Insomnia is associated with a number of medical conditions. In depression, for example, there is the classic early morning wakening syndrome in which the subject gets off to sleep easily enough but wakes again in the early hours. Insomnia is common in patients with arthritic disease, when pain keeps them awake, in those with prostate or bladder trouble where there is a constant need to get up and pass water and in Parkinson’s disease where the patient has difficulty in turning and can get very uncomfortable in bed. People tend to require less sleep as they get older. The results of poor sleep are irritability, fatigue and anxiety. People’s sleep requirement varies considerably and there is evidence to suggest that the individual’s worry about loss of sleep can, sometimes, be more of a problem than the loss of sleep itself. Nevertheless, poor sleep is associated with a lack of mental sharpness on the day following associated with an increased tendency to industrial, domestic and road accidents.

One can make a number of useful changes to alleviate the symptoms. If possible, the sufferer is advised to go to bed as relaxed as possible. Regular exercise, a sensible diet – the last full meal not eaten late in the evening – a bath before retiring, all help. A warm milky drink and a carbohydrate snack on retiring are worth trying particularly as the latter increases the level of serotonin and promotes a feeling of well being. Caffeine should be avoided for several hours before bedtime, this includes coffee, tea and cocoa. Sometimes if the insomnia is severe, it may be necessary to see a doctor and, if acute, a short course of sleeping tablets may be given. Doctors try and avoid this option as far as possible because most of such medications are addictive. If, however, the doctor suspects that the insomnia has a depressive basis he may give anti-depressants medication which can be given over a long period and is not, generally, addictive.