Women Genital Hygiene

Women Genital hygiene

Genital hygiene is very important for preventing infections from developing and spreading.
Many women take the issue of genital hygiene very seriously even to the extreme of becoming obsessed in cleanliness and aroma. Over cleaning of the vagina can in fact be harmful.


The inside of the vagina rarely needs cleaning with the use of soap. It has a natural balance of substances that can become disturbed by washing causing any bacteria that enter to have the potential of developing into an infection.
The external part of the vagina, the labia, should only need cleaning after toilet release using a mild soap and water. The area should also be cleaned following sexual intercourse.


Washing should be performed using a singular front to back motion to avoid bacteria around the anus from coming into contact with the vagina or urethra (the external opening to the bladder).

The anus should be the last part to be cleaned so the bath water or flannel does not become contaminated with bacteria that would be spread to other parts of the body.

Wash cloths and towels should be individual and washed after use.
Particular attention should be paid in the incidence of thrush and cystitis. All items should be single use and washed immediately, not left in the laundry basket.

There is no need to increase washing frequency whilst menstruating, as long as appropriate sanitary wear is being used. The use of stockings instead of tights and cotton underwear with good coverage rather than thongs, can help reduce the likelihood of perspiration and the transfer of bacteria from the anal region being introduced to the genital area. Perfumes and deodorants should not be directly applied to the genital region.

Once seen as a taboo subject, menstrual hygiene is now a multi-billion dollar industry with many products available giving women choices as to how they manage their personal menstrual hygiene.

Cleanliness
It is essential to maintain strict hand-washing practices before and after changing sanitary products. Any bacteria on the hands and fingers prior to fitting a sanitary product can be transferred to the vaginal canal and cause infection. Likewise, any bacteria on the fingers following the changing of a product can be transferred to other items.

Many women feel uncomfortable and unclean during their menstrual cycle and may wish to bathe more often. There are no rights and wrongs for washing and bathing and each individual will adopt practices that are acceptable to them. It should be noted though, that there is no need to clean inside the vagina during your period as this can disturb the normal body flora and increases the risk of infection. It is fine to gently cleanse around the external labia of the vagina and pat dry.

There are many feminine wipes and fresheners available for use during the menstrual cycle, though they are usually unnecessary and are used as much for their reassuring qualities than any other. They should not be used inside of the vagina as they may cause irritation.

Types of Products Available

Tampons

These are tubes of tightly packed cotton that are inserted into the vagina by either the fingers or with the use of an applicator. They are very discreet and once the correct technique of insertion has been established, they are extremely comfortable. They have the benefit of being wearable during any activities that the user wishes and are normally very reliable. The maximum time that they should be worn is eight hours, with the ideal duration between changing being four to six hours, or more frequently if necessary.

If you are likely to have a long sleep, it is not advised that they are worn overnight as the risks of developing toxic shock syndrome are higher. Toxic shock syndrome (TSS) is a potentially life-threatening condition that can arise from the prolonged use of tampons.

It is recommended that the lowest absorbency is used for each individual’s period so as to lower the risk of TSS. It is perhaps advisable to alternate the use of tampons with sanitary towels. Tampons should be avoided in the presence of a vaginal infection as the tampon provides an excellent breeding ground for bacteria and can spread the infection further.

Sanitary Towels

These are worn externally and are attached within the user’s underwear. They are less invasive than tampons, though can be more uncomfortable top the buttocks and upper thighs due to chaffing, especially in the summer months. They can be noticeable as pads designed for heavy flow tend to be bulky in some brands, so they are not ideal for use with some summer clothes.
Again these should be changed when needed and prolonged use should be avoided as they can develop noticeable odours. It is safest to use sanitary towels at night to avoid TSS.

Menstrual Cups

Menstrual cups can be either disposable or reusable and are worn internally. They collect and retain the flow, and can be emptied, cleaned and reused.
They are the best option for protecting the environment and are very cost-effective. They are discreet and the disposable variety are reported to be extremely comfortable.
All women manage their hygiene needs individually. There are no ‘correct’ practices and many of the issues surrounding menstrual hygiene are dependent of finances and cultures.

Sexually Transmitted Disease

The subject of STDs is a very important topic of discussion in modern society. With children in primary schools being taught about sexually transmitted diseases and the importance of protected sex, this subject cannot go without mention.

Types of STD
There are a multitude of diseases that can be spread from unprotected sex, some causing life threatening illnesses, others causing minor but highly irritating and embarrassing problems.
Sexually transmitted diseases can range from the extremely frightening HIV to the less problematic cystitis.

Preventing a Sexually Transmitted Disease
The most common ways of reducing the chance of transmitting an infection is by abstinence from sexual intercourse or by using condoms.

Condoms can be worn by either the male or female (Femidom), and are available in a wide range of colours, flavours, sizes and can even come with added features such as being ribbed.

Many people enjoy full sex lives without the need for having full sex by using methods of massage, touching and foreplay to enrich their lives; indeed this is particularly useful with a new partner until trust or the subject of being tested has been discussed.

There is nothing to be lost by asking a new partner for a full screen to be undertaken at your nearest clinic, but it is only fair to offer this test to be done on yourself also.
STDs can also be spread through oral sex and the use of condoms or cling film is useful to prevent this occurring.

Common Types of Illnesses

Herpes
Herpes can be found around the mouth or the genitals and can be spread easily from person to person by having unprotected sex and oral sex. Herpes results in painful sores and blisters and is a virus that once treated will continue to remain in the system through-out life.

Medications can be bought over the counter, though if these are not effective, a prescription from your GP or local GUM clinic may be necessary.
Avoid having sex whilst suffering from an outbreak and use condoms at all other times; though if sores have spread to areas outside the coverage of a condom, it can still be spread.

Gonorrhoeae
Gonorrhoeaeis a bacterial infection that can be passed by vaginal, oral or anal sex. The main consequence of Gonorrhoeae is infertility, and as it has no symptoms in its initial development it can be spread very quickly and very easily from person to person.

If left untreated for a long period of time, other parts of the anatomy may be affected and can have serious consequences. The best protection from Gonorrhoeae is the use of condoms and not having multiple partners.

Chlamydia
Chlamydia is a bacterial infection passed through intercourse and oral sex. It has no obvious symptoms and can cause urinary tract infections and infertility if left untreated.
Usually the only symptom of Chlamydia is from the urinary tract infection which can cause burning and increased frequency of urination.

Typical Symptoms of an STD
Below is a list of many of the symptoms that accompany STDs; it is worth remembering that these symptoms often occur a long while after the infection has developed so your treating doctor or nurse will want you to remember all sexual partners so that each infected person can be traced and treated.

. Discharge from the vagina or penis, often with itching.
. Pain during intercourse or when passing urine.
. Sore throat.
. Pelvic Pain.
. Sores or blisters developing that do not respond to other treatments.
. Swollen glands, fever, night sweats.

It is important to remember that by using condoms and by reducing the amount of sexual partners you have is the easiest and most effective way of protecting yourself from diseases.

It is impossible to tell from appearance who has an infection and who hasn’t. Do not be embarrassed to go and seek medical help; all appointments are confidential and you will gain respect for taking the responsibility seriously.

Thrush

is a yeast infection that occurs mainly in the mouth, vagina or with nappy rash. It is caused by a fungus that thrives in a warm, dark and moist environment, it is very common is women and is more likely to occur when pregnant, as a side-effect of certain medications, when run down or when immuno-suppressed, such as with HIV or when receiving chemotherapy. The fungal particles are usually harmlessly present in humans, but when unwell or under stress, it can multiply and become problematic.

Signs and Symptoms

Oral thrush is first seen with a redness of the tongue with the occurrence of a few small white spots. It can develop to a full coverage of the tongue with a thick whitish carpet-like appearance.
Vaginal thrush is distinguished by having a thick creamy discharge that can be odorous and itchy. The area may be red and tender with a small chance of pain when passing water.

Treatments
There a many creams and pessaries available for the treatment of vaginal thrush, and a selection of oral preparations to help eliminate oral thrush, many available as a single dose; the pharmacist at your local chemist can help select an appropriate treatment.

Prevention of Thrush

Avoid tight fitting clothes and underwear, especially in hot weather as this can increase the chances of developing thrush. If you know you are prone to thrush, try wearing stockings instead of tights and always wear cotton underwear, which should be changed at least once daily. Ensure the correct methods of sterilization of baby equipment is followed to help reduce the incidence of thrush in infants; if you are unsure, speak to your health visitor who will give advice on types of sterilization equipment available and demonstrate how to use it.

If using an inhaler of any type, always rinse the mouth after using the inhaler to prevent bacterial and fungal build-up.

Use separate towels for bathing and ensure strict hand washing techniques are employed to avoid the spread of thrush and the transfer of fungal infection from hand to mouth, especially after using the toilet or tending to menstrual hygiene. Avoid the unnecessary use of anti-biotics as this can increase the use of thrush developing.

Avoid unprotected sex, even with a long-term partner if thrush has developed as the infection can spread to partners. If thrush is a persistent problem, speak to your GP who may want to do blood and urine tests to rule out the incidence of diabetes.

If you are caring for someone with thrush, particularly the very dependent such as the elderly or mentally incapacitated ensure they have a frequent supply of clean fresh fluids and ensure teeth/dentures are cleaned thoroughly to help alleviate the symptoms.

Thrush is a very common problem and should not be confused with a sexually transmitted infection. It is a fungal infection that can develop in people of any age at any time.

Urinary tract infection or UTI

A urinary tract infection or UTI occurs when bacterial cells are found in the urine. Normally sterile before being passed from the body, urine is produced to excrete waste products from the body via the kidneys and out through the urethra. The urinary tract consists of the kidney, the ureters (tubes that connect the kidney to the bladder), the bladder, muscles and the urethra (the tube that connects the bladder to the external orifice.

If an infection is limited to the urethra, it is called urethritis, if it concerns the bladder, it is called cystitis; involving the kidneys is named pyelonephritis.
Causes of a Urinary Tract Infection
The bacteria that causes a UTI is normally found in the digestive tract, and is found to be abnormal to the bladder. As it is more common in women than men, experts believe that the reason for this is due to the shorter length and location of the urethra; it is a lot closer to the anus than in men, and it is thought that bacteria from the digestive tract migrates to the frontal area.

It can be transmitted through sexual intercourse, either from the transmission of germs from the anus, or passed on from the partner if they are suffering from a UTI themselves.

Signs and Symptoms
The most common symptom of a UTI is finding the urge to pass urine is a lot more frequent than normal. Often sufferers want to go to the toilet often, but when trying, cannot pass anything.
When able to pass water, it is often accompanied by a burning sensation that can be very uncomfortable for some. Urine may appear cloudy or even blood stained, and may cause pelvic pain. Any pain felt in the kidney area indicates the infection has reached the kidneys and needs immediate treatment, as untreated kidney infections can cause permanent damage.

Risk Factors

Being female seems to be the greatest risk factor as the incidence is much higher in women than men. There is also further increased risk if pregnant.
Those who are diabetic are more probable to develop a UTI, as are those who wear a catheter or use an intermittent catheter. Any foreign body of the urinary tract raises the chances of developing an infection; factors such as tumours or stones all increase the likelihood of an infection.
Children whom suffer from these types of infections are often found to have some degree of anatomical abnormality which will need treating.

Treatments
Increasing oral intake of fluids is useful for helping to flush toxins away and out of the bladder.

Drinking cranberry juice has been proven to help prevent the bacteria from adhering to the tissues of the urinary tract, so a daily drink of cranberry coupled with a generous intake of water will help to clear the infection.
Anti-biotics are frequently prescribed for the treatment of this infection, and the full course should be taken or symptoms may return.
Anatomical abnormalities, tumours or stones will need to be removed, often by a surgical procedure in order for the condition to be eliminated.
If pregnant, see your GP immediately who will prescribe anti-biotics, as a urine infection can complicate the pregnancy. Scientists are currently exploring the benefits of acupuncture in the treatment of a UTI.

Prevention

. Drinking plenty of fluids, including cranberry juice will help to stave off infections.

. If you are prone to infections, it may be worth considering a change in sexual practices as this may be the cause.
. When passing water make sure the bladder is fully emptied.
. When using toilet roll, always clean the area from front to back to avoid spreading the bacteria from anus to urethra.
. A diet rich in zinc and vitamin C increase the body’s immunity to infections.
. Urinary tract infections are a very common and often recurrent problem that affects more women than men. By employing some preventative measures the risk of developing a UTI may be lowered, some however will still be at significant risk of developing an infection.

Herbal medication for all women Genital Hygiene

Vagaclean powder is our herbal line of diseases and health problem prevention; it maintains healthy vagina, female organs, urinary tract, and in general good health and high female hygiene at one time.
It eradicates most resistant bacteria, virus, or fungus infection before it does any harm to your organs and your body.

Vagaclean powder is 100% organic herbs, no additives no chemical inside the formula.
It is very gentle and soft for all sensitive parts in your body. It is stringent, and would stop most of the vaginal discharges from happing, protect the urinary tract from infection, and keep your healthy organs maintained.

Package: 50 grams powder in tight container

Uses direction: use one small teaspoon in 3 cups of boiling water. Let it boil for 5 minutes, then let it to cool down or use it as little warm. Put the prepared liquid in a douche container, and start to clean the vagina and area around until the liquid is finished.
Repeat every day in the same time if you feel there is still dissatisfaction or abnormal discharge continues.

Price: 10 USA dollars or 30 RM inside Malaysia + shipping accordingly.

Insomnia, Difficulty falling asleep

What Is Insomnia?

Insomnia is a sleep disorder in which a person experiences poor sleep or has trouble sleeping. Insomnia can involve:

. Difficulty falling asleep
. Difficulty staying asleep (that is, waking up many times during the night), without necessarily having had any difficulty falling asleep
. Waking up too early in the morning
. Not feeling refreshed after a night's sleep

In any of these cases, the person feels tired the next day, or feels as if he or she did not have enough sleep.
Poor sleep for any length of time can lead to mood disturbances, lack of motivation, decreased attention span, trouble with concentration, low levels of energy, and increased fatigue.
About one-third of the average person's life is spent sleeping. Healthy sleep is vital to the human body and important for the optimal functioning of the brain and other organs.

There are three types of insomnia:

. Transient, or mild, insomnia - sleep difficulties that last for a few days; there is little or no evidence of impairment of functioning during the day
. Short-term, or moderate, insomnia - sleep difficulties that last for less than a month, that mildly affect functioning during the day, together with feelings of irritability and fatigue
. Chronic, or severe, insomnia - sleep difficulties that last for more than a month, that severely impair functioning during the day, and cause strong feelings of restlessness, irritability, anxiety, and fatigue

Need To Know:

Q: What is the right amount of sleep I should get?

A: Since everyone has different sleep needs, there is no "correct" amount of sleep. On average, most people need between seven and nine hours of good quality sleep each night in order to feel alert the next day. But some function perfectly well with only four or five hours a night. The key to healthy sleeping seems to be a consistent pattern, rather than the number of hours one sleeps.

Is Insomnia Serious?
Insomnia can have physical and psychological effects. The consequences of insomnia include:

. Impaired mental functioning. Insomnia can affect concentration and memory, and can affect one's ability to perform daily tasks.
. Accidents. Insomnia endangers public safety by contributing to traffic and industrial accidents. Various studies have shown that fatigue plays a major role in automobile and machinery accidents. As many as 100,000 automobile accidents, accounting for 1,500 deaths, are caused by sleepiness.
. Stress and depression. Insomnia increases the activity of the hormones and pathways in the brain that cause stress, and changes in sleeping patterns have been shown to have significant affects on mood. Ongoing insomnia may be a sign of anxiety and depression.
. Heart disease. One study reported that people with chronic insomnia had signs of heart and nervous system activity that might put them at risk for heart disease.
. Headaches. Headaches that occur during the night or early in the morning may be related to a sleep disorder.
. Economic effects. Insomnia costs the U.S. an estimated $100 billion each year in medical costs and decreased productivity.

Normal Sleep
Sleep is not a simple process. Many different parts of the brain control and influence sleep at different stages. There are two natural daily peak times for sleeping: at night and at mid-day, which in parts of the world is traditional "siesta" time.

Here is how the body initiates sleep:

. As light fades, cells in the retina of the eye send a signal to a cluster of nerve cells located in the hypothalamus, in the center of the brain.
. These cells in turn send a message to the pineal gland in the brain to produce the hormone melatonin, which causes a drop in body temperature and sleepiness.
. At the same time, another cluster of nerve cells in the brain is believed to deactivate three major chemical messengers in the body, that keep us alert: histamine, norephinephrine, and serotonin.

There are two distinct phases of sleep:

. Non-rapid eye movement (Non REM) sleep - The quiet or restful phase of sleep, also referred to as "slow wave sleep"; it is divided into four stages of progressively deepening sleep
. Rapid eye movement (REM) sleep - The phase of sleep in which the brain is active and dreaming occurs; it is also known as "dream sleep"

When we first go to sleep, the "brain waves" (the electrical activity normally produced in the brain) slow from a frequency of 10 cycles per second that usually occurs while we're awake, to about 6 cycles per second as our alertness decreases and we fall asleep. Then after about an hour, there is a sudden increase in brain wave activity for a few minutes when the electrical activity in the brain speeds up, similar to normal waking. This is REM sleep. During this time if the person is woken up, he will say he was dreaming.

Then the electrical activity of the brain slows down again. This cycle may be repeated several times during one night's sleep. Total REM sleep for the night is about 20% of the total sleep time. So we spend about a fifth of our sleeping time dreaming.

The phases of sleep occur in a repeated cycle of Non REM followed by REM sleep, with each cycle lasting about 90 minutes. The sleep cycle is repeated four to six times a night. It is possible to identify which stage of sleep a person is in by measuring different activities of the brain and body.
Each phase of sleep is important. Research suggests that Non REM sleep may play a role in bolstering the immune system and may also be tied to the rhythms of the digestive system. Experts believe that REM sleep is necessary for long-term emotional well-being and may help bolster memory.

Need To Know:
If your insomnia lasts longer than a few weeks and is affecting your mood, relationships, and ability to function well, it is a good idea to see a doctor, therapist, or sleep specialist.

What Are Sleep Disorders?
An estimated 40 million Americans experience some type of sleep disorder, but 95 percent of them go undiagnosed and untreated, simply because they do not realize they have a problem or because they think that nothing can be done for them.

Common sleep disorders include:

Insomnia, an inability to sleep or to remain asleep throughout the night
Obstructive sleep apnea, in which a person's breathing passages become temporarily blocked during the night; this condition is often marked by excessive snoring
. Chronic sleep apnea, a neurological condition in which the brain "forgets" to instruct the body to breathe

. Restless leg syndrome, in which a person has occasional movement and/or uncomfortable sensations in his or her legs, feet, or toes just before they fall asleep

. Hypersomnia, an increase in sleep by about one-fourth of a person's regular sleep patterns
. Narcolepsy, in which a person gets sudden attacks throughout the day and night of drowsiness and sleep that cannot be controlled
. Parasomnias, which are vivid dreams and physical activities that occur during sleep, such as sleepwalking (somnambulism) and episodes of screaming and flailing about (night terrors).

Nice To Know:
Chronic sleep deprivation - in which a person sleeps soundly, but just doesn't get enough sleep - is not classified as a sleep disorder, but it contributes greatly to our sleepy society. Experts say most of us need at least one more hour of sleep per night than we get.

Facts about insomnia:
. Studies estimate that about one-third of the adult population in the world experiences some insomnia each year.
. Experts estimate that only about 5 percent of people with insomnia seek medical help, and 69 percent never even mention the problem to their doctor.
. More than 35 million Americans suffer from long-lasting insomnia, with 20 to 30 million others experiencing shorter-term sleeplessness.
. Insomnia costs the U.S. approximately $100 billion each year in medical costs and decreased productivity.
. In the U.S., as many as 100,000 automobile accidents and 1,500 deaths from these accidents are caused by sleepiness.
. In one study, 40 percent of people with insomnia also had a psychiatric disorder.
. At least 70 percent of people with depression also experience insomnia.
. As many as 25 percent of people with anxiety disorders also experience insomnia.
. Substance abuse - especially alcohol, cocaine, and sedatives - plays a role in an estimated 10 to 15 percent of cases of chronic insomnia.

How Is Insomnia Diagnosed?
Insomnia is almost always the result of some other problem and is not an 'illness' in its own right. Discovering its cause is the most important step in relieving it. Your doctor will ask questions such as:

. How would you describe your sleep problem (for example, do you have trouble falling asleep, or is the problem waking up too early)?
. How long have you been experiencing the problem?
. Does it occur every night?
. Does it affect your daytime functioning?
. Do you snore?
. Do you have any medical conditions?
. Are you taking any medication?

Nice To Know:
Keeping a sleep diary can help your doctor make a diagnosis. You should record all sleep-related information such as how long it took you to fall asleep, how restful the sleep was, what you ate or drank before bed, how often you woke during the night, etc. Your bed partner can also help by adding observations about whether you snored, moved in your sleep, etc.

Most of the time, a physician can make a diagnosis of insomnia from the information provided by the person. But if unexplained insomnia persists, or if there is evidence that the sleep disorder is caused by a breathing problem, a doctor may suggest a sleep study at a sleep lab to identify the root of the problem.

Getting Help At A Sleep Lab
There are many excellent sleep labs throughout the U.S. that are designed to diagnose sleep disorders through a sleep study. Most require spending one or more nights in the lab. The American Sleep Disorders Association has a list of the accredited sleep labs in the United States.

Most sleep labs require a referral from your doctor. However, you may want to call and find out if you can have an evaluation done independently. Once you have made an appointment, you will receive complete instructions as to what tests will be done and what is required of you.

How-To Information:

How is a sleep study done?

A sleep study is conducted overnight. The individual arrives in the early evening and plans to spend the night in a bed in the sleep lab. Although a sleep study may look high-tech, it is pain-free and individuals are usually quite comfortable.
Electrodes will be attached with soft tape to various parts of the body, including the head, chest and legs. A belt may be placed around the abdomen and chest. These devices are linked to computerized equipment that record the body's sleep patterns through the night.

Recordings are made of brain wave activity, respiration (breathing), heart rhythm, eye movements, chest movements, arm and leg movements, and pulse oximetry, which measures the level of oxygen in the blood. In the morning, there is a wealth of data that can be analyzed.

Nice To Know:
Q: Will my insurance pay for a sleep study?

A: Most authorized sleep studies are considered medical procedures and are covered by most insurance companies, including Medicare. Check with your insurance provider to determine if your policy covers a sleep study.

How Is Insomnia Treated?
Sleep research has led to major advances in the treatment of insomnia. Many experts now consider sleeping pills to be overused, as well as dangerous because they can become addictive. They suggest that medication be used a last option, after other treatments have been tried.

Non-medicine treatment options include:
Physical Relaxation

If you are anxious about falling asleep, certain muscles in your body become tense and sometimes painful, interfering with sleep. Physical relaxation techniques can help.

. Find a quiet, peaceful place in which to practice the following technique about 30 minutes a day:
. Lie perfectly still until you find the most comfortable position for yourself. Now deliberately tense up the muscles in your arms and legs as tightly as you can. Try to hold this tension for about a minute and then let the muscles relax gradually-first your legs, and then your arms.
. Now let your whole body feel as relaxed as it possibly can. Take a rest for five minutes and then repeat the procedure twice more.
. At the end of the session, try to concentrate on the feeling of your muscles and let them go as limp and relaxed as possible for the rest of the period. Try to make your breathing slow and steady as you relax.

.This technique is designed to teach individuals how their body relaxes and how to control relaxation and tension.

Mental Relaxation

Since stress and worry, including the worry about not being able to fall asleep, are often at the core of insomnia, many people have found that mental relaxation techniques can help them to feel less anxious and therefore sleep better.

This method also requires finding a peaceful, quiet place to practice this technique for about 30 minutes a day:

. Try to relax your body first, by finding the most comfortable position for yourself. Then empty your mind of all thoughts by concentrating on one particular object in the room or a particular part of the room.
. After a minute, sit up, and then walk around for a bit. Then return to your position and repeat the exercise.
. Now think of a particularly happy time in your life that you really enjoyed. If you cannot immediately think of something, find a poster of some exotic place or beautiful scenery. Concentrate on imagining yourself in this place for about five minutes.
. Try to feel the sensations first in your neck muscles, and then in your arm and leg muscles, as they gradually become relaxed. After another few minutes, get up and walk around the room a bit. Then repeat the process.
This exercise differs from the physical technique in that it emphasizes controlling the psychological components of anxiety before attempting to relax your body.

Other Techniques
Other relaxation techniques to try include:

. Yoga or meditation
. Exercise (shown in studies to be an effective way to achieve a healthy sleep)
. Mind-body therapies such as guided imagery or hypnotherapy
. Reading while lying in a relaxed position
. Listening to music while lying in a relaxed position
. Having a soothing bath or shower before bed
. Massage, especially of the neck, shoulder, and leg muscles

Need To Know:
Some people find psychotherapy (the treatment of mental and emotional disorders with professional counseling) very helpful in relieving anxiety or depression that could be contributing to insomnia.

Can Medication Help Insomnia?

Sleep medications should not be taken lightly. Low-dose sleep medication can help short-term insomnia but is rarely helpful for long-term sleep problems. Many experts today recommend only trying medications as a last resort, after other treatments for insomnia have failed, because they can be addictive and can have serious side effects.

Hypnotics (sedatives, minor tranquilizers, and antianxiety drugs) are among the most commonly used medications for insomnia.
. Most hypnotics require a doctor's prescription because they may be habit-forming or addictive, and overdose is possible.
. Many hypnotics can lose their effectiveness once a person has become accustomed to them.
. Hypnotics also may produce withdrawal symptoms, and this can make the insomnia return. For this reason, doctor's recommend reducing the dose slowly; complete withdrawal can take several weeks.

Sleep medications are available as:

Over-The-Counter Medications
Two inexpensive medications available without a prescription that can relieve mild or occasional sleeping problems are diphenhydramine and dimenhydrinate.

. These medications can leave you drowsy the next day, but they are not addictive.
. Side effects include dizziness, blurred vision, and dry mouth.
. They should not be used be used by people with angina, heart arrhythmias, glaucoma, prostate problems, or urinary problems.

Over-the-counter medications for insomnia are purchased more than any other type of drug.

Commonly used over-the-counter sleep medications include Nytol, Sleep-Eez, and Sominex.
When sleeplessness is caused by minor pain, over-the-counter pain relievers such as acetaminophen (Tylenol) or a nonsteroidal anti-inflammatory drug (Advil, Motrin) can be very helpful.

Some newer medicines (such as Anacin P.M., Excedrin P.M., and Tylenol P.M.) contain both a sleeping medication and a pain reliever.
Antihistamines have a sedating effect and may be used as mild sleep inducers. They include chlorpheniramine (Chlor-Trimeton) and diphenhydramine (Benadryl).

Need To Know:
About melatonin supplements

You may have heard about the treatment of insomnia with melatonin supplements. Despite its widespread use, little is actually known about the long-term safety of melatonin supplements. The U.S. Food and Drug Administration does not monitor melatonin, and many of the melatonin products sold in health food and supplement stores contain unknown substances.

Prescription Medications
Prescription medications for insomnia should be taken at the lowest dose possible. Various types of prescription medication include:

. Benzodiazepines. These are the most common and safest hypnotics. They include lorazepam (Ativan), alprazolam (Xanax), triazolam (Halcion), and temazepam (Restoril), among others. Side effects include respiratory symptoms, daytime drowsiness, memory loss, and odd mood states. Benzodiazepines are potentially dangerous when combined with alcohol and should not be taken by people who use the ulcer medication cimetidine (Tagamet).

. Non-benzodiazephines. These hypnotics may pose less of a risk of dependence. They include zolpidem (Ambien), zopiclone, and zaleplon. Side effects include nausea, dizziness, nightmares, agitation, and headache.

. Antidepressants. These can relieve insomnia associated with depression or early morning awakening. Newer antidepressants include trazodone (Desyrel), nefazodone (Serzone), and paroxetine (Paxil). These medications have far fewer side effects, and much less danger for overdose, than other anti-insomnia drugs.

Need To Know:

What are the ground rules for being prescribed sleeping medication for insomnia?
Simply put, the focus should be on what's causing the insomnia and not simply on giving treatment to help someone sleep. For example, is the insomnia due to a brief short-lasting worry, or is it a symptom of an underlying disorder such as depression? Sleeping pills do not relieve such an underlying disorder, whereas antidepressants usually do.

Many experts suggest the following ground rules:
. Try to avoid benzodiazepine sleeping pills and use a nonaddictive one instead.
. Try to take them only occasionally and not make a habit of it.
. Accept that the course of treatment will be short (no more than two weeks) and the prescription will not be repeated.

Nice To Know:
For women who have reached menopause, hormone replacement therapy (HRT) helps prevent insomnia caused by hot flashes, a common symptom of menopause. Studies have shown that women who take HRT seem to fall asleep faster, have fewer wakeful periods, and sleep longer than those not taking estrogen.

How Can I Avoid Insomnia?
Prevention of sleeplessness is very much dependent on your ability to relax and learn techniques for sleeping well.

How-To Information:

Here are some tips to help improve your sleep:
. Learn to use physical and mental relaxation techniques.
. Establish a regular sleep schedule. This involves setting a regular bedtime and wake-up time and making every attempt to stick to it, including on the weekends. This will help to set the body's clock in a way that will make nighttime sleep deeper and more consistent.
. Avoid taking naps, especially in the afternoon.
. Exercise regularly during the day.
. Use the bed only for sleep and sex, not reading or watching television.
. If you do not fall asleep fairly quickly, get out of bed. Do not return until you are feeling drowsy.
. Try to reduce stress in your life, or find better ways to cope with stress. .
. If it is noisy in your bedroom, introduce some form of "white noise" such as a rotating fan.
. Do not over-focus on falling asleep by watching the clock.
. Create a bedroom environment that is quiet, relaxing and peaceful.
. Set up a regular bedtime routine that revolves around an activity that helps you unwind.
. Avoid caffeine, and other stimulants, especially late in the day.
. Eliminate smoking. It has a detrimental effect on the lungs, heart, sinuses, and circulation, and it also interferes significantly with sleep, as nicotine is a stimulant that prevents the brain from resting. Cutting back on cigarette smoking may lead to nicotine withdrawal in the middle of the night, which can awaken you, so it is important to stop smoking completely.
. Avoid alcohol. Even if it helps you fall asleep quicker, it actually worsens insomnia by causing shallow, unrefreshing sleep.

Frequently Asked Questions

Here are some frequently asked questions related to insomnia.

Q: What is the right amount of sleep I should get?

A: Since everyone has different sleep needs, there is no "correct" amount of sleep. On average, most people need between seven and nine hours of good quality sleep each night in order to feel alert the next day. But some function perfectly well with only four or five hours a night. The key to healthy sleeping seems to be a consistent pattern, rather than the number of hours one sleeps.

Q: How can I tell if I am getting enough sleep?

A: Here are some simple questions to ask yourself to test for sleepiness:
Do I need to set an alarm clock in order to wake up in the morning?
If so, do I usually press the snooze button?
Do I feel like I need a nap during the day?
Do I fall asleep while watching TV?
Does reading a book make me feel sleepy?
If you answer yes to more than one of these questions, you are not getting enough quality sleep to meet your needs.

Q: What can I do to avoid insomnia?

A: Here are some rules to abide by:
Don't exercise just before going to bed.
Don't read or watch television in bed.
Don't use alcohol to help you sleep.
Don't take another person's sleeping pills.
Don't participate in stimulating activities just before bed.
Avoid all foods and drinks containing caffeine close to bedtime.
Don't lie in bed fretting. If you can't sleep, get up and do some quiet activity. Only return to bed when you are sleepy. Do this as many times in a night as necessary.

Q: Does insomnia ever go away on its own?

A: Sometimes insomnia does go away on its own. Usually this happens with short-term insomnia that is due to some temporary stress in your life. When it persists, however, it may be a sign of another illness, such as anxiety or depression, and you should seek treatment.

Q: What is REM sleep and why is it important?

A: REM sleep stands for rapid eye movement sleep. For most of the night, our eyes are still. However, every so often the eyeballs of a sleeping person will make rapid side-to-side movements under the lids. People woken up during these times report that they have been dreaming. During REM sleep the muscles of the body are very relaxed and movements are difficult. Some believe this semi-paralysis of the muscles stops us from walking around or otherwise acting out the scenes being played out in our dreams. Although adults spend only a fifth of the night in REM sleep, a newborn baby may spend half of its sleep in this stage. Some studies suggest that REM sleep is particularly useful for growth and repair of the brain itself, while the other type of deep, or slow-wave, sleep is useful for repair of the rest of the body.

Q: Why is alcohol detrimental to sleep?

A: After we have had a few drinks, alcohol often causes drowsiness and lets us get off to sleep quite easily. Later in the night, however, when the alcohol level in our blood decreases, our body's arousal mechanism is stimulated and our normal sleep pattern is impaired. In addition, one of the effects of alcohol is to stimulate the pouring of adrenalin into the bloodstream, causing arousal, sweating and palpitations. This can result in waking up half-way through the night, or earlier than normal, with the heart pounding, making it quite difficult to get to sleep again.

Q: Will my insurance pay for a sleep study?

A: Most authorized sleep studies are considered medical procedures and are covered by most insurance companies, including Medicare. Check with your insurance provider to determine if your policy covers a sleep study.

Putting It All Together

Here is a summary of the important facts and information related to insomnia.
Insomnia is a sleep disorder in which individuals experience poor sleep or have trouble sleeping.

. Poor sleep for any length of time can lead to mood disturbances, lack of motivation, decreased attention span, trouble with concentration, low levels of energy, and increased fatigue.
. Factors that increase a person's chances of developing insomnia include being female, being elderly, having certain medical conditions, taking certain medications, having had childhood fears, and having a lifestyle that includes frequent travel, smoking, or overuse of alcohol or caffeine.
. Insomnia has psychological causes (such as anxiety or depression), physical causes (such as illness or pain), and other causes (such as jet lag or environmental noise).
. The consequences of insomnia include impaired mental functioning, a higher risk for accidents, stress and depression, heart disease, and headaches.
. Treatment options for insomnia include physical and mental relaxation techniques, other techniques (such as yoga, massage, or meditation), and medications (over-the-counter or prescription).
. Prevention of sleeplessness is very much dependent on your ability to relax and learn techniques for sleeping well.

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