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Insomnia can lead to irritability, depression, and accidents. It is a symptom that needs to be taken seriously.
Shakespeare in The Tempest assures us that our little lives are rounded with a sleep, yet despite these encouraging words he was familiar with the horrors of insomnia. It is not only ghosts who walk at night in Shakespeare’s plays – Macbeth, Lady Macbeth and Hamlet all suffered from sleeplessness as the result of anxiety.
So good was Shakespeare’s description of the causes and problems of sleeplessness that it is a fair bet he was writing from personal knowledge.
Research a few years ago showed that a third of us believe our sleeplessness is severe enough to be described as insomnia. Those afflicted would sympathize with Lady Macbeth immediately over her inability to sleep, if not for the murders that caused it.
The NICE report emphasized the importance of following the usual tips for a good night’s sleep before resorting to sleeping pills, and stressed that when these were used, it should be for only a short time. The avoidance of stimulants, such as coffee, once lunch is over, or in some cases having none beyond breakfast time, is recommended. Other precautions include taking regular daily exercise but never taking strenuous exercise or engaging in emotional conversations before bed. Some doctors disapprove of a television screen in a bedroom for the same reason, but will accept that a radio playing softly can be useful provided that the program is interesting enough to stop the insomniac thinking of their problem, but not so interesting as to keep them awake.
Bedrooms should never be used for writing, studying, eating or working. They are for sleeping. Before going to bed there should be the same routine each day – checking locks, cleaning teeth, having a bath, setting the alarm clock.
Insomnia is important. 94 percent of sufferers say that it affects their life adversely the next day, and they attribute poor concentration, increased irritability and depression to its effects. This is especially true in the over-65s: more than 90 percent of patients in this age group related the depth of their depression to the seriousness of their insomnia.
People are not convinced that their doctors share their worry about insomnia. Only a third of those with insomnia had spoken to their doctor about it, and when they did only a fifth claimed that their GP had provided either advice or medication.
Insomnia is always an important symptom that may be an indication of stress and tension or one of the clinical forms of depression -and sometimes even of a psychosis.
Problems concerning personal life, rather than work, are more likely to cause sleeplessness. Many men are reluctant to admit that personal stress leads to sleep disturbance; they would rather blame the hours they work. Bereavement, the most common single reason given for sleeplessness, affects women in this way five times more often than men.
Accidents as the result of sleep disturbance, either because of tiredness the next day or due to the lasting effect of a sleeping pill taken the night before, are always of concern. Research from New Zealand and Australia has shown that 60 per cent of all accidents are partly related to fatigue. A large survey even suggested that a third of all road accidents could be attributed to driver fatigue. Other research has shown that the influence of tiredness on motorway accidents is even greater. Again, many researchers suggest that sleeping pills can be helpful in these situations.