Welcome to Insomnia and Sleeplessness

It was a very busy day.  I looked at my appointment list, and was surprised to see  Ben (not his real name), a 27 year-old fit young  man, truck driver, was fitted into seeing me-”pain” attached beside his name. 

I saw him a few times for the last few weeks and a few days ago cleared him from workcover for soft tissue injury to his left arm and a sprained neck, after he rolled his truck.  He was very grateful as I gave him 2 weeks off for rehabilitation with the help of competent physiotherapist to manage his injury.

I am usually very quick to respond when dealing with acute pain.  I jumped the queue, and called his name.
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I gave a dirty look to my colleague that night when she turned up about half an hour late to the meeting.  When I went to work earlier than usual the next morning to work, I saw her sitting inside her room staring into space.  Since I had about 15 minutes, I sat down and wanted to have some social chat with her.  “Good morning, gee, we are early today.”  “Swee, my father passed away last night.”  My jaws dropped. “I am so sorry to hear that.”
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A 33 year-old slim cachetic, puffy eyed, strong smell of tabacco lady came in today requesting me to help her to quit her 21-year of marijuana use.  She is spending about $270 per week to buy marijuana.  She wakes up at 6am and the first thing she is does is to smoke her marijuana, until 6pm at night.  She has been having recurrent chest infection, daily sputum production, very tired, but difficulty to fall asleep at night, paranoid and unable to look after her 2 young kids.  She tried to move from where she lived for 3 months and did quit her marijuana, but this causing tremendous withdrawal symptoms and badly treated her children in that 3 months period.  Unfortunately, she reverted to smoking marijuana after 3 months.  She went to see counsellor, psychologist, psychiatrist and hospital, none of the measures helped her. 
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A universal complaint among shiftworkers are difficulties in initiating and maintaining sleep. This leads to related fatigue and mood problems, especially when sleep and work are mismatched to the normal schedule of sleep and activity.

Symptoms include:

1) Insomnia during the major sleep period, or

2) excessive sleepiness during the major waking period (when working nightshift or frequently changing shiftwork).
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Bedwetting causes fatigue, disruption to family sleep, stressful event and fear of underlying pathology for parents and adult sufferers.

Nocturnal enuresis impacts the daily life of 61% of children. 1.5% of 13-year-olds and  adolescents rate nocturnal enuresis as significant event in their life. This can persist into adulthood, with 0.5% of adults with nocturnal enuresis, which can be associated with a high incidence of depression, lower self-esteem and sleep disturbances.
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Insomnia, depressed or irritable mood, anhedonia, vegetative function change, anxiety symptoms, suicidality, helplessless and hopelessness can be the the symptoms of postnatal depression.  This can occur at the onset of postnatal period upto six months after childbirth.
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There are different treatments available for asthma.  However, if untreated or misdiagnosed asthma, it may cause comorbity and mortality. 
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Australia has been hit by the worst drought in 15 years.  As the drought worsens, farmers’ health are getting affected as well.  In particular, the drought has led to increasing incidence of mental health issues among farmers. 

Farmers are encouraged to identify the warning signs of depression, anxiety, sleep disturbances, anger problems, disturbing and suicidal thoughts. They should get help early with their doctors.

Most migraine or headache sufferers will tell you they do not sleep well at night.  Insomnia is their main complaint.  Having a headache may actually be a legitimate excuse for avoiding sex also, but this may not be the same for migraineurs, according to researchers.

A US study found that people who experienced migraine headaches had more sex drive than those with tension-type headaches.  The migraineurs rated themselves on average as having a higher sex drive than their peers with no migraine. 
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Obstructive sleep apnoe (OSA) patients usually present with symptoms of snoring, daytime sleepiness and obesity, more importantly with insomnia, which is due to the disruptive effects of obstructive arousals.
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