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Sleep Disorders

No sleep in weeks! Having sensitivity

08/18/2008

Question:

I have insomnia, but the past couple of weeks I`ve been really stressed. My body hasn`t had 8 hours of sleep a day since I can remember. In fact, I haven`t been able to sleep even 3 to 4 hours a night in maybe 2 weeks or more. I feel it wreaking havoc on my body. Today I was feeling a weird pain above my right breast and I also felt sensitivity to the touch on my right forearm and palm under my right pinky. Do you think its due to my nerves and lack of sleep. What exactly is it?

Answer:

I apologize for the delay in answering your question and hope that I still may be able to offer some helpful advice. If I understood your problem correctly, you have developed difficulty falling asleep recently associated with excessive stress. This would be considered a form of acute insomnia resulting in inadequate sleep.

A large percentage of the population reports insomnia of several weeks duration at least once in their lifetime. The causes are numerous and include social and job stressors, changes in one's regular routine due to work, family obligations, travel, grief, depression, medical illness, bed partner issues, and medications, to name a few.

You mention a distinct period of time for the onset of your symptoms. This is indicative of an event or stressor that may have precipitated the problem. It would be important to review and recognize the possible event or stressor as further evaluation and management of this problem may be needed (such as counseling). In conjunction with management of any underlying problems, medication therapy can be considered for the short-term to help you sleep. A number of effective medications are now available as sleep aids and these are generally well-tolerated. However, they are really recommended for short-term use only and require a prescription from a physician.

An alternative approach to medications would be to attempt behavioral changes, which can be effective as well. Some of these include going to bed only when very sleepy, but maintaining a set wakeup time. In addition, you should get out of bed if you haven't fallen asleep in 15-20 minutes and do something that is not stimulating (i.e. reading in a dimly lit environment or listening to soothing music). Exercise about 5 hours before bedtime can be very helpful. Avoiding alcohol and caffeine within 4-6 hours of bedtime is a good idea as well.

It's hard to know for sure if the other symptoms you have are related to the insomnia or not. Acute sleep deprivation, as you are experiencing, can lead to wide ranging consequences including increased anxiety, feeling poorly, body aches, nausea, etc. However, localized pains and sensations would be somewhat unusual and may point to another problem distinct from your sleep issues.

If you find you are still having problems falling asleep, or the other symptoms seem to be persisting, then you should discuss this issue with your primary care physician. Specific factors in your history may be useful in tailoring a strategy that might work for you. Referral to a Sleep Specialist in your area may also be helpful. To learn more about insomnia or other sleep disorders, please visit the American Academy of Sleep Medicine website. In addition to information, the website contains a list of Sleep Centers across the country so that you may locate one near you. 

Good luck and here's to better sleep!

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Response by:

Dennis   Auckley, MD Dennis Auckley, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University