These days, sleep problems have become a common sight, as people regularly encounter difficulties in this respect. Furthermore, in the context of present-day developments, people tend to sacrifice their rest time in order to perform multiple tasks, and the negative consequences of this behavioral pattern are obvious. For this reason, BBC has introduced a podcast Mysteries of Sleep. Sleep Deprivation and Insomnia. The topic of this audio record is a variety of problems with sleep and their impact on an organism. It is mentioned that they increase the risks of heart failure, stroke, and cancer (Abrahams, 2017). In addition, difficulties with sleep affect cognitive skills, memory, mood, resiliency to stresses, and others (Abrahams, 2017). Therefore, sleep deprivation has a significant influence on both the physical and mental state.
Recent explorations and articles in this field may prove this thesis. Tobaldini et al., who are a group of scientists, have published their collective research in 2017. Their work may be considered accurate and relevant to the current innovations, as it covers multiple details in this regard and implies a comprehensive literature review. They highlight, Short sleep duration is associated with increased incidence of cardiovascular diseases, such as coronary artery disease, hypertension, arrhythmias, diabetes and obesity (Tobaldini et al., 2017, para. 1). Other modern scientists Hanson and Huecker introduced their exploration in 2020 and conducted a proper analysis of this topic. They proved the aforementioned conclusion and also paid attention to the impact of sleep deprivation on the mental state. They state that it may lead to anxiety, depression, and psychosis (Hanson & Huecker, 2020). Thus, the importance of sleep problem should not be underestimated.
Although sleep is not explored entirely, and there are numerous mysteries in this field, appropriate medications and treatment plans exist. It is crucial to control the sleeping schedule, and in case of serious difficulties, it is advisable to appoint a specialist. These problems are worth being paid attention to, as they affect both the physical and mental states. In addition, they determine the quality of everyday life and health condition.
Source Type. This source is the chapter of the book created by the StatPearls group.
Currency. The last time the books content was updated in 2020, which indicates the relevance of the materials. In studying topics, especially in the health sector, it is crucial to choose recent sources published over the past five years.
Relevancy. The chapter provides a knowledge base that is useful when studying the topic of sleep deprivation. Subsequent sources help to increase the knowledge gained from these materials.
Authority. StatPearls group aims to provide peer-reviewed and accessible health care materials to improve the level of medical education. The authors of the chapter also testify to the reliability of the source. Martin Huecker is an assistant professor and research director at the University of Louisville, and Joseph Hanson is a doctor specializing in mental health.
Accuracy. The material is based on existing studies of sleep problems that can be validated due to the reference list provided.
Purpose. The purpose of the chapter is to familiarize readers with basic knowledge about sleep deprivation with a medical bias, particularly with such aspects as etiology, pathophysiology, epidemiology, potential diagnoses, and other characteristics. Such knowledge provides a complete basic view of the problem.
Tobaldini, E., Costantino, G., Solbiati, M., Cogliati, C., Kara, T., Nobili, L., & Montano, N. (2017). Sleep, sleep deprivation, autonomic nervous system and cardiovascular diseases. Neuroscience & Biobehavioral Reviews, 74(B), 321-329. Web.
Source type. A scientific article in the medical journal dedicated to neuroscience.
Currency. The article is published in 2017 and contains current information.
Relevancy. The article provides more information about neuro processes during sleep and its disorders. To a greater extent, the source reveals such aspects as the consequences of the studied problem.
Authority. The authors of the study work in the field of health care and could face the consequences of sleep deprivation in practice. Moreover, the text before publication is checked by the journals editorial board.
Accuracy. The work is based on published studies on the consequences of the problem. All sources are listed in the reference list and can be verified.
Purpose. The article aims to inform about the harmful consequences of sleep deprivation and draw attention to timely prevention. A balanced view of the issue is provided by the authors experience and comprehensive literature analysis.
The DSM-V (20103) devotes an entire domain to Sleep-Wake Disorders. Specifically identified is Insomnia Disorder (G47.00), Hypersomnolence Disorder (G47.10), Narcolepsy, Obstructive Sleep Apnea-Hypopnea (G47.33), Central Sleep Apnea, Sleep-Related Hypoventilation, Circadian Rhythm Sleep-Wake Disorder, Non-Rapids Eye Movement Sleep Arousal Disorders, Nightmare Disorder (F51.5), Rapid Eye Movement Sleep Behavior Disorders (G47.52), Restless Leg Syndrome (G25.81), Substance Medication Induced Sleep Disorder, and various unspecified categories. Following is a discussion regarding the major types of drug interventions available for sleep disorders. Additionally, contained in a review of the addiction potential of these medications. Also covered below are the complexities that sleeping medications bring to the counseling environment. In closing, a discussion associated with the incorporation of this information into my clinical practice.
Major Drug Types & Addiction Potential
The addiction potential of medication is an important component of the decision-making process associated with pharmaceutical interventions as the intention of the prescriber is to help not harm their patient. Best practice for sleep disorder treatment is behavioral therapy (Matheson & Hainer, 2017). Preston and Johns (2011) assert medicinal interventions should be reserved for patients whos sleep disturbance is due to recent environmental causes rather than a chronic condition. Matheson and Hainer (2017) identified the following as regularly recommended medications, Benzodiazepines, Z-drugs, Melatonin antagonists, Tricyclics, Orexin receptor antagonists, Antipsychotics, and Anticonvulsants. For this paper, the focus will be on the most frequently prescribed medications, Benzodiazepines, z-drugs, and Melatonin.
Benzodiazepines
Benzodiazepines are a schedule IV drug as there is a high risk of addiction, withdrawal, and can cause rebound sleep issues with an increase in anxiety Matheson and Hainer (2017). When used, Benzodiazepines may be used in patients suffering from the inability to fall asleep but should be avoided when the insomnia is present in the middle of the night or is represented by early waking (Preston & Johns, 2011). The latent sleep disturbance is indicative of a depressive cause making a benzodiazepine contraindicated.
Z-drugs
The z-drugs (zaleplon, zolpidem, and eszopiclone) are the most commonly prescribed medication for sleep disorders (Matheson & Hainer, 2017). Although highly prescribed the z-drugs are also classified as a schedule IV due to abuse potential. Preston and Johnson (2011) assert Zolpidem’s addiction potential renders it a high risk for SUD individuals suffering from insomnia.
Melatonin
Melatonin is a natural hormone made in the pineal gland that participates in sleep regulation. Therefore, when an individual is deficient in Melatonin, sleep disorders can arise (Matheson & Hainer, 2017). Matheson and Hainer (2017) assert controlled-release melatonin are effective, lacks addictive properties, and is available over the counter. As an over the counter medication, Melatonin is not regulated by the FDA, so consumer research is recommended for a quality product (Perry, Alexander, Liskow, & DeVane, 2007). Perry et al (2007) assert naturally secreted Melatonin reduces as an individual age making Melatonin use in the elderly beneficial. Melatonin also provides drowsiness but does not impair psychomotor activity (Perry et al., 2007).
Malingering
Adetunji, Basil, Mathews, Williams, Osinowo, & Oladinni (2006) define malingering as “the intentional production of false or grossly exaggerated physical or psychological symptoms” (p. 68). Malingering is enacted by a patient to achieve a benefit (e.g. presenting with a painful presentation to obtain pain medication for the purpose of diversion). Despite a provider’s suspicion of malingering behavior, a thorough exam must occur (Adetunji et al., 2006). Psychiatrists are fearful of legal action and lose of a therapeutic alliance when encountering a patient who they feel might be malingering.
Malingering can be identified by inconsistency in the patient’s story or presenting behaviors. Observing a patient for this abnormal behavior, peculiar presentations, and inconsistent stories is essential in identifying a malingering client (Adetunji et al., 2006). Adetunji et al. (2006) recommend the use of psychometric tests to determine if a patient is presenting with malingering behaviors. These tests include the Minnesota Multiphasic Personality Inventory, Structured Interview of Reported Symptoms, Miller Forensic Assessment of Symptoms Test, The Victoria Symptom Validity Test, Personality Inventory for Youth, Structured Inventory of Malingered Symptomatology, Test of Memory Malingering, Rey Auditory Verbal Learning Test, and Wisconsin Card Sorting Test.
An epithetic nonthreatening approach should be used when conversations regarding malingering behavior is necessary. Exploration of causation for the malingering behavior should be explored. Adetunji et al. (2006) encourage practitioners to have a strong knowledge base of signs and symptoms specific to psychological diagnostic criteria, always assume the patient is being truthful until proven otherwise, and tactfully offer the client a nonthreatening way out of the situation.
Journal Review
The Journal Detection and Management of Malingering in a Clinical Setting (Adetunji et al., 2006) offers readers a wealth of information associated with how identification and approach individuals suspected of malingering. I will easily be able to incorporate this knowledge into my clinical approach. I am particularly appreciative for the assessment tools suggested by the authors as it provides an empirical tool to assist in solidifying a counselor’s suspicions. Lastly, I appreciated the suggestion regarding how to approach the crucial conversation in a nonthreatening and productive manner.
References
Adetunji, B. A., Basil, B., Mathews, M., Williams, A., Osinowo, T., & Oladinni, O. (2006). Detection and Management of Malingering in a Clinical Setting. Primary Psychiatry, 13(1), 61–69. Retrieved from https://search-ebscohost-com.ezp.waldenulibrary.org/login.aspx?direct=true&db=psyh&AN=2006-01601-016&site=eds-live&scope=site
Diagnostic and statistical manual of mental disorders: DSM-5. (2013). Washington, D.C.: American Psychiatric Publishing.
Matheson, E., & Hainer, B. L. (2017). Insomnia: Pharmacologic Therapy. American Family Physician, 96(1), 29–35. Retrieved from https://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=28671376&site=eds-live&scope=site
Preston, J., & Johnson, J. (2011). Clinical psychopharmacology made ridiculously simple (7th ed.).Miami, FL: MedMaster, Inc.
Waking up in the middle of the night (or in the middle of a sleep cycle) and being unable to fall back asleep is a common sleep disorder called insomnia. If you’re experiencing long stretches of any kind of insomnia, you’ll first want to schedule a trip to the doctor to make sure there are no underlying medical issues behind those sleepless nights. It’s important to know that symptoms of depression such as low energy, loss of interest or motivation, feelings of sadness or hopelessness and insomnia can be linked, and one can make the other worse. The good news is that both are treatable regardless of which came first.
What is Meditation?
Meditation is a process in which we learn the technique to focus our mind, controlling our emotions and rolling thoughts that are creating anxiety by suppressing them so that we can bring our mind to a stage of relaxation. Meditation is regular practice where there is no limitation of going to any specific level. Gradually, enhance practice by bringing mind in relaxation where we are not forcefully suppressing our thoughts. You manage to bring your mind in a stage where your body feels lighter, mind becomes focus and you tend to think positive towards your approach to life.
I have been practicing LDM Meditation Technique from Yogashray Sewayatan Naturopathy Centre Jaipur for few months which helps in reducing stress and bring peace as it allows mind to settle at one thought, instead of being pulled in all directions through which stress level reduces. Practicing LDM Meditation helps you to gently ignore what is unnecessary and focus more on what is important which enhances clarity and makes capable of doing anything that you do.
I have struggled for hours to sleep because of thoughts racing through mind, worrying about the past and the future which used interferes with my sleep at night. After practicing LDM Meditation on a regular basis, gradually begin to cherish the moment, allowing me to sleep soundly. When you wake up the next morning, you’ll feel lighter and fresher. Maintaining a balanced sleep cycle can help to eliminate many health problems. LDM meditation process helps me spending time with myself and is a journey of self-discovery. Daily struggles and irritations no longer impact remains centered in yourself and the present moment.
In order to make meditation a regular practice, you need to put meditation time into schedule. Make it a regular habit to meditate at a certain time of day and you’ll likely find that you’ll commit to it more regularly. Practice Mudra Pranayam for Insomnia which is also good for Insomnia. At Yogashray Sewayatan before going for meditation class they make patients practice pranayam which opens the channels of mind and helps in meditation. You can subscribe and you can get update.
Alternate nostril breathing balances the two main energy channels Ida and Pingala thereby balancing the two hemispheres of the brain. Pranayam relaxes the brain, while activating the parasympathetic nervous system, which will helps in inducing deep sleep. Daily Pranayama positively affects autonomic nervous system which controls and governs essential functions of the body like the heart rate, respiration and blood pressure etc.
Making behavior and lifestyle changes can improve overall sleep quality and help fall asleep faster. These changes don’t have the side effects that sleep medicines can cause. And the improvements last longer over time.
Lifestyle changes:
Making simple lifestyle changes may help insomnia. These may include:
Changing your sleep area or schedule. Keep regular bedtimes and wake times every day, and try not to nap during the day.
Avoiding big meals or too much fluid later in the evening.
Staying active.
Avoiding alcohol before bed.
Doing relaxation exercises.
How to Meditate for Beginners:
Here are five tips for beginners to learn how to meditate:
Find a quiet, peaceful place.
Sit comfortably, with eyes closed and focus on the heart.
Begin with a suggestion that the source of light is within my heart and it is attracting me inwards.
Meditate for 10 minutes, or until you feel ready to come out of the meditation.
Repeat it every day, in the morning and the evening. Incorporating this time for quiet contemplation and reflection can bring you enormous mental and physical benefits.
Using Meditation for insomnia is a great aid in regulating mind. The mind’s tendency is to think a lot and to be easily pulled in different directions depending on our personal likes and dislikes. When we pay attention to every unnecessary thought, we are drawn away from what is truly important. Practicing guided meditation for insomnia helps gently ignore what is unnecessary and focus more on what is important. Insomnia meditation techniques will give greater clarity and makes us faster and more capable of anything that we do.
Individual who is committed to balancing their mental energies is also a lot more energized. The positivity that we develop in our mind will give us the zest and enthusiasm to maximize our productivity throughout the day. When we feel calmer and happier, our relationships with people around grow stronger.
Sleep is one of the most important parts of our health. It affects every aspect of our lives. Tons of people around the world suffer from insomnia. This is a sleeping disorder in which people have trouble sleeping. It is also known as sleeplessness. It may last for either a short period (days and weeks)so or a long period ( more than a month). Insomnia can be two types: primary (when sleep problems aren’t linked to any other health condition) and secondary (when sleep problems are linked to other health conditions like depression, heartburn, asthma, etc.).
What causes sleeplessness?
It’s important to say what are the common reasons behind insomnia. As we already mentioned above, this disorder can be either primary and secondary. The list of things that can cause primary insomnia is longs. Some of it includes: stress, the setting around (noises, lights),long staring at the screen before going to bed.
Secondary insomnia can be cause by lots of things too. Mental health illnesses like depression and anxiety are some of the main reasons. The other ones include different medication; body pain; substances like alcohol, coffee or tobacco.
Symptoms to look out for if you think you have insomnia
Now that you already know a little bit more about insomnia itself, it’s time to talk about the symptoms. You have trouble sleeping. You think that you have some sort of listed above problems. Now you are wondering do you suffer from insomnia. The list of symptoms below should give you the answer to your questions.
Try to be careful of your health even if only one of these symptoms seem familiar to you:
Falling asleep very difficult at night
3 AM. Again. Your eyes are wide open, staring at the ceiling. You turn around and close your eyes. You try to calm yourself down. And yet the sleep doesn’t arrive. You reach for the clock only to calculate after how many hours you have to get up. That sounds even worse than a nightmare but is one of the red flags of insomnia.
Waking up during the night or/and waking up too early
Waking up during the night can damage your health. You are interrupting your sleeping cycles. One of them lasts around 90 minutes. Interruptions can lead to slower reaction speed; memory loss and even Alzheimer’s disease. Also waking up too early in the morning when you still feel tired is another sign.
Feeling tired
When you have a good night’s sleep you feel well-rested, calm and happy. You are productive and concentrated. Sadly, things are not always this way. If you feel tired after you wake up and during the whole day, you are probably suffering from insomnia.
Feeling depressed and anxious
Depression and anxiety are one of the main reasons for insomnia, but insomnia can cause them too. You can feel tired almost all the time as a result of this sleeping disorder. Then you start to feel negative emotions which can lead to mental illnesses.
Problems with concentration and memory
When you don’t sleep well you start feeling tired. When you feel tired you are not able to stay concentrated and productive for a long period. You will also start forgetting important things you have to do during the day. This can damage your work.
Grumpiness
Everyone knows that feeling when the alarm rings in the morning but you can’t seem to get up. When you finally get out of the bed. The only thing you want is to go back to your comfy bed. Being moody and nervous can harm your relationships with other people. That is another reason to consider some kind of help with your insomnia.
How to beat insomnia?
We talked about the reasons behind insomnia and the symptoms you should look out for it. You still wonder how to beat it? There are a few tips that may work wonders if you are ready to work hard to improve your sleeping habits. And now without further ado, let’s get going with the tips:
Go to bed and wake up at the same time every day and night. It is preferable to go to bed early every night and wake up early every day. Following a certain schedule when you sleep it’s as important as following one when you work. As a result of it, your body will start to work as a well-tuned clock. You will get tired at the same time every night and you will feel rested at the same time every day. The only obstacle here is to do it on the weekends too no matter how big the temptation of staying in bed until 11 AM is.
Be careful with your coffee consummation. The effects of caffeine can last from 4 to 6 hours but sometimes coffee can continue to do its wonders up to 24 hours! That is why you should think before you drink another cup! The best option is to drink only one in the morning. If you can’t survive without your second cup, make sure you drank it before 5 PM.
Reduce stress. Try to live a calmer life. Don’t overthink everything, enjoy your work and enjoy your weekends too! Try therapy if you feel like you need more help; go to yoga; try to meditate. Before going to bed, leave the stressful thoughts out of the bedroom.
Turn off all your electronic devices at least one hour before going to bed. This is a crucial, yet often underestimated thing that affects your sleep. The reason for it is hiding behind the blue light that your electronic devices emit. Blue light is bad for both your vision and your brain because can affect your internal body clock. This way you are not able to fall asleep since your body gets confused and doesn’t know if it’s day or night.
Unfortunately, some people work long hours in front of the computer. They often don’t have the chance to rest their eyes before going to bed.
Don’t worry! There is a decision for this problem! Iris is a software that protects the eyes from harmful blue light. With Iris, you will get your work done and you will get your night’s sleep! It also works on all kinds of devices, even on smartphones!
You should consider downloading a program like Iris if you want to improve your sleep. It’s going to be a game-changer for your health and well-being!
Conclusion
People often neglect their sleeping habits. The reason is that they do not think sleep is so important. The truth is that not getting enough sleep can lead to serious health issues. Some of them include: weight gain, low productivity levels, depression, mood swaps and illnesses like heart disease and type 2 diabetes. Insomnia can be a dangerous disorder, which should not be underestimated.
It is advisable to take immediate action if you think that there is even the smallest chance you are suffering from insomnia. Every single one of the symptoms must be taken into account. Try to incorporate some of the tips mentioned above in your daily routine. You should see the difference almost immediately!
We’ve all been there. A long sleepless night with endless position changes and yet no sign of sleep. A survey from the Sleep Health Foundation in 2016 pointed out that 26% of the Aussie population suffers from some level of insomnia. Experts are now pointing out the “24/7 society” lifestyle as one of the primary causes of not being able to sleep properly, especially using the internet and mobile devices right before sleep. Read on to find out what insomnia really is, what causes it, and how you can prevent it to get a comfortable sleep and greet the sun fresh next morning.
What is insomnia?
Insomnia is a sleep disorder that makes it difficult for the patient to fall asleep, stay asleep, or simply, get adequate sleep. In other words, it is not always about the quantity of sleep; quality of sleep can also determine whether you have insomnia or not.
As a recognised medical disorder, insomnia regularly cripples sleeping habits of millions of people across the globe. Surveys show that many Australians don’t get enough sleep and the results, such as tiredness, irritability, anxiety, and lack of concentration, are taking a toll on their performance at school and at work.
On average, an adult needs between seven and eight hours of proper sleep, depending on their hormonal condition and physical needs. To be sure, every adult experiences insomnia at some point, which is why we need to classify this disorder into two broad categories: acute insomnia and chronic insomnia.
The former may be caused by a traumatic incident or general stress and lasts only a few weeks. What is the subject of major concern is chronic insomnia. Caused by bad sleep habits or medications and extensive nicotine or substance intake, chronic insomnia can last from weeks to months and even years, often serving as a stepping stone for other chronic diseases.
What are the causes of insomnia?
Insomnia might well be a problem unto itself, but in most cases, it has been found to be associated with other conditions. Short-term insomnia types such as transient and acute insomnia are caused by a trauma or a recent accident, and therefore, can be treated by a couple of counselling sessions and maybe even doses of sleep medicine if suggested by a practitioner.
However, when it comes to chronic insomnia, let’s dig deeper and discover its physical, psychological and medical causes. This will help us verify its symptoms as well as possible methods of treatment:
The following are some of the major causes of chronic insomnia:
Psychological factors: Depression and anxiety, if not addressed, can lead to long-term sleep deprivation. People with a history of bipolar disorder, PTSD, or psychotic disorders are highly susceptible to chronic insomnia.
Irregular circadian rhythms: Simple known as the 24-hour sleep/wake cycle. Extreme temperatures, high altitudes, ever-changing shift timings, noise pollution, and work routine that involves travelling in different time-zones all contribute to disturbing the circadian rhythm.
Medical condition: A person’s medical condition can result in long-term sleep disorder. People with cancer, cardiac diseases, stomach problems, overactive thyroid, and diabetes remain at a greater risk of developing chronic insomnia because of the auxiliary stress and pain associated with these issues.
Substance intake: If you need a substance such as nicotine to relax or sleep at night, you are compromising on the quality of sleep you will get. It prevents deeper stages of sleep and often causes judders in the middle of the night.
Nicotine is a stimulant which is notorious for interfering with your sleep. Caffeinated drinks such as tea, coffee, and cola too are stimulants that keep you from falling asleep, especially when you prefer to have them in the later hours of the day. Other causes can include the following.
Poor “sleep hygiene”: An inability to strike the right balance between sleeping and non-sleeping hours disrupts your sleep hygiene. Yes, just like nutrition, sleep also needs to be hygienic. It should be a pure experience which requires you to have a sleeping haven. Taking irregular naps in the daytime, eating in bed, watching TV and smartphones screens for hours, and an untidy bedroom are all bad sleep habits and are detrimental for your mental and physical health.
Stress: An overthinking mind cannot help you get a good night’s sleep. If even in your bed, you are unable to let some uncomfortable thoughts go of your mind, you are probably going to become an insomniac.
Eating late: Sometimes, working extra hours takes a toll on your eating habits. When you finally find time to eat, it will be already too late, often just before going to bed, resulting in a backflow of acid and food from your stomach into the esophagus, which may keep you awake.
Symptoms of insomnia
Never let a random episode of sleep deprivation convert into chronic insomnia. You should be aware of the obvious and the underlying symptoms to be able to get a timely appointment with a sleep therapist. Insomnia symptoms and signs may include:
Difficulty falling asleep at night
Waking up during the night
Waking up too early
Feeling restive after a night’s sleep
Daytime tiredness or sleepiness
Inability to focus on tasks, difficulty remembering things, and struggling to pay attention
Higher incidence of uncalled for accidents and committing unforced errors
Mysterious headaches that feel like a tight band around the head
Can insomnia be dangerous?
Unfortunately, insomnia is one of those disorders that are left undiagnosed and untreated in a disproportionate manner. This is what makes it a dangerous prospect. While there are numerous repercussions of insomnia, ranging from mild to some extremely deleterious ones, some of the common ones include mental health issues. Long-term sleep deprivation can result in memory loss, insecurities about one’s appearance, drug usage, and even chronic depression.
ad sleeping patterns also affect eating habits. Insomniacs have nocturnal cravings prompting them to devour meals during midnight, leaving no time to burn calories and leading to obesity in some cases.
Insomnia treatment
The key to insomnia treatment lies in determining the root cause. Once that is done, the underlying condition can be properly treated and, as a by-product of this treatment, the ghost of insomnia is eliminated.
The following are some of the most effective methods to treat insomnia:
Cognitive behavioural Therapy: Generally referred to as CBT, this method encourages patients with insomnia to change certain behavioural patterns pertaining to sleep. For instance, the patient is asked to bring order into their sleeping schedule by setting up regular bedtime and wake up time, eliminating afternoon naps and avoiding spending too much time in bed after waking up. The thinking component is what makes CBT the most sought after cure for sleeplessness. By virtue of this approach, CBT takes on fears and superstitions and seeks to replace these feelings with rational and positive thinking. CBT’s insomnia cure rate is phenomenal to say the least.
Relaxation Training: Also known as progressive muscle relaxation, this approach teaches the patient to systematically relax and tense different bodily muscles. This exercise brings a tranquilising effect to the body which helps induce sleep. Meditation, breathing exercises and yoga can also be classified as relaxation techniques and all have the potential to cure restlessness. Listening to audio lectures on different relaxation methods is a sleep inducing formula in itself, keeping the person motivated at the same time.
Stimulus Control: This approach hits right on the money with its emphasis on building a natural association between the bed and the sleep by restricting the scope of activities in the patient’s bedroom. This means the person can go to bed only when they are feeling sleepy, and are not allowed to spend more than 20 minutes in bed once their eyes have been opened.
Sleep Restriction: This is a pragmatic approach centred on devising a strict schedule of bedtime and wake time and limits the amount of time spent on bed so as to accommodate only the sleeping phase.
The movie tells the story of how an office worker Edward Norton meets an eccentric man named Tyler Durden and how both start a secret fight club that evolves into a secret underground cult. The big twist is that Tyler is actually not real. He is a figment of the imagination of the author. The writer and director of Split, M. Night Shyamalan, professes to have been intrigued by dissociative identity disorder, commonly known as split personality disorder for a lifetime. The protagonist of the movie undergoes a serious condition of insomnia and through that many other stereotypes are built upon as well, portraying how illnesses in the real world are dealt with. Usually, insomnia is dealt with multiple different types of medication and support groups which is shown in the movie, however, as Edward Norton, tries to deal with insomnia through support groups, he finds himself to come in contact with other people who become an important part of his life. Edward Norton and Brad Pitt also known as Jack decide to take matters into their own hands and form a strictly regulated fight club in which rules and associations would be dealt with through them. Tyler, the main character, is soon attracted to a female named Marla whose role is played through Helena Bonham Carter. This not only somewhat diverts Tyler’s attention from the underground fight club they created, but also develops into a coping mechanism for his illness. Through multiple characters and multiple interactions, Tyler and his “close friend” go through many obstacles due to their bodies inability to regulate a consistent sleeping schedule.
In the movie, the character finds a way to relieve stress in a day resulting in him sleeping at night time. Insomnia may be caused by anxiety. Insomnia Dissociative fugue and Dissociative identity disorder are psychological disorders that narrator suffered from in this movie.
In the real world and as shown in the movie, insomnia can be treated, even if everyone’s solution may not be the same. To keep it working properly, sleep is important, but chronic insomnia can interrupt how information is normally sent by your body. Deprivation of sleep also has a negative effect on your mental and emotional capacity. You may feel more anxious or prone to changes in mood. Chronic insomnia (sleeping trouble for three months or longer) can also lead to mood changes, lack of motivation and energy. Tyler worked several night jobs which could also lead to fatigue and tiredness, which overall can make his symptoms more drastic.
Insomnia affects Marla as a character because Tyler is seen to be sleeping with her multiple times throughout the movie. This not only affects Marla but also affects Jack as he is also associated with the fight club. The effect of this disrupts the fight club as it pulls the attention away from the club itself to something more insignificant. The day Marla decides to take those pills and call Jack and Jack does not really show any attention, that shows what the insomnia disorder was doing to Marla. Later in the movie she questions Jack and asks her why he stopped coming to the support groups and when Jack tells her that he found his own way of coping through insomnia since neither the support groups or the doctor he was visiting were of any help. The plot of the story changes from Jack and Marla make tradeoffs on which support groups they will both attend to something more independent in a sense where each person ends up doing their own thing. At the end of the movie the audience is let in on the movie’s biggest twist where the creator shows Tyler and Jack as the same person and Jack’s alternate personality. This makes Jack realize that its been him whose been having sex with Marla since he is Tyler. As the creator of the movie unveils the plot, the character Jack is seen to be as a dynamic character since his ways of coping and his relationships with other people progressively develops into something much more complex.
In modern society, Insomnia is dealt with in some cases, intensive therapy, where the person diagnosed, sits with a health professional and discuss ways to dissect the cause of insomnia as the reason for being diagnosed is most likely different case by case. A minor case of insomnia can be dealt with at home through some counseling by a friend or a trusted family member. Most causes for insomnia include some prevailing negativity that keeps bothering someone, such as regurgitating some bad memory or concept which causes one to lose sleep. In the movie from the audiences perspective the level of severity was somewhat high. The movie showed the audience an unknown way of coping through insomnia, it was through roughhousing at some fight club established by two people (Jack and Tyler) on the spot with really strict rules. This mechanism of coping would not be typically recommended by doctors in the real world because of the violence involved but Jack and Tyler make it work and through that fight club they end up finding more members which discourages one of them because that would have to mean that one of them is breaking the code. Although the climax of the movie is towards the end when Tyler is revealed as Jack himself, the movie shows an unusual way of coping through insomnia which is not typically seen in society today as it is dealt with medication and intensive therapy sessions.
Stick to a regular weekly sleep schedule of seven days. Workout for at least 30 minutes a day for most days of the week. Evite intense workout morning or afternoon. Until bed, more relaxing exercise can be done, such as these yoga poses to help you sleep. Get plenty of access to natural daylight. Open your blinds in the morning and get out during the day. You can even try using a light box in the morning on dark winter days to help your brain wake up and control your body’s rhythms. Take a warm bath or shower before bed, set up a regular, relaxing bedtime routine.
The way that insomnia is shown in the movie is an accurate representation of how insomnia works in real life. Insomnia is one of those disorders that does not just go away, it takes time and effort and not everyone deals with it the same way. In the movie, Tyler’s disorder affects his everyday life but also brings upon unwanted changes to the lives of those around him. In reality, this is how this disorder, along with many others, work. Each disorder has its own stereotypes and whether those can be met or not depends on each individual person. It is hard to realize how badly insomnia affects someone’s life, until one has gone through it on their own. Marla starts a relationship with Tyler and at first, she was all hands on about helping him get through it. As it started to affect her own life, she slowly became frustrated with not only Tyler, but her choice in being with him in the way she was.
Personally, I do not know anyone with insomnia, but watching this movie and analyzing different parts of it has given me a general idea. I will be honest and say I am not one who disregards stereotypes altogether, but I do believe in cases like this, stereotypes do more harm than good. Disorders are not things people wish to have, they are things they have to learn to live with. As easy it may seem to get over time for the ones actually going through it, the amount of patience and effort required is incomparable to anything else. If I were in Marla’s place for example, and I loved the girl I was with, I would do anything to help make her life easier even if it made mine harder because in the back of my mind, I know hers is a lot worse. I would be there for my person and help them through it because their pain is not complaining, it is just one of the ways they can be open about what they are going through, since I can not experience for my own. Tyler has a trigger to where his personalities split and when this happens, it is not up to him to decide. So overall if I were in this position, I would make sure to help the person as much as I can, to the point where I can at least make a difference in their life, if not everyone else’s.
These days, sleep problems have become a common sight, as people regularly encounter difficulties in this respect. Furthermore, in the context of present-day developments, people tend to sacrifice their rest time in order to perform multiple tasks, and the negative consequences of this behavioral pattern are obvious. For this reason, BBC has introduced a podcast Mysteries of Sleep. Sleep Deprivation and Insomnia. The topic of this audio record is a variety of problems with sleep and their impact on an organism. It is mentioned that they increase the risks of heart failure, stroke, and cancer (Abrahams, 2017). In addition, difficulties with sleep affect cognitive skills, memory, mood, resiliency to stresses, and others (Abrahams, 2017). Therefore, sleep deprivation has a significant influence on both the physical and mental state.
Recent explorations and articles in this field may prove this thesis. Tobaldini et al., who are a group of scientists, have published their collective research in 2017. Their work may be considered accurate and relevant to the current innovations, as it covers multiple details in this regard and implies a comprehensive literature review. They highlight, “Short sleep duration is associated with increased incidence of cardiovascular diseases, such as coronary artery disease, hypertension, arrhythmias, diabetes and obesity” (Tobaldini et al., 2017, para. 1). Other modern scientists Hanson and Huecker introduced their exploration in 2020 and conducted a proper analysis of this topic. They proved the aforementioned conclusion and also paid attention to the impact of sleep deprivation on the mental state. They state that it may lead to anxiety, depression, and psychosis (Hanson & Huecker, 2020). Thus, the importance of sleep problem should not be underestimated.
Although sleep is not explored entirely, and there are numerous mysteries in this field, appropriate medications and treatment plans exist. It is crucial to control the sleeping schedule, and in case of serious difficulties, it is advisable to appoint a specialist. These problems are worth being paid attention to, as they affect both the physical and mental states. In addition, they determine the quality of everyday life and health condition.
Source Type. This source is the chapter of the book created by the StatPearls group.
Currency. The last time the book’s content was updated in 2020, which indicates the relevance of the materials. In studying topics, especially in the health sector, it is crucial to choose recent sources published over the past five years.
Relevancy. The chapter provides a knowledge base that is useful when studying the topic of sleep deprivation. Subsequent sources help to increase the knowledge gained from these materials.
Authority. StatPearls group aims to provide peer-reviewed and accessible health care materials to improve the level of medical education. The authors of the chapter also testify to the reliability of the source. Martin Huecker is an assistant professor and research director at the University of Louisville, and Joseph Hanson is a doctor specializing in mental health.
Accuracy. The material is based on existing studies of sleep problems that can be validated due to the reference list provided.
Purpose. The purpose of the chapter is to familiarize readers with basic knowledge about sleep deprivation with a medical bias, particularly with such aspects as etiology, pathophysiology, epidemiology, potential diagnoses, and other characteristics. Such knowledge provides a complete basic view of the problem.
Tobaldini, E., Costantino, G., Solbiati, M., Cogliati, C., Kara, T., Nobili, L., & Montano, N. (2017). Sleep, sleep deprivation, autonomic nervous system and cardiovascular diseases. Neuroscience & Biobehavioral Reviews, 74(B), 321-329. Web.
Source type. A scientific article in the medical journal dedicated to neuroscience.
Currency. The article is published in 2017 and contains current information.
Relevancy. The article provides more information about neuro processes during sleep and its disorders. To a greater extent, the source reveals such aspects as the consequences of the studied problem.
Authority. The authors of the study work in the field of health care and could face the consequences of sleep deprivation in practice. Moreover, the text before publication is checked by the journal’s editorial board.
Accuracy. The work is based on published studies on the consequences of the problem. All sources are listed in the reference list and can be verified.
Purpose. The article aims to inform about the harmful consequences of sleep deprivation and draw attention to timely prevention. A balanced view of the issue is provided by the author’s experience and comprehensive literature analysis.
In this assignment, we are testing the population means of two independent samples. We test the data using the two-sample t-test for random samples and the sample sizes are less than 30. The data are obtained from Martha who experimented with 20 samples. The aim is to determine whether special visualization therapy reduces the time taken to fall asleep in patients affected with mild insomnia.
Testing the two Population Means using a two-sample t-test
Choice between independent and dependent samples t-test
Martha should use an independent samples t-test. The samples of twenty numbers of the treatment are chosen randomly and the treatment is assigned randomly. The treatment samples are independent of each other. If the treatment X1 and X2 are given to the same samples and time was recorded, then the samples are related. Here the treatments X1 and X2 are given to different samples. Hence Martha should use independent samples t-test. (Fisher, R. A)
Independent and dependent variables
Time taken to fall asleep is the dependent variable as it is believed to depend on the treatment and the dichotomous data of with treatment and without treatment is the independent variable, as the selection for treatment is random.
Defining the hypothesis
Null hypothesis: The therapy does not affect the time taken to fall asleep. That is, there is no difference between the means of both treatments X1 and X2.
Alternate hypothesis: The therapy reduces the time taken to fall asleep. That is the mean of treatment X1 is less than the mean of treatment X2.
H0: µ2 = µ1 H1:µ2 > µ1
One-tailed or two-tailed test?
We would use a one-tailed test as the critical region for the hypothesis is in one direction of the right side. Also, the hypothesis is to test whether the meantime is reduced after treatment. Hence the hypothesis is a one-sided test. Suppose if Martha has to test whether there is any difference in the meantime, then it is a two-tailed test as the critical region lies on both sides.
Degree of freedom
The degree of freedom for two samples t-test is n1 + n2 – 2 where n1 and n2 are the sample sizes of the two samples respectively. Here n1 = n2 = 10. Hence df = 10 + 10 – 2 = 18.
Critical value
The critical value for a =.05 is 1.734. This value is found at the intersection of df = 18 and P = 5% (since one-tailed test) from the table.
Statistical interpretation
The tobt = 1.49. Since this value is less than the critical value, we have no evidence against the null hypothesis. Hence the null hypothesis can withstand at a 5% level of significance (Weisstein, Eric W).
Decision
Martha should conclude that the treatment does not affect the time taken to fall asleep as the test result show that both means are the same.
Conclusion
We have learned to do a hypothesis test to check the population means of two independent random samples. Inferential statistics provide us most important results so that we can take decisions. A more detailed test and further test like a test for variances will also provide good information about the population.
References
Fisher, R. A. “Applications of ‘Student’s’ Distribution.” Metron 5, 3-17, 1925.
Weisstein, Eric W. “Hypothesis Testing” from MathWorld–A Wolfram Web Resource. Web.
There are numerous motives why individuals have a hard time sleeping. The upside is that regular complications with sleep are frequently effortlessly addressed without the exploitation of medicine or pharmacological sleep aids – there are no failsafe natural remedies for sleeplessness, but there are operative stages one can go through, together with natural sleep aids (Byrne & Sarris, 2011).
There are various natural and herbal nonprescribed medications for sleeping complaints. Even though these sleep medications are vented as nutritional supplements, they should always be seen as suppositories. Intrinsically, they have knock-on effects and may have treatment interactions that have not been recognized and are not registered.
Valerian is often used for the production of supplements and is a common ingredient of sleep aids. It is frequently combined with other natural products that also provoke sleepiness such as passionflower and chamomile. Some provisions will similarly syndicate valerian and melatonin together with the other constituents enumerated previously (Sarris, Panossian, Schweitzer, Stough, & Scholey, 2011). Even though research specifies some healing profit, other investigations have not confirmed the equivalent aids.
Valerian commonly does not seem to cause unexpected results. Another herb that is often used as an insomnia medication is chamomile – a respected tranquilizing herb which can be exploited by kids and grownups without any harm. Chamomile brew is regularly used for sleeplessness and insomnia in conjunction with petulance, predominantly in children. Chamomile oil can as well be added to bathwater to pacify stressed nerves, watered down to 2% to produce a first-class massage oil, or utilized as an inhalant.
Another helpful herb is lavender, a tender firming stimulant for the nervous system. It can be used in ways similar to the use of valerian to lessen sleeplessness complications. Passionflower is also considered to be a vital herb for insomnia triggered by psychological anxiety, overstrain, or nervous fatigue. It is a component in more than 50 diverse regularly-sold tranquilizing medications. It is an exceptional sedative with no secondary effects even when exploited in large quantities.
Currently, Jujube seed (originally called Suan Zao Ren) is regularly used to cure neurasthenia, petulance, insomnia, hallucinations, night perspirations, anxiety, and so forth. From the viewpoint of American medicine, it encompasses the deep sleep periods by influencing the slow-wave slumber (SWS). It is also soothing the cognizance and calming the nerves (Yeung et al., 2012). Owing to its special curative properties on wakefulness, it is called the oriental slumbering fruit. Also, it is as well somewhat a refresher.
A frequently prescribed Chinese patent medication includes it as one of the key components. Jujube seed cures insomnia, tremors, and downheartedness by sustaining the heart. The regular medicines for insomnia and misery in current medicine are rather addictive and with a large number of secondary effects. On the other hand, Chinese herbs for despair and insomnia are not causing dependency and would not end up in medication addiction (Yeung et al., 2012).
Jujube seed can effectually help dismiss sleeplessness naturally, recover sleep value, and relieve nuisances, faintness, exhaustion, and other singularities. Moreover, it can also relieve strain, anxiety, despair, and forgetfulness. More notably, it helps individuals sleep well again, in the usual way. Jujube seed can help the patients dispose of the torment of insomnia and in so doing give them a safe and sound sleep, improve the heartbeat of the individuals who are struggling with arrhythmias, and make patients active again.
References
Byrne, G., & Sarris, J. (2011). A Systematic Review of Insomnia and Complementary Medicine. Sleep Medicine Reviews, 15(2), 99-106. doi:10.1016/j.smrv.2010.04.001
Sarris, J., Panossian, A., Schweitzer, I., Stough, C., & Scholey, A. (2011). Herbal Medicine for Depression, Anxiety and Insomnia: A Review of Psychopharmacology and Clinical Evidence. European Neuropsychopharmacology, 21(12), 841-860. doi:10.1016/j.euroneuro.2011.04.002
Yeung, W., Chung, K., Poon, M. M., Ho, F. Y., Zhang, S., Zhang, Z.,… Wong, V. T. (2012). Chinese Herbal Medicine for Insomnia: A Systematic Review of Randomized Controlled Trials. Sleep Medicine Reviews, 16(6), 497-507. doi:10.1016/j.smrv.2011.12.005
Insomnia is a sleep disorder that bothers millions of people around the whole globe. The reasons for insomnia vary from certain medical or psychiatric conditions to personal problems and poorly developed habits. Regarding the existing number of causes and outcomes of this disease, many treatments and alternatives can be offered to adults with insomnia. This paper will discuss the main aspects of insomnia and introduce Tai Chi as a possible treatment for patients. The goals of this project include the evaluation of the effectiveness of Tai Chi, the examination of its frequency and other sleep patterns, and the analysis of the recommendations that may be given to patients with insomnia. Not all medical facilities use Tai Chi as the main therapy for insomnia challenged patients, and it is necessary to investigate the cases for and against the chosen practice.
Introduction to Study
Insomnia is defined as one of the most prevalent disorders in the global population. It is defined as a subjective perception of difficulties that may occur during sleep initiation, duration, and quality (American Psychiatric Association, 2015). This disorder may be characterized by different complains and outcomes, therefore, multiple practices and approaches can be offered to help patients with insomnia, including psychological or pharmacological practices, stimulus control as a part behavioral interventions, or sleep hygiene as an example of education for patients (Qaseem, Kansagara, Forciea, Cooke, & Denberg, 2016). Problems with sleep may result in stress and unstable physical conditions that promote an increased possibility of inflammatory processes in the body. Tai Chi is used as one of the possible movement meditation types to reduce the level of inflammation in older adults (“Better sleep and tai chi,” 2015). It may have its positive and negative effects on people of different ages, and not many sources can be found at this moment to give clear explanations and evaluations of the chosen practice.
Research Problem
Insomnia is a problem for about a third of the US adults who report that they cannot meet the criteria of the recommended amount of sleep because of their chronic diseases and mental health problems (Centers for Disease Control and Prevention, 2017). To avoid negative outcomes of insomnia and promote good health, many adults find it helpful to practice different psychological and behavioral therapies, including Tai Chi (Liu et al., 2016). Still, the effects of Tai Chi on adults with insomnia remain unclear, and it is hard to understand if it is reasonable and effective to offer this practice as an option for all adults.
Research Question
The main research question that has to be answered in this research paper is if Tai Chi practice during 12 months can be effective for adults who suffer from insomnia. This research question can be divided into several sub-questions with the help of which a paper can be developed. These questions are as follows:
What is the essence of Tai Chi practice?
What are the effects of Tai Chi on adults with insomnia?
What are the alternatives for Tai Chi in insomnia treatment?
Who are the supporters of practicing Tai Chi?
Literature Review
Sleep is an important part of human life, and it has to be properly managed because the absence or lack of sleep can result in various disorders, as well as sleeping all the time can change the work of the body and the mind (Feldman & Christensen, 2014). The causes and outcomes of sleep problems may vary, and clinicians have to make a correct choice, investigate a patient, and treat people in regards to their demands, peculiar features, and health conditions. Sleep problems may be treated medically and psychiatrically (Smith & Shimp, 2014). Sometimes, it is enough to promote certain lifestyle changes and establish personal obligations (Bhalla, 2016). About 3-7% of patients receive medical prescriptions like doxepin or melatonin to deal with their sleep disturbance problems (Sateia, Buysse, Krystal, Neubauer, & Heald, 2017). In some cases, patients have to combine medications and physical exercises.
Tai Chi is one of the behavioral practices that can be offered to people who want to deal with their sleeping problems and improve the quality of their life. Positive effects of this practice have been already shown to the patients with Parkinson’s disease, chronic pain, breast cancer, and poor cardiovascular health (Irwin et al., 2014b; Raman, Zhang, Minichiello, D’Ambrosio, & Wang, 2013; Yang et al., 2015). Several attempts to investigate the effectiveness of Tai Chi as a treatment alternative has been already made by Abbott and Lavretsky (2013) who proved that the conditions of patients with mental disorders could be improved with the help of such invasive therapy. Still, the peculiar feature of past research is that authors combine sleep problems and Tai Chi with other diseases or health problems (Abbott & Lavretsky, 2013; Raman et al., 2013). Not much attention is paid to Tai Chi as a central method of treatment for patients with insomnia as the main complaint.
Modern people are concerned with some problems connected with their health, work, living conditions, family relationships, and other topics that have to be discussed. The solution to such problems leads to stress and other behavioral changes (Edinger et al., 2015). Insomnia is one of the main outcomes of stress and anxiety, and Tai Chi is a practice that can be offered by clinicians (Chan et al., 2016). It is a lifestyle intervention that can target both problems, stress, and inflammatory processes, reducing its complications at the cellular level (“Better sleep and tai chi,” 2015). Medical experts call this combination of cognitive-behavioral therapy and physical experiences as a successful contribution to the improvement of human health from the physical and psychological perspectives (Irwin et al., 2014b). Sleep duration cannot be ignored by people. Still, living conditions and social obligations may influence human health, and Tai Chi helps to reduce the number of outside social effects. However, as Feldman and Christensen (2014) state, physical experiences maybe not enough to deal with emotional problems. Therefore, medications and consulting with experts have to be combined to achieve the desired results.
Tai Chi is the practice that can improve the functional abilities of a person, prevent falls, and promote a supportive case that cannot be offered by the medical staff (Smith & Shrimp, 2014). Many patients confuse such therapies as yoga and Tai Chi or use them as synonyms to treat insomnia or other mental disorders (Feldman & Christensen, 2014). However, it is necessary to remember that in comparison to yoga where extreme movements and physical experiences may be offered to different patients regardless of their past medical history, Tai Chi includes calm and slow movements with breathing exercises that have to be controlled by a trainer or with the help of alarm or special programs.
It has been proved that such problems as insomnia or the inability to control the amount of sleep required for healthy life start bothering people with age (Irwin et al., 2014b). Age is also the factor that determines the quality of life and promotes the creation of new additional health problems and the necessity to deal with several supplementary diseases at the same time. As an example, Parkinson’s disease may be developed along with insomnia, hypertension, or depression (Yang et al., 2015). Panic and anxiety may be the outcomes of hard-working days or family conflicts, and a good portion of sleep is the solution that cannot be made (Bhalla, 2016). Tai Chi is an opportunity for people to improve their sleep habits, as well as to think about other aspects of life, which turns out to be a positive aspect of this therapy.
Significance of the Problem
It is necessary to admit that Tai Chi is a widely available practice for patients despite their age, geographical location, and gender (Irwin et al., 2014a). Therefore, millions of people can use this practice anytime they find it necessary. They have to be aware of their peculiarities, epistemology, and possible effects to make the right choice and be prepared for different outcomes. Tai Chi may change the quality of life and the relation between physical exercises and mental health (Chan et al., 2016). Also, insomnia in adults may be caused by different factors, including the environment, personal concerns, chronic disorders, or other diseases’ complications. Tai Chi makes people do slow physical movements, breathe deeply, and meditate (Clarke, Black, Stussman, Barnes, & Nahin, 2015). Such requirements may be challenging for patients with asthma, cardiovascular diseases, or problems with bones or joints. The clarification of the effects of Tai Chi on adults turns out to be a significant problem for discussion in terms of which the improvement of public knowledge is possible.
Methodology and Research Design
The choice of methods and research design for a future project is a crucial step that cannot be neglected. To evaluate the effectiveness of Tai Chi practices, an exploratory study will be used to provide a general picture of the practice, evaluate the results of earlier studies, and gather the opinions of different people on the same intervention. It is similar to a descriptive design with the only difference that lies in the necessity to prove the appropriateness of a hypothesis about the possibility for adult patients with insomnia to improve their sleep pattern with the help of Tai Chi practice. A quantitative research method, a questionnaire, will be developed and supported by the results obtained from the literature review. A questionnaire will consist of several specifically organized questions that allow gathering information on the topic (Creswell, 2014). The results of this method can be introduced in numbers and easily analyzed.
Setting/Sample Design
A questionnaire will consist of 15 close-ended questions with several answers for personal choice. It is expected to cooperate with adult patients. The main inclusion criteria are the nationality (the citizens of the United States), age (from 25 to 85), sleep disorder (insomnia), and treatment practice (Tai Chi and several alternatives). Several local hospitals and medical centers may be chosen for the analysis of patients, and their databases can be used to identify patients who suffer from insomnia. The desired number of participants is 40. Both male and female patients should be invited. Their social and marital statuses should not influence the choice. Still, this information can be helpful as a possible factor in insomnia development.
Confidentiality
First, research has to be approved by an appropriate research ethics committee to support initial contact with the participants. Then, hospital leaders and managers have to approve the use of their databases to choose people. Finally, after contact with potential participants, they will be asked to give their prior signatures to inform consent and prove their free will to participate in the study. All participants will receive similar agreements in terms of which their anonymity and confidentiality rights will be described. The participants may use their right to drop out of the research process any time they want, giving clear explanations. Anonymous information will be given in the description of the study.
Procedure/Intervention
As soon as the chosen patients agree to participate in the study, a researcher should gather their contact information and discuss the most appropriate for the participant’s methods of communication. It is expected to send a questionnaire to all participants via email. Still, if some people refuse to give this information, do not have e-mail, or have some personal or physical problems that prevent using the Internet, it is possible to use written examples or receive oral answers to all questions. A questionnaire has to be developed in the way the information about sleep patterns, hours, treatment methods, and the level of knowledge about the practice and insomnia can be gathered.
Aligning Stakeholders
There are three main groups of stakeholders in this project. First, there is a researcher who has to establish clear goals, give informative explanations, and provide the participants with the expected guarantees. Second, there are hospitals and other medical facilities that can be used to find out the participants and get permission to cooperate with people. Finally, there are adult patients who suffer from insomnia and use Tai Chi as the main practice to treat this disorder. The rights of all stakeholders have to be aligned through the identification of rights and the explanation of duties. Adults as the main participants of the study and the only sources of primary information about the outcomes of Tai Chi on insomnia treatment should understand their responsibility and possible effects on the study. They have to give true answers and avoid the situations that may confuse a researcher.
Instruments/Scales and Measurement of Outcomes
Measurement of outcomes can be based on several scales developed at different periods. For example, Crönlein et al. (2013) introduce the RIS (Regensburg Insomnia Scale) to evaluate cognitive, emotional, and behavioral factors of insomnia. Sadeghniiat-Haghighi, Yazdi, and Firoozeh (2014) investigate the worth of the insomnia severity index and polysomnography as the two methods to evaluate sleep disorders. The scale that will be used in this research is based on the ideas developed by Edinger et al. (2015) about the necessity to consider pre- and post-treatment assessment and the frequency of use of Tai Chi practice. First, the number of hours of sleep before Tai Chi should be calculated. Then, the same issue should be evaluated after practice. The length of the practice has to be identified.
Data Collection and Data Analysis
In addition to some past studies and results obtained by different researchers, the data will be collected through a questionnaire that has to be developed with 40 participants. They have to give clear answers and avoid omissions. All answers have to be introduced in an electronic form even if the answers are gathered orally. The questions will be created in the way the participants can use the most appropriate for the participant’s answers. For example, the question will be “How long should a good and healthy sleep last?”, and the answers will be as follows “A –less than 5 hours, B – 6-7 hours, C – 8-9 hours, D – 9 and more hours”. Descriptive statistics will be used to analyze the data. It should be supported by graphs to give a clear visual representation of the information and make conclusions about the effectiveness of the chosen practice.
Significance of the Study
The significance of the study can be proved in several ways. First, this study will help to analyze the already developed investigations and results. Tai Chi and insomnia are frequently discussed questions if they are separated. It is necessary to promote the importance to combine these issues and identify the impact of Tai Chi on patients with insomnia. The second reason to investigate the effectiveness of Tai Chi is the possibility to focus on sleep patterns of adults and their understanding of healthy sleep habits. Finally, a questionnaire with different people will help to gather different opinions and compare the experiences based on different treatment methods. Tai Chi is the core approach to the analysis in this paper. Still, it is also important to understand what alternatives are available to adults with insomnia and if the benefits of Tai Chi prevail over other techniques.
Assumptions and Limitations
The results of this study can be used for the development of further research on insomnia and Tai Chi as the main practice for treatment. As soon as the effectiveness of the approach is proved, it will be possible to develop new methods of treatment based on Tai Chi, combine this practice with other treatments, and enlarge the knowledge of people about Tai Chi. The only limitation of the study is its sample. A small number of participants do not promote common outcomes. From a global point of view, people may use different techniques. Tai Chi is not the only option. Also, Tai Chi has Chinese origins, and the representatives of the Chinese culture or the citizens of China may be more helpful sources of information about the connection between insomnia and this practice.
Conclusion
In general, this research proposal shows how important the evaluation of the effects of Tai Chi on patients with insomnia can be. It is not enough to promote the usage of this practice to treat insomnia. It is necessary to explain the effects of Tai Chi on adults with insomnia. Communication with the participants and the analysis of past studies can help to develop certain conclusions and prove the necessity to investigate this practice from different perspectives, including the age and race of patients, the presence of other alternatives, and the period of the intervention.
References
Abbott, R., & Lavretsky, H. (2013). Tai Chi and Qigong for the treatment and prevention of mental disorders. Psychiatric Clinics, 36(1), 109-119.
American Psychiatric Association. (2015). Sleep-wake disorders: DSM-5 selections. Arlington, VA: American Psychiatric Publishing.
Better sleep and tai chi reduce inflammation and promote health. (2015). Web.
Centers for Disease Control and Prevention. (2017). Sleep and sleep disorders. Web.
Chan, A.W.K., Yu, D.S.F., Choi, K.C., Lee, D.T.F., Sit, J.W.H., & Chan, H.Y.L. (2016). Tai chi qigong as a means to improve night-time sleep quality among older adults with cognitive impairment: A pilot randomized controlled trial. Clinical Interventions in Aging, 11, 1277-1286.
Clarke, T.C., Black, L.I., Stussman, B.J., Barnes, P.M., & Nahin, R.L. (2015). Trends in the use of complementary health approaches among adults: United States, 2002-2012. National Health Statistics Reports, 10(79), 1-16.
Creswell, J.W. (2014). Research design: Qualitative, quantitative, and mixed methods approaches (4th ed.). Thousand Oaks, CA: SAGE.
Crönlein, T., Langguth, B., Popp, R., Lukesch, H., Pieh, C., Hajak, G., & Geisler, P. (2013). Regensburg insomnia scale (RIS): A new short rating scale for the assessment of psychological symptoms and sleep in insomnia; Study design: Development and validation of a new short self-rating scale in a sample of 218 patients suffering from insomnia and 94 healthy controls. Health and Quality of Life Outcomes, 11(1), 65-72. Web.
Edinger, J. D., Buysse, D. J., Deriy, L., Germain, A., Lewin, D. S., Ong, J. C., & Morgenthaler, T. I. (2015). Quality measures for the care of patients with insomnia. Journal of Clinical Sleep Medicine, 11(3), 311-334.
Feldman, M.D., & Christensen, J.F. (2014). Behavioral medicine: A guide for clinical practice (4th ed.). New York, NY: McGraw Hill Professional.
Irwin, M. R., Olmstead, R., Breen, E. C., Witarama, T., Carrillo, C., Sadeghi, N.,… Bower, J. E. (2014a). Tai chi, cellular inflammation, and transcriptome dynamics in breast cancer survivors with insomnia: A randomized controlled trial. Journal of the National Cancer Institute Monographs, 2014(50), 295-301.
Irwin, M.R., Olmstead, R., Carrillo, C., Sadeghi, N., Breen, E.C., Witarama, T., … Bootzin, R. (2014b). Cognitive behavioral therapy vs. tai chi for late life insomnia and inflammatory risk: A randomized controlled comparative efficacy trial. Sleep, 37(9), 1543-1552.
Liu, Y., Wheaton, A.G., Chapman, D.P., Cunningham, T.J., Lu, H., & Croft, J.B. (2016). Prevalence of healthy sleep duration among adults – United States, 2014. Morbidity and Mortality Weekly Report, 65(6), 137-141.
Qaseem, A., Kansagara, D., Forciea, M.A., Cooke, M., & Denberg, T.D. (2016). Management of chronic insomnia disorder in adults: A clinical practice guideline from the American college of physicians. Annals of Internal Medicine, 165(2), 125-133.
Raman, G., Zhang, Y., Minichiello, V.J., D’Ambrosio, C.M., & Wang, C. (2013). Tai chi improves sleep quality in healthy adults and patients with chronic conditions: A systematic review and meta-analysis. Journal of Sleep Disorder and Therapy, 2(6). 141-146.
Sadeghniiat-Haghighi, K., Yazdi, Z., & Firoozeh, M. (2014). Comparison of two assessment tools that measure insomnia: The insomnia severity index and polysomnography. Indian Journal of Psychological Medicine, 36(1), 54-57.
Sateia, M. J., Buysse, D. J., Krystal, A. D., Neubauer, D. N., & Heald, J. L. (2017). Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: An American academy of sleep medicine clinical practice guideline. Journal of Clinical Sleep Medicine, 13(2), 307-349.
Smith, M.A., & Shimp, L.S. (2014). Family medicine (4th ed.). New York, NY: McGraw Hill Professional.
Yang, Y., Hao, Y.I., Tian, W.J., Gong, L., Zhang, K., Shi. Q.G., … Zhao, Z.L. (2015). The effectiveness of tai chi for patients with Parkinson’s disease: Study protocol for a randomized controlled trial. Trials, 16(1), 111-117.