Insomnia

Sleep disorders can be prevented by following certain routines and maintaining good ways of life. Seeking help at an early stage is recommended, however. Prolonged insomnia can be very stressful to the body. It is also advisable to study and treat the typical causes of insomnia, such as pain and restless legs syndrome. Experts can help you find a solution to both common and rare problems!

How to sleep better at night

• Relax in the evening and before going to sleep
• Stick to a regular sleep schedule
• Maintain healthy ways of life
• Focus on exercising, outdoor activities and nutrition
• Enjoy beverages and alcohol in moderate amounts
• Apply bright lights and a smart alarm clock to maintain your sleep Schedule

Irregular difficulties falling asleep

• Often associated with stress and adversity
• Sleep hygiene is important
• Regular circadian rhythm
• Good prognosis!
• Mood and depression treatment
• Alcohol use interferes with the circadian rhythm!
• Sleep medication should not be used for prolonged periods

Sleep disorders of organic origin and excessive daytime sleepiness

• Daytime sleepiness is often caused by disruptions in sleeping at night
• Apnoea and restless legs can disrupt sleep
• Organic sleep disorders often cause additional risks
• Treatment can be performed after thorough examination
• Treatment is often quickly effective
• Report the symptoms at an early stage

Help with insomnia and sleep disorders

The examination of sleep disorders is important in order to determine and treat the underlying causes. If you experience insomnia or difficulties falling asleep, you may book an appointment with an occupational health physician or a general practitioner. Neurologists, psychiatrists and pulmonologists can help you with the underlying causes.

• Examination of sleep disorders
• Treatment of sleep disorders
• Non-pharmacological treatment of insomnia

Typical stories told at appointments

When people are asked about any health issues in their lives, the most common answers include various pains, aches, etc. The second most common issues are related to sleep: insomnia, daytime sleepiness, coping, the circadian rhythm, stress caused by working in shifts, etc. As in the case of pains, these issues can be caused by a variety of underlying factors of varying seriousness. In which cases there exists a medical problem that should be brought up at an occupational health physician’s, general practitioner’s or personal doctor’s appointment? What special symptoms and examinations are included? What can I do in order to improve the situation?

Circadian rhythm

Some aspects of sleep and daytime alertness are apparent and affected by our everyday activities. Parents are responsible for maintaining an appropriate sleep schedule for their children. Leaving the TV screen or computer monitor and going to sleep should be performed early enough to make going to school in the morning pleasant. The hurries and worries of everyday life can make the days of adults long, and weekends are mostly spent on recovering. Retired people may enjoy a siesta in the afternoon, but napping excessively should not interfere with a good night’s sleep by causing you to wake up too early in the morning. Maintaining good sleep hygiene refers to creating an ideal sleep environment that is quiet and calm and includes an optimal bed, blanket and pillows. People have different rituals before going to sleep: strenuous physical activities in the evening might not be appropriate for some because their body remains hyperactive, for example. It is also common that eating late in the evening causes trouble sleeping. Excessive use of alcohol in the evening is an efficient way of disrupting the circadian rhythm, and it can cause very serious sleep disorders. A small “nightcap” might actually help you fall and remain asleep.

We are all familiar with the circadian rhythm and its variations. For some, living according to the clock comes naturally, but there are night owls who have trouble waking up in the morning and early birds who are just unable to stay up late. In recent years, brain research has generated a lot of information on the properties of the biological clock of humans, also known as the circadian rhythm. The circadian rhythm follows level of illumination and presence of external stimuli, such as physical activity and consists of an approximately 24-hour cycle. In addition to the circadian rhythm, other cycles follow this schedule too. The secretion of cortisone, a hormone related to stress, as well as the temperature of the body vary in according to a 24-hour cycle.

Abnormal circadian rhythm

Some experience this schedule to be very “strict”, and even the slightest deviations can cause problems. For them, shifting to and from daylight saving time and travelling abroad can cause troublesome jet lag. There are people who are so sleepy in the morning that they are diagnosed with “delayed sleep phase syndrome (DSPS)”. This is very common among young people. Severe modes of DSPS may force people to select a job that includes night shifts, such as the profession of a security guard or night manager. Tiredness early in the evening is not as common, and it is called “advanced sleep phase disorder (ASPD)”. These conditions can be hereditary, and certain genetic defects related to them have been identified. Aligning the daily routine with the abnormal circadian rhythm can be very difficult for persons with these conditions.
Under normal circumstances, the cycle of the circadian rhythm depends on the level of physical activity and illumination. Some may benefit from bright light therapy performed in the morning, especially during the dark months of winter. Various studies on the sleep inducing effect of melatonin and its compounds have been conducted.

Maintaining a regular circadian rhythm is important if a tendency to deviate from the rhythm excessively causing difficult consequences has been identified. The rhythm may be interrupted during weekends, a holiday or travels. This may lead to an insomnia-like state, usage of sleep inducing medication and, in the worst case scenario, prolonged usage of sleeping pills.

A regular rhythm can be established and maintained with so-called smart alarm clocks. They are devices worn on the wrist that wake the user up before the defined wake-up time when they detect that the user is beginning to wake up. Waking up during this phase feels more pleasant than waking up during deep sleep, which often causes a groggy sensation. This “waking up on the wrong foot” can thus be avoided and the circadian rhythm can be improved. The smart alarm clock uses movement detection and identifies the sounds caused by movement to determine the appropriate time of waking up the user. Several smart alarm clocks are already available on the market. These innovations include the Finnish smart alarm clock named ArousalClock, which is based on mobile phone technology, does not require purchasing a new clock and is always available.

Difficulty in falling asleep

Everyone experiences occasional difficulties in falling asleep. Another common form of insomnia is to wake up too early in the morning and fail to fall asleep again. Insomnia usually begins with a slight disruption in the sleep schedule caused by stress or an adversity. This type of psychophysiological insomnia is not a disease per se. If insomnia caused by an external factor (grief, for example) is treated with medication, it must be ensured that the usage of the medication does not become the default mode of falling asleep. In the worst case scenario, using a sleep inducing medication regularly for a couple of weeks can already cause problems. It can be difficult to get rid of the habit without compromising the quality of sleep. The usage of sleep inducing medications must be infrequent and performed only when it is necessary. A recommended maximum rate of use is approximately 4 times a week, for example. A good schedule is not to use the medication on Friday, Saturday and Wednesday nights. This ensures that there are at least four nights of good sleep every week, either with or without the help of the sleep medication!

Daytime sleepiness

If excessive daytime sleepiness causes problems, identification of the underlying cause can be difficult. Every one of us can occasionally feel tired during the day. The condition is examined through questions like “do you feel more tired than your friends or co-workers” or “in which situations do you tend to fall asleep”. In addition to completing a survey, it is useful to keep a simple sleep pattern journal in order to record the varying degree of daytime sleepiness between different days, at what time of the day does the sleepiness occur and the related consequences (drinking large amounts of coffee, narcolepsy, napping) over 2–4 weeks.

Heavy daytime sleepiness can cause traffic accidents or poor performance at work due to narcolepsy. Maintaining alertness can also feel very arduous. The purpose of seeing a doctor due to excessive daytime sleepiness is to determine whether the condition is caused by an organic sleep disorder. In such cases, daytime tiredness is caused by poor quality of sleep or the lack of sleep and the actual need for sleep.

Restless legs syndrome

The restless legs syndrome is a curious but surprisingly common night-time movement disorder that causes trouble falling asleep. Some patients with this condition experience pain in their legs that is so intense that it can cause serious problems with falling asleep. The condition can be treated efficiently with new modes of dopamine medication once the diagnosis is confirmed

Learn more: (in Finnish)

Restless legs syndrome