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Insomnia

Insomnia

Insomnia is the term used to describe either difficulty falling asleep when going to bed, or staying asleep during the night. Many people, especially shift workers, suffer from sleep disturbances when they change their sleeping pattern after moving from night shift to afternoon or day shifts and vice versa. 

Insomnia falls into two usual categories - either chronic or ongoing inability to sleep through the night, or the occasional or episodic pattern of sleepless nights. Some of us manage to have full productive lives with less than six hours sleep each night; famous examples include Winston Churchill and Margaret Thatcher. For the rest of us, after a night of poor sleep we feel exhausted and not able to function at a peak level of achievement. 

Insomnia is most commonly suffered by new parents - poor sleep patterns become a way of life for the first few months of their child’s life as they struggle to get four or more uninterrupted hours rest each night.  Others may suffer from insomnia when they are over-stimulated, by stress, too much alcohol or caffeine, drugs such as diet medications or cold remedies, noise or changes to the sleeping environment.

Sleeping well is a habit. Disturbing that habit by going to bed and not being prepared for sleep by activities, such as using electronic devices, can change your ability to fall asleep or to stay asleep. As you age the urge to urinate tends to wake many of us, and having difficulty falling asleep after one of the many trips to the toilet can impact on the quality and length of sleep achieved each evening, leading to sleep deficits.   

Before appropriate treatment for insomnia can be determined, it is important to establish what is your usual sleep pattern or needs. Not all of us need eight or nine hours sleep as we age. First of all talk to your pharmacist. They can help to determine if there has been any change that may have caused a change in your ability to sleep.   

Sleep hygiene is about undertaking activities that should help you fall asleep; either on first going to bed, or to fall asleep more easily after being woken. Establishing a pattern of only going to bed when tired and ready for sleep, and only trying to go to sleep when you get into bed, helps build a pattern of sleep preparation. Remove stimulants, such as bright bedroom lights, televisions, cell-phones and computers from the bedroom, or ensure they will not cause you to wake up by turning them off. It is often helpful to remove clocks as repeated checking of how long you have taken to fall asleep generally worsens the anxiety about being able to sleep.

If this is not successful in allowing you to fall asleep within about 30 minutes of going to bed, then it is helpful to get up and do something in another room to stop you worrying about being unable to sleep, and return to bed after a period of quiet reading, de-stressing or relaxing exercises, such as yoga.  

If these do not assist in helping to normalise your sleep patterns then short term use of medicines, such as sedating antihistamines, may be helpful for a day or two to break the habit of sleeplessness. These sedating medicines should only be used if safe for you and this is best discussed with your pharmacist or referred on to your doctor, especially if the sleeplessness is caused by mild depression or anxiety.

It is important to realise that alcohol is not helpful in assisting sleep problems. Although it does sedate you, it can also cause insomnia, so is best avoided if troubled by sleep disturbances. Talk to your community pharmacist for help in getting a good night’s rest, as they can assist with safe effective treatments as well as advice to deal with this troubling disturbance to your enjoyment of life.

Swallowing difficulties (dysphagia)

Causes of swallowing difficulties

Swallowing difficulties can happen at any age. There are a wide range of causes for them, including:

  • some medicines, such as antipsychotics
  • heartburn and acid reflux
  • cancer, such as mouth or throat cancers
  • nervous system or brain disorders
  • muscle disorders
  • blockages or structural issues with your mouth, throat or oesophagus.

Symptoms of swallowing difficulties

Symptoms of swallowing difficulties may include:

  • coughing or choking when eating or drinking
  • bringing food back up, may be through your nose
  • the feeling that food is stuck in your throat
  • having issues chewing your food
  • problems with dribbling.

Swallowing difficulties can cause weight loss, dehydration and chest infections.

Diagnosing swallowing difficulties

Let your healthcare provider know if you have swallowing difficulties. They will ask you about your symptoms and check if any other health conditions you have may be the cause.

Your healthcare provider may refer you to a specialist for tests. These may include a:

  • gastroscopy—a camera is passed down through your mouth to look at your throat and stomach
  • swallowing study—your throat and stomach are x-rayed as you swallow small amounts of food.

Treating swallowing difficulties

How your swallowing difficulties are treated depends on the cause and how severe it is. Treatments may include:

  • medicines to treat acid reflux
  • swallowing therapy with a speech and language therapist
  • making changes to what you eat and drink, such as softer foods and using thickener in drinks
  • using special spoons, plates and cups
  • surgery to widen your oesophagus.
  • using special medication lubricants eg Gloup to help make it easier to swallow tablets etc. For more information click here.

Self care for swallowing difficulties

As well as seeing your healthcare provider, the following tips may help you to get food or liquids into your stomach.

  • Sit upright in a chair—at a table is best.
  • Have regular small meals instead of the main large meals.
  • Eat or drink small mouthfuls at a time.
  • If your voice is gurgly when you eat or drink, give a small cough to make sure your airway is clear.
  • Wet food will be easier to swallow as dry food can catch in your throat.
  • If your food has 2 consistencies, such as fruit in juice and cereal in milk, try to mix it into 1 consistency, or eat the solid and liquid portions separately.
  • Concentrate on eating and avoid talking.
  • Hot, ice-cold or fizzy liquids are easier to swallow than room temperature liquids.
  • If you are told to have thickened liquids, avoid ice-cream and jelly as they thin before swallowing.
  • Drink from the top half of you cup to avoid tipping your head back.

 

Have a look at our range of Gloup medication lubricants here which can help with difficulties swallowing tablets... 

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