Insomnia is the commonest sleep disorder in the general population.
Insomnia is defined as the subjective perception of difficulty with sleep initiation, duration, consolidation, or quality that occurs despite adequate opportunity for sleep, and that results in some form of daytime impairment.
This is 74 year old male presented with chronic insomnia from past 3 decades. He was subjected to sleep study which revealed poor quality of Slow wave Sleep (SWS) and REM sleep. He was admitted for sleep re-education, which included Hypnotics orally and Benzodiazepene Intravenous administration with MVI infusion. While history taking it was clear that the insomnia was related to an underlying Anxiety about the fear of inability to sleep. History revealed that the patient had many traumatic situation in his life time which included the refuge during the partition of India. Patient underwent CBT and counselling, he was educated about sleep hygiene, Binaural sound waves were used to induce relaxation. Progressive muscular relaxation followed by hypnosis induction helped the patient to induce sleep.the primary treatment goal in insomnia regardless of any therapy insomnia evaluation and structured approach to therapy needs meticuloous history taking and identifying the source.
We follow following protocol in our SAANS Seep Rehabilitation Program
1. Detailed daily Sleep diary
2. Srict Sleep hygeine rules
3.Anxiety assestment through detailed pschycometric questionnaire
4. Co morbidity asssesment
5. Day time Sleep restrcition
6. Detailed supervised polysomnograghy to rule out othercauses and pattern of sleep
7. Breathing retraining techniues using Buteyko method to control sympathetic breathing
8. Cognitive Behavioural Therapy and Source revolution
9. Neuro Muscular relaxation using Pilates
10.Nutrional modification using high dose antioxidants and milk proteins
11. Judicious use of short acting hypnotics and mealotonins
13. Music therapy and biurnal sound