An Overview Of Insomnia And Its Prevention

Introduction

Chronic insomnia is a public health crisis.

Insomnia is a sleep disorder that is characterized by having difficulty falling or and staying asleep t is defined as difficulty with the initiation, maintenance, duration or quality of sleep that results in the impairment of daytime functioning, despite accurate opportunity and circumstances for sleep. Waking up during night and having trouble going back to sleep, waking up too early in the mooring, feeling tired upon waking up are also considered as symptoms of insomnia. Other symptoms are sleepiness during the day, general tiredness, irritability, problems with concertation memory. 

Insomnia is divided into two main types: primary insomnia and secondary insomnia. The first type which is primary insomnia aid to a person with sleep problems that aren’t precisely associated with any other health condition or issue. On the other hand, secondary insomnia is associated with a problem or a health condition such as depression, arthritis, cancer, or heartburn, or pain medications they are taking or substance they are using like alcohol. Insomnia also varies in duration and how regularly it occurs. Acute insomnia is a short-term meaning that it can last for one night to few weeks, whereas chronic insomnia lasts at least three nights a week for three months or longer. Various causes of acute insomnia include illness, emotional or physical discomfort, some medications that may interfere with sleep, intervention in normal sleep schedule such as jet lag. Other causes may include environmental factors like noise, light, or extreme temperature hot or cold that interfere with sleep. Significant life stress like losing a job or a chance, death of a loved one, divorce, moving are also causes of acute insomnia. Unlike acute, causes of chronic insomnia include depression, anxiety, chronic stress, pain or discomfort at night. Being the most prevalent of all sleep disorders insomnia occurs in approximately one-third of the population. Individuals with insomnia who have consulted a physician at some time for their sleep problem were estimated to be between 5% to 36%, while people who have discussed it with a physician during a consultation for another problem were 27-55%. Chronic insomnia affects 10 to 15% of adults worldwide. Bearing in mind the social and financial tolls that are required for the serious health conditions that are associated with insomnia as well as greater healthcare utilization, work absenteeism and accidents of all kind. “With accumulating evidence of the effectiveness of cognitive behavioral therapy for insomnia (CBTI), adherence to this treatment is fundamental to public health, clinical, and scientific concerns” (Matthews, Arnedt, McCarthy, Cuddihy & Aloia 2013). Insomnia is a costly medical condition and associated with increased health service utilization. 

Health Belief Model 

The health belief model (HBM) was first established by a scientist at the U.S around the early 1950s. it was developed for Public Health service for the purpose of understanding the breakdown of people to adopt disease prevention strategies or screening, tests, consulting all for the early detection of diseases. The HBM recommend that an individual belief in a personal threat of an illness or a disease together with a person’s belief in the effectiveness’of the recommended health behavior or action will predict the likelihood that the individual will adopt the behavior. The HBM is derived from a psychological and behavior theory with the foundation that two components of health-related behavior are one the desire to avoid illness , or a conversely get well if already ill. Two the belief that a specific health actions will prevent or somehow cure, the illness .Basically, an individual's course of action usually depends on their perceptions of the benefits and barriers related to health behavior (LaMorte, 2019). In this case insomniac patients will try to avoid behaviors that could lead to insomnia or engage in activates that will help them get the best sleep at night. In addition, or they could consult a physician as soon as they belief that they’re susceptible to insomnia.

There are six constructs of the HBM. The first four constructs were developed as the original tenets of the HBM. However, the last two were added as research about the HBM evolved. The first concept is perceived susceptibility which are beliefs about the chance of getting a condition. The second concept is perceived severity that explains the beliefs about the seriousness of a condition and its consequences. The third concept perceived benefits, beliefs about the effectiveness of taking action to reduce risk or seriousness. Perceived barriers is the forth concept about the beliefs the material and psychological costs of taking action. The fifth concept is cues to action, the strategies to activates “readiness to changes”. The sixth concept and the last is about the confidence in one’s ability to take action. 

Limitations of Health Belief Model

Health belief model has several limitations that limits the utility in Public Health. Including the fact that it does not account for the individual’s attitudes, beliefs, or different individual determinants that dictate their acceptance of a health behavior. It conjointly does not take into consideration behaviours that are performed for non-health related reasons like social acceptability. Environmental or economic factors that may prohibit or promote the recommended actions are not accounted for. The assumption that everyone has the appropriate access to an equal amount of information about illness and disease. Another assumption is that the cues to action are widely prevalent in encouraging people to act and that 'health' actions are the main goal in the decision-making process. The HBM is more descriptive than explanatory and does not suggest a strategy for changing health-related actions. In preventive health behaviors, early studies showed that perceived susceptibility, benefits, and barriers were systematically related to the required health behaviour, perceived severity was less typically associated with the desired health behavior. The individual constructs are useful, depending on the health outcome of interest, but for the most effective use of the model it should be integrated with other models that account for the environmental context and suggest strategies for change. 

Discussion

According to the study and the HBM, perceived susceptibility will reflect an individual whom beliefs about the subjective perception of the risk of acquiring insomnia. This individual will think they’d been healthy the past couple of years so they won’t suffer from any physical illness therefore they don’t require a consult. On the other hand, perceived severity will reflect an individual’s own feeling about the seriousness of contracting this condition or leaving it untreated, which then later will lead them to seek help. An individual who will put all the possibility in front of him and not take anything randomly. In this case it’s the best thing to do because insomnia could lead to so many other complications not only personal but can also reflect on the persons surrounding environment. Perceived benefits, a person’s perception of the benefits and or the effectiveness of their behavior, by going to the physician and asking for help or simply getting a consult to reduce the threat of insomnia or cure it. Perceived seriousness and benefits are the best way to approach any disease. Public health should focus on the perceived barriers since it’s the obstacles keeping the individual from doing the recommended health action, which is not only seeking help but also getting the right information without any interference with mass media. A health action could be any form of action involving health starting from education to consulting a physician to changing or continuing in the same path if it was the right one. In order to trigger the individual’s decision-making process to accept the recommended health action, cues to action is needed for stimulating it. For example, setting up lectures about insomnia and educate people at their workplace if possible, also in malls and places where people spend most of their time at. Lastly is the self-efficacy which refers to level of the individual’s confidence in their ability to successfully perform the behavior.

Limitations And Advantages Of Using Health Belief Model (HBM) To Do The Intervention In The Studies

Insomnia is a significant public health problem, which affects large segments of the population at one point or another in life. The burden of chronic insomnia is also widespread both for the individual, in terms of reduced quality of life, and for society at large, in terms of work absenteeism, disability, and health care costs. Although significant advances have been made in therapeutics, there is more limited knowledge on its epidemiology, risk factors, long-term course, and prognosis. A better understanding of these critical issues would be informative to develop more effective therapies. The difference in education level and socioeconomic level may also reflect other important differences that were not assessed. including knowledge about the relationship of sleep to health and likelihood of discussing sleep with a doctor. A final limitation of this study relates to the issue of comorbidity. The lack of formal diagnostic interviews to establish the presence or absence of medical and psychiatric comorbid disorders precludes a clear interpretation of the relationship of insomnia and the increased use of health-care services and work absenteeism and reduced productivity.

Public Health Education And Prevention Of Insomnia

Despite the Sizeable health, social, and economic burden of insomnia, it’s usually underrecognized and untreated in both pediatric and adult population. Though there's solid proof showing the effectiveness of insomnia therapies and strong incentives for prevention strategies ,ways for preventing insomnia stay underdeveloped. As such, it's imperative to search out applicable ways for the prevention of insomnia. Although some risk factors are unmodifiable, (e.g., age, sex, genetics),other are modifiable like maladaptive sleep practice. Unmodifiable risk factors may be used to determine people at-risk, whereas education and behavioral interventions that are sensible and simply property may be used to alter modifiable risk factors. For instance, given the bigger probability of insomnia at intervals a family, prevention approaches may be significantly useful to change lifestyle behaviors (e.g., maintain a daily sleep schedule, reduced intake of stimulants) and sleeping setting , such as reduced noise level, all of which can have a major impact on the general population, however most importantly among vulnerable populations. From a public health perspective, a very important step in insomnia interference involves increasing awareness on the importance of adequate sleep and also the debilitating effects of insomnia. Some people hold misconceptions or lack information regarding healthy sleep patterns and sleep disorders (e.g., causes, consequences, treatment) that, in turn, can contribute to poor sleep practices.

Public health education campaigns will prove useful to extend awareness regarding the importance of sleep and regarding activity practices to prevent sleep issues. Thought it's recognized that health care professionals ought to routinely valuate sleep and supply some sleep education as a part of patient care, several professionals rate their own sleep information as honest or poor. Moreover, throughout consultations, health care professionals don't generally initiate inquiries regarding their patient’s sleep. Thus, a very important step is increasing education and coaching on sleep for health care professionals.

Sleep subject matter because it might cause changes in patients’ attitudes, knowledge, and behaviors toward sleep. Borrowing productive successful methods from alternative interference programs may in addition lead to changes. For example, providing the correct needed information regarding the importance of sleep and variations in sleep desires. Likewise, creating easy and specific behavioral recommendations such as reduce time spend awake in bed and get up at the same time every morning, are often effective to alleviate insomnia before it reaches clinical threshold. The relationship between sleep knowledge and sleep practices are interacted, sleep education remains a vital step in promoting health sleep. In fact, general education interventions targeted at children and parents have yielded promising results.

Given the significant burden that insomnia places on the individual and society, implementing pretention methods at the community level is vital. Recently, Kraus and Rabin projected launching a public wide awareness camping entitled sleep America, with specific aims. First, to promote insomnia education using numerous mediums such as web-based initiatives. Second to increase accessibility of insomnia treatment like behavioral sleep medications. Third aim is to monitor and probably refute misleading claims regarding non evidence-based insomnia treatment. Future analysis is required to judge the cost effectiveness of bar methods that concentrate on modifiable risk factors, emphasize information translation on sleep education, and may be delivered at the individual and social level. This analysis ought to be enforced, significantly among population at risk for an efficient campaign that improves public health (Morin & Jarrin, 2013).

Conclusion

In conclusion, chronic insomnia is a worldwide significant public health problem, considering not only the personal but also the social coast associated with the serious health conditions, greater healthcare utilization, work absenteeism and accidents. Cognitive behavioral therapy has been an efficacies treatment for insomnia, yet attrition and suboptimal adherence may diminish its impact. The prevalence of insomnia is high all around the word. The changes in lifestyle, optimizations of living environment can be really helpful to reduce the risk factor for both acute and chronic insomnia. Also symptom control can reduce the burden of insomnia and improve the quality of life form the individual and the society,

References

• Ellis, J. G., Gehrman, P., Espie, C. A., Riemann, D., & Perlis, M. L. (2012). Acute insomnia: Current conceptualizations and future directions. Sleep Medicine Reviews, 16(1), 5–14. doi:10.1016/j.smrv.2011.02.002 
• Morin, C. M., & Jarrin, D. C. (2013). Epidemiology of Insomnia. Sleep Medicine Clinics, 8(3), 281–297.doi:10.1016/j.jsmc.2013.05.002 
• Matthews, E. E., Arnedt, J. T., McCarthy, M. S., Cuddihy, L. J., & Aloia, M. S. (2013). Adherence to cognitive behavioral therapy for insomnia: A systematic review. Sleep Medicine Reviews, 17(6), 453–464.doi:10.1016/j.smrv.2013.01.001
• Daley, M., Morin, C. M., LeBlanc, M., Grégoire, J. P., Savard, J., & Baillargeon, L. (2009). Insomnia and its relationship to health-care utilization, work absenteeism, productivity and accidents. Sleep Medicine, 10(4), 427–438.doi:10.1016/j.sleep.2008.04.005 
• LaMorte, W. W. (2019, September). Behavioral Change Models. http://sphweb.bumc.bu.edu/otlt/MPH-Modules/SB/BehavioralChangeTheories/BehavioralChangeTheories2.html