It is estimated that about 20 per cent of the normal population experience some form of insomnia at some time in their lives. The Australian Bureau of Statistics conducted a survey in 1983. They interviewed 465100 people at random and asked them if they had been taking sleeping medication in the last two weeks. They found that 3.6 per cent of those interviewed had been. Hence the problem of insomnia is fairly common. Consequently the manufacturers of sleeping pills are making millions of dollars out of insomnia.
But what is insomnia? The Oxford Dictionary states that insomnia means habitual sleeplessness. To the doctors, insomnia is only a symptom of underlying problems. Insomnia itself is not an illness. It is like a fever which is symptomatic of some underlying infection. If a patient has a fever, there is generally a cause for it. Both the fever and the cause should be treated.
However, there is a difference between fever and insomnia. Fever can be confirmed objectively by taking body temperature, and we can measure how high the temperature is. Insomnia is a subjective symptom and cannot be confirmed by measurement to assess how bad it is. Very often people complain that they never sleep a wink. Does this mean that they have the most severe form of insomnia? In other words, how reliable are people’s assessments of the severity of their insomnia?
With the help of the sleep laboratory we can now measure and objectively assess how much insomnia these people have. In Paris, Dr Betty Schwartz tested chronic insomniacs who insisted that they never slept. These people were monitored at night in the sleep laboratory. Since these people were convinced that they did not sleep at night, they agreed to press a button to signal that they were still awake whenever they heard a buzzer. It was found that, in most cases, they all had a normal sleep pattern on the EEG recordings. The buzzer sounded many times throughout the night, but none of these people pressed the button. These people, who insisted that they had insomnia, had in fact been sleeping soundly and could not hear the sound of the buzzer. In the morning, when they were questioned about their sleep, they still insisted that they had not been sleeping at all.
It has been reported that 95 per cent of healthy adults fall asleep within half an hour. Hence those who fall asleep within half an hour do not have insomnia. But is this true? People who fall asleep easily may wake up at 2 a.m. or 3 a.m. in the morning and fail to go back to sleep. This is called early morning insomnia. What about those that sleep and wake at normal hours, but wake up very frequently throughout the night. Do they have insomnia? And there are people who need only three or four hours of sleep without feeling any distress at night, and they function well the next day. They never complain of insomnia, but are they experiencing insomnia?
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