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Insomnia: Causes and Treatment
Abstract
This study aimed to explore to root causes of sleep disturbances, sleeping pills use, and their subsequent side effects among insomniacs. Insomnia is a common health challenge globally with severe health challenges. A thematic analysis was conducted on data obtained from the messageboard posts by seven patients. The findings indicated that there were different causes of insomnia, different methods of interventions and side effects of prescribed sleeping pills. Patients displayed different symptoms, treatment outcomes and adverse effects of drugs. It was concluded that insomnia is a serious medical condition that required individualised intervention or a combination of interventions to avoid certain side effects of self-administered sleeping pills.
Introduction
Sleep disturbances and their related consequences are common among adults and a part of human experiences, as many studies have indicated (Dyas et al., 2010; Moloney, Konrad, & Zimmer, 2011). Insomnia affects many people globally. For instance, over one-third of adults in the UK and North America have reported insomnia (Dyas et al., 2010). Women are more susceptible to sleep disturbances relative to their male counterparts, and the condition increases with age (Morlock, Tan, & Mitchell, 2006). Insomnia has costly consequences such as dysfunction, perturbed diurnal waking state, absenteeism from work, poor quality of life and dependence on sleeping pills.
More than one-third of people with sleep disturbances experience recurring symptoms or chronic conditions. In most cases, insomnia is comorbid and has been associated with physical abuse, depression, anxiety, chronic pain and other physical challenges. Evaluation of patients condition is imperative, but effective treatment of the condition leads to better outcomes and improved quality of life.
As studies have shown, most people with insomnia seek medical attention from general practitioners first (Touitou, 2007). Services provided may differ from one GP to another. Patients must confront a new diagnosis, which could be frightening, and doctors often offer sleep hygiene education and prescriptions. Reported cases of insomnia have demonstrated that there is a need to enhance the management of sleep challenges through effective medications, patient education, evidence-based practices noted in psychosocial interventions such as cognitive behavioural therapy.
To offer effective management and enhance patients experiences of care for insomnia, it is imperative to understand patients beliefs and conditions of the problem and their expectations. In most cases, however, general practitioners have often offered sleeping pills to manage cases of chronic insomnia. Like any other drugs, these drugs have different side effects on different patients. Most users have reported daytime drowsiness and confusion at night. Sleeping pills are powerful hypnotics and could be helpful, but sleep may persist after patients have woken up. Pagel (2005) had observed that previous sleeping pills used to induce sleep were dangerous and addictive, and clinicians failed to address the major causes of the problem. Over the years, however, sleep medications have improved, and understanding sleep problems have increased significantly. It is imperative to take sleeping pills at the right time to avoid daytime side effects. Drugs such as Ambien and Lunesta are common, and patients use them before going to bed. Sleeping pills are effective when taken at the right time, i.e., when one can get a full night of sleep, between seven to eight hours before waking up. A recent study has demonstrated that patients take their sleeping pills in the middle of the night (Roth et al., 2013). These are mainly associated with self-medication tendencies among insomniacs. It is a source of concern as patients become prone to self-administered drugs after nocturnal awakenings, yet little efficacy or safety data exist to support such usages.
This thematic analysis aimed to explore root causes of sleep disturbances, sleeping pills use and other interventions and their subsequent side effects among insomniacs. The study would form part of themes that define causes, pills interventions, and their side effects and outcomes in attempts to manage sleep challenges.
Do clinicians apply integrative approaches or interventions to treat insomnia in patients?
To answer this question, the study had to explore the causes of insomnia, interventions and outcomes of treatments provided.
This topic is important for understanding insomnia, its causes, interventions and outcomes, and therefore, it would contribute to treatment and management.
Method
Design
A qualitative study was conducted using online message board posts for patients with insomnia to explore root causes of sleep disturbances, sleeping pills use, and their subsequent side effects. The researcher was interested in patients experiences with different drugs and side effects so that the study could provide majors themes in sleep disturbances management.
A thematic analysis was used to identify major themes in the message board posts. The researcher believed that thematic analysis would provide an accessible and theoretically flexible approach to analyse qualitative data (Braun & Clarke, 2006).
Participants
Participants for the study were chosen from the messageboard posts. They consisted of male and female patients who had suffered insomnia for several years. There were seven participants, consisting of four male and three female chosen randomly from the messageboard. Participants were aged between 26 and 85 years old. These participants were Americans and British. Participants were a good sample because they could offer thematic concerns for sleeping pills use among people with sleeping disturbances. Moreover, they originated from different continents to reflect if treatments and experiences were similar.
Materials
Texts for the study were obtained from https://www.everydayhealth.com/. These posts were made between the year 2010 and 2011. Revolution health was health-based Web site and accessible to global users. Everyday Health provides materials for health education purposes on different health issues to different visitors. It also discusses current health issues to provide personalised health programmes for everyday living (Everyday Health, Inc., 2014).
Data from this Web site were appropriate for the study because of wide coverage and diverse contributions from users or patients.
Procedure and ethics
Data were obtained from the website, as mentioned above. Participants were randomly selected based on their posts, age and gender regarding insomnia. Only relevant texts to the study themes were selected for analysis. Texts were left in their original forms to capture true comments or themes.
Texts were analysed based on themes. Posts were reviewed and coded to identify similar themes. This process was repeated several times to refine and capture three major themes and their sub-themes. Although patients provided different accounts of their experiences, only relevant themes were selected for the study.
Although all study participants provided their names and locations, no names were captured in the analysis. Instead, anonymity was maintained during the coding process by using P1, P2 to P7 for all patients in the study. The material used was readily available from the public domain.
There was no ethical approval for this study because no human subject was directly involved.
Analysis
This thematic analysis aimed to explore root causes of sleep disturbances, sleeping pills use and their subsequent side effects among insomniacs.
One can simply identify themes as causes, interventions and outcomes or side effects of treatment. Critically, the study showed that there is no single cause of insomnia; sleeping pills alone were common for intervention, but were not effective and had severe side effects. That is, general practitioners did not address the root causes of insomnia.
To answer the research question, the study showed that general practitioners did not use integrative interventions to treat insomnia, but rather prescribed sleeping pills alone, which could not address the root causes of the problem.
Table 1: Table of themes on causes, interventions, and side effects of sleeping pills
Patients with insomnia described different causes of their conditions. For instance, causes of insomnia were related to past physical abuse, lack of care, certain diseases, worrying, anxiety, depression, certain life crisis and tinnitus, among others. These sub-themes showed that causes of insomnia varied among different persons, between male and female and patient of different ages. For instance, P7 wrote that his insomnia resulted from tinnitus.
Patients also used different means to manage insomnia. Majorities sought help from general practitioners, who prescribed sleeping pills. Other patients used different methods, including physical exercise and yoga. It is imperative to note that pills were self-administered, and patients could easily change them, use them at different periods or combine them when they wish. For instance, P6 used a combination of pills and later noted thus, I decided to try my experiment I would take a 30-day supply of Lunesta, followed by a 30-day supply of Ambien, testing to see which was more effective for me .
Although some patients reported a lack of side effects with certain pills, majorities reported cases of pain, effects on physical and mental health associated with fatigue, dizziness, anxiety and depression and causes of abnormal behaviours.
Note: ovals show major themes, boxes show sub-themes and arrows show relationships
Discussion
Three major themes were noted after thematic analysis of the posts on insomnia. Patients mentioned causes, interventions and side effects. Causes of insomnia varied from patient to patient. Still, generally, a history of physical abuse, life crisis, depression, anxiety, use of certain medications and tinnitus were responsible for insomnia among patients who took part in the study. Moloney et al. (2011) noted that medicalization was contributing to insomnia in the US. The condition affected patients of both sexes with different ages (Morlock et al., 2006). Severity and effects of insomnia differed among patients.
Generally, many patients consulted their general practitioners when their conditions persisted. Previous studies by Dyas et al. (2010) had shown similar outcomes. Many clinicians did not address the root causes of insomnia. In this study, patients showed that they only received prescribed sleeping pills from general practitioners while there were no attempts to address the root causes of insomnia. Except for the patient who combined medication and exercise and reported positive improvements, others reported continued pain, abnormal behaviours, fatigue and dizziness among other side effects. Other studies have shown that sleeping pills had such side effects, particularly when self-administered (Roth et al., 2013). Patients had tendencies to self-administer sleeping pills, a practice that exposed them to adverse effects of such pills (Roth et al., 2013). It is therefore imperative to use sleeping pills alongside other interventions, such cognitive behavioural therapy to address root causes of insomnia.
Sleeping pills exposed patients to different forms of side effects. However, not all patients experienced similar side effects, while others did not experience such side effects at all with certain pills. This indicates that insomnia resulted from different causes, therefore, required different approaches. No specific interventions were appropriate for all patients. Therefore, clinicians need to understand the side effects of sleeping pills on their patients. Patients must also understand that self-administration of different drugs caused adverse effects on their health.
While this study provided significant insights on thematic issues in insomnia, it had some limitations. Data were gathered from patients posts, which did not capture certain data. Moreover, patients did not follow any guideline in their responses and issues of bias were not controlled. A small sample was also used in this study. Nevertheless, the study highlighted failures by patients to adhere to prescription and a lack of patient education on their conditions.
The study implications focus on clinicians and their roles. There is a need to educate patients on the risks of self-administered sleeping pills. Moreover, clinicians should understand the root causes of insomnia before prescribing sleeping pills because pills do not address causes of sleep disturbances.
In conclusion, insomnia is a serious medical condition that requires individualised intervention or a combination of interventions, including cognitive behavioural therapy, to avoid certain side effects from self-administered sleeping pills.
References
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77-101.
Dyas, J., Apekey, T., Tilling, M., Ørner, R., Middleton, H., & Siriwardena, N. (2010). Patients and clinicians experiences of consultations in primary care for sleep problems and insomnia: a focus group study. British Journal of General Practice, 60(574), e180e200. Web.
Everyday Health, Inc. (2014). Company Overview. Web.
Moloney, M., Konrad, T., & Zimmer, C. (2011). The Medicalization of Sleeplessness: A Public Health Concern. American Journal of Public Health, 101(8), 14291433. Web.
Morlock, R., Tan, M., & Mitchell, D. (2006). Patient characteristics and patterns of drug use for sleep complaints in the United States: analysis of National Ambulatory Medical Survey data, 1997-2002. Clinical Therapeutics, 28(7), 1044-53.
Pagel, J. (2005). Medications and their effects on sleep. Primary Care, 32(2), 491-509.
Roth, T., Berglund, P., Shahly, V., Shillington, A., Stephenson, J., & Kessler, R. (2013). Middle-of-the-Night Hypnotic Use in a Large National Health Plan. Journal of Clinical Sleep Medicine, 9(7), 661-668. Web.
Touitou, Y. (2007). Sleep disorders and hypnotic agents: medical, social and economical impact. Annales Pharmaceutiques Françaises, 65(4), 230-8.
Do you need this or any other assignment done for you from scratch?
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