone can lead to hypertension and impaired memory.
The research leader, Dr. Eve Van Cauter reported that habitual short sleepers have difficulty maintaining stable blood sugar levels, which makes them susceptible to obesity and diabetes. Experts are starting to speculate that sleep deprivation could be a leading cause of the obesity epidemic in the U.S.
Van Cauter said that getting the proper amount of sleep is not only vital for physical health, but also for performance levels and emotional well-being.
What If Sleep Deprivation Is Unavoidable?
For many people sleep deprivation is something that they have to deal with on a fairly regular basis, such as those that have to work odd shifts, or students preparing for exams.
In situations such as these, making up for that lost sleep will take more than merely getting a couple nights of good sleep. First of all, it has been determined that you cannot easily recoup lost slumber unless the sleep you have missed out on is recent.
This means that if you have been going without the right amount of shut-eye for a few months or even longer, you can’t settle that debt by just getting a couple nights of good sleep.
On the other hand, if the sleep deprivation spans only a short period of time, it is possible to regain that rest fairly quickly.
What Can Be Done?
The effects of sleep debt can be hidden, albeit only on a temporary basis, in order to allow for performance to be restored.
There is a catch, though. While a good night’s sleep might remedy the effects of the lack of sleep for a limited time, the person will likely experience a worsening in their performance ability the longer they remain awake thereafter.
They might also experience a range of other fatigue-related problems, like diminished memory, reduced vision and impaired driving.
So, although you may think you can compensate for your sleep deprivation over the weekends, the fact of the matter is that all you are really doing is accumulating your sleep deficit over and over.
There is good news, however. With conscious effort and discipline, sleep debt can be repaid— just don’t expect it to happen in one extended snooze session.
Adding an additional hour or two of sleep a night is a good way to get back on track. For people who have been chronically sleep deprived, it may take a number of months to return to a normal sleep pattern.
So, make the time to erase that sleep debt and you’ll find it’s the best investment you’ve ever made.
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Understanding sleep stages can be very important for people whose sleep cycles feel incomplete or interrupted. Anyone who has ever slept for hours on end, but still awakened feeling tired knows that not all sleep is the same.
Sleep is divided into two major types :
NREM – The first is non-rapid eye movement sleep, or non-REM. This is divided into four sleep stages, each one a little deeper than the previous one.
REM – After the non-REM stages are completed, people move into the second type of sleep, rapid eye movement, or REM, sleep.
During this REM sleep, most dreaming occurs and the eyes move quickly back and forth. People who don’t experience all these stages during a given sleep cycle can awaken tired and disoriented.
The earliest phases of sleep can be hard to detect, since the sleeper still feels relatively awake. The brain, however, has already begun to stop producing as many tiny, fast beta waves and has increased its production of the slower alpha waves.
During this period, most people don’t quite feel asleep and may have thoughts that feel dreamlike.
Some sleepers even experience very vivid sensations and images while in this state. These are called hypnagogic hallucinations and may suddenly cause you to wake up. Some people hear voices, feel as though they are falling, or are struck by the sudden sensation that a person or animal is in the room with them.
Stage One Sleep – Sleep cycles begin with stage one sleep, which is fairly light and acts as a transitional phase between being awake and being asleep. The brain starts producing very slow waves during this sleep stage. This type of brain wave is known as a theta wave.
Stage Two Sleep – This part of most people’s sleep cycles is much longer than stage one and lasts for about 20 minutes. The brain’s wave pattern begins to become rhythmic and repetitive, producing a signature known as a sleep spindle. This encourages the heart rate to slow down and the body temperature to drop.
Stage Three Sleep – Delta waves, extremely slow and deep brain waves, are produced during stage three. This phase is usually fairly short and acts as the transition between lighter sleep and deep sleep stages.
Stage Four Sleep – Often referred to as delta sleep, stage four is characterized by large numbers of delta waves. This stage lasts for about half an hour in most people. It is the phase in which people who suffer from bed-wetting or sleepwalking are most likely to have problems.
Stage Five Sleep – By stage five, the body is ready to enter the REM phase, during which breathing and brain activity speed up. Muscles relax more and sleep paralysis sets in. Most people enter this stage about an hour and a half after beginning sleep, with progressive REM sleep stages lasting longer as the sleep cycles continue.
It’s important to pass through all these phases for healthy sleep. Non-REM sleep stages allow people to build and repair tissues and develop a healthier immune system, while REM stages are important for mental health.
When people get older, their sleep becomes lighter and less deep. Aging is also linked to shorter durations of sleep, although, contrary to public opinion, studies have shown that the necessary amount of sleep remains the same with the increase of age.
Presumably, this would account for the increasing frequency of napping throughout the day with seniors. The body is just trying to compensate for the diminished quality of sleep during the night.
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Delayed Sleep Phase Syndrome (DSPS) is a circadian rhythm sleep disorder in which a person’s sleep cycle is shifted hours later than a conventional bedtime. This causes the sufferer to also wake up later than desired, therefore reinforcing the pattern.
Sleepiness, secretion of melatonin and the appropriate core body temperatures required for falling asleep and waking up is all delayed by a proportionate amount of hours.
Although people with DSPS can’t get to sleep any earlier than about 2am to 6am, they basically fall asleep on the same nightly schedule and their sleep is of normal quality and duration.
If left to their own sleep routine (say, 4am-12pm), they generally will not exhibit symptoms of excessive daytime sleepiness. But, of course, if the person has school, work or family responsibilities in the morning this will cause problems.
Delayed Sleep Phase Syndromepatients are often referred to as “night owls” and are most alert and productive in the wee hours of the night.
Although Delayed Sleep Phase Syndrome (also called Delayed Sleep Phase Disorder (DSPD) and Delayed Sleep Phase Type (DSPT) can occur in any demographic, young adults, especially college students are the most common group affected by this disorder, due to having to stay up late studying for school. And then there’s the partying… As a result, their internal sleep cycle adjusts to this schedule.
This can cause complications if the student has to get up for early classes. Their concentration will be poor, they’ll likely have mood issues and they will eventually acquire a sleep debt. Shift workers can also develop delayed sleep phase syndrome due to their late or rotating schedules.
Adolescents are especially susceptible to DSPS and even cases in younger children have been recorded. Adolescents who refuse to participate in a plan to reinstate healthy sleep patterns, may be experiencing clinical depression. It is uncommon for Delayed Sleep Phase Syndrome onset to take place after the age of 30.
The objectives of treatment are to readjust the body clock back to a normal bedtime. If the subject does not want to change his or her pattern, the goal will be very difficult to accomplish. To reclaim a more traditional schedule:
Practice healthy sleep hygiene:
Don’t nap during the day
Avoid caffeine, nicotine and alcohol close to bedtime
Melatonin is a sleep hormone produced by the body, but it is also available in an over-the-counter synthesized form. No prescription is necessary for purchase. Nevertheless, consult your doctor before considering taking melatonin.
OTC and prescription sleep medications can sometimes be helpful if used as prescribed. Pills can make matters even worse if proper directions are not followed, not to mention the potential for abuse.
If you think you may have Delayed Sleep Phase Syndrome, seek proper medical counsel.
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People all across the world are looking for snoring solutions, whether they want to help themselves or a partner.
That’s because snoring is more than just a noisy annoyance. It often leads to poor quality sleep in both partners, resulting in irritability, tiredness during the day, and an increased chance of getting sick.
People who suffer from severe snoring may also find that it causes problems in their relationships. This can include an increased risk of arguments, as well as loss of intimacy caused by sleeping apart.
Snoring can even indicate serious underlying health problems, such as growths in the nose and throat or sleep apnea. It should never be mistaken for a minor problem. This leaves many people desperate and willing to try any snoring cures they encounter.
Before you can choose the best snoring remedies for your situation, however, you need to understand why snoring occurs.
Snoring is a fairly obvious disorder. It occurs when the air moving through a person’s nose and throat causes the soft tissue to vibrate. When people are awake, they use the same vibrations to speak. When they’re asleep, those vibrations are uncontrolled.
Snoring may involve snorting sounds, loud “sawing” noises, nasal whistles and a range of other sounds. It may be consistent or irregular. Some people snore more because they naturally have softer tissue or more of it.
The following causes can cause snoring to develop or increase in frequency or severity.
Loss of muscle tone in the throat
Smoking or drinking
Poor physical condition
Congenital nose and throat abnormalities
Narrowed breathing passages
Allergies, colds and other respiratory disorders
Nasal polyps and other growths
Taking some medications
Poor sleep posture
Anyone can develop a snoring problem, but the condition is more likely to appear in men, who naturally have narrower breathing passages.
Those with larger neck circumferences are also more likely to start snoring, even if the larger size of their necks is due to muscle development rather than fat. This is because larger necks are more likely to compress the air passages, making it harder to breathe.
Some people may have a more serious underlying problem if they snore regularly and loudly. Called sleep apnea, this sleep disorder actually obstructs breathing completely, causing frequent wake-ups.
Sleep apnea causes extreme fatigue and can contribute to a range of health issues. This snoring cause can even be life-threatening in severe cases.
Finding the right snoring cures often depends on figuring out the underlying cause of the snoring. Fortunately, there are some treatment options that are inexpensive and work for most patients.
These all-purpose snoring solutions include:
Increased physical activity
Establishing healthy, regular sleep patterns
Reduction in smoking and drinking
Reduction in sedative and sleeping pill use
Sleeping on your side with your head elevated
Using a humidifier in dry climates
Avoiding dairy products before bed
Even in severe cases and patients who also have sleep apnea, these behaviors can do a lot to reduce snoring. They aren’t necessarily snoring cures, though.
If the snoring problem has been caused by an illness, growth, or other condition, you may have to participate in physical therapy, have surgery, or wear a medical device when you sleep. These snoring solutions may seem expensive or complicated, but they can lead to healthier sleep and a better quality of life.
Here are a few more advanced snoring remedies:
Mouth, throat, and jaw exercises to strengthen and tone soft tissue
Dental appliances or lower jaw positioners to open your airways during sleep
Surgical removal of soft tissue, including polyps and other growths
Surgical implantation of plastic devices to stiffen soft tissue
Patients should seek medical snoring solutions and the advice of a doctor whenever their partners report that they snore heavily and loudly, especially if they gasp, twitch or choke while they’re asleep.
Other “red flags” for snoring include extreme daytime tiredness and a tendency to fall asleep at inappropriate times. Some people may even find themselves asleep at meals or during conversations.
If you have these symptoms, your doctor may use home or clinic-based sleep tests to identify whether your snoring is caused by a more serious problem. Then, you can discuss the snoring solutions available to you.
Insomnia is an extremely common sleep disorder. In fact, during the course of any given year, 20 to 40 percent of people have some difficulty sleeping.
Most people will suffer from this problem at some point during the course of their lives, with insomnia afflicting almost twice as many women as it does men.
This condition is also significantly more common in people who have unusual work schedules, depression sufferers, and people who abuse drugs or alcohol.
There are several types of insomnia, which are categorized according to cause and duration.
Primary Insomnia Primary insomnia refers to difficulty sleeping when there is no other health problem or condition present. This condition is sometimes diagnosed when a patient actually suffers from delayed sleep phase syndrome, in which the person stays asleep through the night but has trouble falling asleep initially.
Patients who have primary insomnia may have other illnesses that do not directly contribute to the sleep problem. These unrelated issues are called “comorbid conditions.
Secondary Insomnia Secondary insomnia is a sleep condition caused by another medical problem or habit. Some of the most common sources of secondary insomnia include depression, restless leg syndrome, sleep apnea and hormone imbalances.
Medical treatments and some medications can also induce secondary insomnia, as can heartburn and asthma. Patients who use alcohol, caffeine or other drugs may eventually have problems sleeping as well.
TYPES OF INSOMNIA BY DURATION
Doctors also organize the types of insomnia by how long the problem lasts. This can help medical professionals decide the best course and type of treatment, as well as possibly helping patients to identify the underlying cause of the problem.
This condition is extremely short-lived, with most patients having problems for only a few days. Transient insomnia is often caused by mental or emotional problems, changes in sleep environment or timing, or by another disorder. The consequences of this problem are similar to those of sleep deprivation.
Acute Insomnia Acute insomnia lasts for longer than a week but less than a month. A patient can qualify as having acute insomnia if he or she has trouble going to sleep or staying asleep, as well as if sleep occurs but is not restful.
Acute insomnia may also be called short term insomnia. It is often associated with anxiety or increased stress, so some doctors refer to it as stress-related insomnia. This condition may also be caused by an illness, some medications, and environmental factors.
Chronic Insomnia Insomnia is categorized as being chronic when it lasts for a month or more. This condition can be primary or caused by another disorder and is common in people who have imbalances of stress hormones.
It is also a common result of severe depression, ongoing pain, and chronic stress. Long term chronic insomnia can result in severe fatigue, problems thinking clearly, and even hallucinations.
People with this disorder often experience extreme daytime sleepiness and may have trouble staying awake at appropriate times.
This rare form of chronic insomnia develops at birth and and continues into adulthood. Idiopathic insomnia is believed to be caused by an underactive or overactive sleep system. But positive identification of the cause remains unknown. Either gender can be affected and the condition appears to be genetic in nature.
These types of insomnia can happen to anyone, but there are ways to prevent them. By maintaining a strict sleep schedule, avoiding stimulants and depressants, and avoiding excessive activity at night, it’s possible to reduce the symptoms of these sleep disorders.