The Sleep Disorder Clinic manages patients with insomnia, defined as a poor quality of sleep that could be a result of the following:

• difficulty falling asleep,
• waking up frequently during the night with difficulty returning to sleep,
• waking up too early in the morning,
• unrefreshing sleep

INSOMNIA

Insomnia is a condition that affects the quality and/or duration of a person's sleep or the behaviour during sleep

Insomnia can be a primary sleep problem or secondary to a mental condition or related to a medical illness or substance abuse.

Studies estimate that 10% to 15% of the adult population have chronic sleep problem and an additional 25% to 35% of the population have transient or occasional sleep difficulties. Certain individuals are vulnerable for example the elderly whose sleep is more fragmented and teenagers who sometimes have difficulty falling asleep until late at night and awaking early in the morning. Shift workers and those who travel frequently are also at increased risk for insomnia.

Causes

Sleep can be affected by numerous factors and six groups of etiologies have been proposed for sleep difficulties. Physical or medical disorders for example conditions causing pain, itch, cough, breathlessness etc. can disrupt substances such as caffeine, nicotine and alcohol also impair sleep.

Circadian rhythm problem such as shift work and jet lag; psychological factors and psychiatric disorder such as depression, anxiety and psychosis. Lifestyle issues, poor sleep habits and environmental factors such as noise, light and temperature also interrupt sleep.

If sleep problems persist and are bothersome or if they interfere with how you feel or function during the day, you may need to seek your doctors' advice.

If sleep problem worsen and are not treated complications such as psychiatric disorders can occur. The quality of life of the individual is likely to be compromised, the work performance effected and he or she is at significant risk of accidents such as vehicle accidents.

Treatment

Treatment of sleep problems depends upon the specific sleep problem and can be broadly classified into non-pharmacologic and pharmacologic treatment. Good sleep habits can prevent many cases from worsening, some recommendations for good Sleep Hygiene include:

• Avoid excessive day time naps
• Do not go to bed until you are drowsy
• Wake-up at approximately the same time each morning including weekends
• Avoid alcohol and caffeine before bedtime
• Exercise regularly
• Make the sleep environment conducive to sleep
• Have a light snack before bedtime
• Pay proper attention to stress reduction

Sometime sleep problem resolve spontaneously. At other times, medicines for example sleeping pills may be needed. Benzodiazepines are the most frequently prescribed hypnotics. There are also non-benzodiazepines, newer medications without the side-effects noted with benzodiazepines.

Other behavioural techniques that are taught to improve sleep include relaxation therapy, stimulus control and sleep restriction therapy. These are specific techniques that reduce or eliminate anxiety and body tension and recondition individuals to associate the bed and bedtime with sleep.

Seek treatment early. Don't suffer unnecessarily. Help is available and effective.

Appointments

For appointments, please call our Appointment Line at Tel: 63892200 during office hours.
You can also send an email to imh_appt@imh.com.sg.
For private consultations, you may select the Psychiatrist of your choice. You may make an appointment directly by contacting us as above.

Alternatively, you may make an appointment for a subsidised consultation after first obtaining a referral from any polyclinic.

Clinic Tel No Fax No Address IMH Clinic Monday to Thursday: 8am – 5.30pm Friday: 8am – 5pm 6389 2200 6385 1075 Institute of Mental Health Buangkok Green Medical Park 10 Buangkok View Singapore 539747 Behavioural Medicine Clinic - Health Promotion Board Monday to Thursday: 8am – 5.30pm Friday: 8am – 5pm 6435 3879 6534 3677 Health Promotion Board Building 3 Second Hospital Ave #03-01 Singapore 168937

INSTITUTE OF MENTAL HEALTH

We endeavour to promote mental health through the provision of person-focused service that is integrated, comprehensive, accessible, cost-effective and by pursuing continuous learning and research.