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DIFFICULTY SLEEPING - There are many reasons why you might have trouble sleeping. Some may be minor, while others may require medical treatment. Use this chart if you often lie awake at night, wake at odd hours or if you feel tired in the morning

Do you find it difficult to get to sleep?                   

Are you often tense and irritable during the day?

Do you find that you keep waking up very early in the morning and that it's then difficult to get back to sleep again?

If you are female, is there a chance that you might be pregnant?

You could be suffering from anxiety. Try to cut back on the stress in your life. Make time to learn and practise a relaxation therapy such as yoga or some form of meditation.

When you lie awake, are you preoccupied with problems? Do you feel a failure or that your life has no purpose?

When you wake. do you find that you often feel breathless?

It's quite common to have trouble sleeping during pregnancy. Often there is a need to urinate during the night. If this is your problem, cut back the amount you drink in the evening. If you are constantly tired, consult your doctor.

Difficulty sleeping is often a sign of depression. Discuss this with your doctor.

Attacks of breathlessness could signify a heart condition.

If you are under 40, however, the problem is more likely to be asthma. Discuss this with your doctor.

Have you been drinking a lot of tea, coffee or cola drinks during the day?

Do you often go to bed feeling overfull or after having drunk a lot of alcohol?

Have you recently given up sleeping pills or tranquillizers?

Are you generally an inactive person who takes very little exercise?

Are you aged 60 or over?

Too much caffeine overstimulates the central nervous system and can interfere with your sleep. Some people are particularly sensitive to caffeine while others can consume little or none without suffering adverse effects.

Eating and drinking too much late at night can cause sleeplessness. Though alcohol initially helps you get to sleep, too much can cause you to wake during the night or too early in the morning.

Drugs like these can upset normal sleeping patterns and it may take several weeks before your body learns to readjust. The withdrawal symptoms should eventually pass.

Your body may not be tired enough to allow you to fall asleep easily. Try to get some exercise during the day. Do not exercise too close to bedtime, as this could make the situation worse.

The amount of sleep we need and the way in which we take it often changes as we get older. Elderly people often fall into a pattern of waking early and then taking an afternoon nap. As long 'as you don't feel sleepy or unwell, there's nothing to worry about.

Cut down on your caffeine intake. Switch to decaffeinated drinks or herbal teas or try cutting out caffeine altogether.

If you're at all concerned about the length of time this is taking, discuss it with your doctor.

Try to adjust to your new sleeping pattern by finding more to do in your waking hours.

 Taken from THE HEALTH FILE  A Complete Medical Encyclopedia, A MARSHALL CAVENDISH REFERENCE COLLECTION,MEDICHECK  by DR JOHN CORMACK, WEEKLY Australia, New Zealand, Malaysia Singapore Malta RSA Other Countries Namibia.

DR JOHN CORMACK, BDS MB BS MRCS LRCP, is the medical consultant to The Health File. The senior partner in an Essex­ based practice, he is also a member of the General Medical Council and has written for numerous magazines and news­papers as well as for the medical press. He is a regular broadcaster on television and radio and has scripted a number of award-winning educational videos.

 Note: Where gender is unspecified, individuals are referred to as 'he', This usage is for convenience only and not intended to imply that all doctors and patients are male. Medicheck charts are only a rough guide to diagnosis, Always seek medical advice if you have worrying symptoms.

Copyright Marshall Cavendish 1995, Printed in Great Britain, Published by Marshall Cavendish Partworks Ltd, 119 Wardour Street, London WIV 3TD

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