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Understanding Insomnia: An Overview
If you have insomnia, you may have trouble falling asleep, staying asleep, waking too early, or getting good quality sleep that leaves you feeling rested. Instead, you don’t feel refreshed when you wake up. During the day, you’re sleepy and tired and have trouble functioning. Insomnia is a Sleep Disorders: Defines as difficulty with the initiation, maintenance (difficulty with sleep maintenance implies waking after sleep has been initiated but before a desired wake time), duration, or quality of sleep that results in the impairment of daytime functioning, despite adequate opportunity and circumstances for sleep.
Types of Insomnia
Two kinds of insomnia exist:
Primary insomnia:
Sleep problems are not directly connected with any other health problem. Instead, major stress, emotional upset, travel, and work schedules can trigger this type of insomnia. Even after such causes go away, the insomnia may persist. You can also develop primary insomnia because of certain habits, such as taking naps or worrying about sleep.
Secondary insomnia:
Sleep problems occur because of another issue, such as a health condition or disease, chronic pain from arthritis or headaches, medications, or alcohol, caffeine, and other substances.
Sub classification:
- Transient insomnia lasts less than one week,
- Short-term insomnia lasts one to four weeks.
- Chronic insomnia lasts more than one month.
What Are the Causes of Insomnia?
Many factors can cause acute or chronic insomnia:
- Stress (including job change or loss, moving, death of a loved one
- Medical condition or disease (including depression, anxiety, post-traumatic stress disorder, asthma, cancer, heartburn, heart failure, overactive thyroid, Alzheimer’s and Parkinson’s disease, and other health problems)
- Pain or physical discomfort
- Medications
- Noise, light or extreme temperatures
- Interference with one’s regular sleep schedule (including jet lag or switching work shifts)
- Substance abuse
What Are the Symptoms of Insomnia?
If you have insomnia, you may have some of these symptoms:
How is Insomnia Diagnosed?
To diagnose insomnia, your doctor will ask about your sleep patterns and habits, stress levels, medical history, level of physical activity, and use of medications, alcohol, caffeine, tobacco, and illegal substances. He or she might also ask you to keep a detailed log of your sleep habits, including sleep and wake times, napping, and any specific problems with sleeping. Your doctor will also do a physical exam to look for health disorders that can cause insomnia. If your insomnia persists even after treatment, your doctor may refer you to a sleep disorders specialist for an evaluation. If the specialist suspects a disorder, such as sleep apnea or restless legs syndrome, you may need to do an overnight sleep study at a special sleep center.
How is Insomnia Treated?
If you have short-term insomnia, you may not need treatment. Often, good sleep habits and self-care can cure a mild case. If you have trouble functioning during the day because of poor sleep, your doctor may prescribe sleeping pills for a few weeks. Commonly used sleep aids include sedatives, minor tranquilizers, and anti-anxiety drugs. Most are safe if a doctor supervises their use. Some sleep aids can become habit-forming or pose the potential for overdose if not used as directed. Newer sleep aids can be taken for longer periods without losing effectiveness. If you use an over-the-counter sleep aid, take it exactly as directed. An OTC product may help with an occasional sleepless night, but it is inappropriate for chronic insomnia. Chronic insomnia could be a sign of a serious, underlying disorder, so see your doctor. If you decide to try an OTC sleep aid, keep in mind that these products often contain antihistamines, which can cause nervousness, agitation, falls, confusion, urinary difficulties, and daytime sleepiness, especially in older people.
Common Pharmacological treatment
- Common Medications: sleeping pills / sedatives
- They are prescribed to over 95% of insomniac cases
- Used mainly to reduce symptoms in acute insomnia
Common Side-effect:
Day time fatigue, motor vehicle crashes, cognitive impairments and falls and fractures.
Other Risks:
Some can cause psychological and physical dependence, which manifests in withdrawal symptoms if the drug is not carefully tapered down. Psychological dependence refers to drug craving that can lead to drug-seeking behaviour.
Sleep medications raise the risk of dying
Hypnotics’association with mortality or cancer: a matched cohort study. BMJ Open 2012;2: e000850. If you have chronic insomnia, getting treatment for any underlying health condition or other
problem may help you to sleep better. If you still have insomnia, your doctor may suggest behavioural therapy, which is frequently used when insomnia stems from the mind or body being unable to relax. Behavioural therapy teaches a person how to alter behaviours that worsen insomnia and learn new ways to promote sleep.
Insomnia Myths:
- A Drink Will Help You Sleep : alcohol can help you fall asleep. But as it moves through your body it may lead to disturbed, restless sleep, or it may make you wake earlier.
- Screen Time Helps You Wind Down: It’s tempting to try to wind down by reading on the computer or watching TV before bed, but both can actually stimulate you. The light and noise of TVs and computers can be engaging and can reduce brain melatonin levels. Need just a little noise to help you drift off? Try listening to relaxing music on the radio, which is less involving.
- Sleep Aids Are Risk-Free: It’s true that today’s sleeping pills are safer and more effective than many older drugs. But all medications have potential risks, including the risks of dependency. Always talk to your doctor before using sleeping pills. Some sleep aids can help relieve insomnia symptoms temporarily. They can’t cure insomnia. Resolving underlying health issues and addressing your sleep environment is often the best approach to insomnia.
- You Can Make Up For Lost Sleep: It’s unlikely that you can fully catch up on sleep you’ve lost. Sleeping in one or two days a week or over the weekend may actually upset your natural body clock. The disruption may make it harder to get to sleep the next time. The only way to catch up on lost sleep is to get back into a regular sleep schedule.
- You’ll Learn to Need Less Sleep: Believing this myth can lead to serious consequences. Everyone is born with a set sleep need. Most adults need at least eight hours. You can learn to get by on less sleep, but you can’t train your body to need less sleep. If you’re sleep deprived, you might not be able to pay attention or remember things. Being chronically tired can have serious consequences, including poor work performance and an increased risk of accidents.
- Sleep Problems Go Away on Their Own: Until you know what’s causing your insomnia — whether it’s stress, medication, illness, or another issue — don’t expect it to disappear
on its own. If you’ve had problems getting to sleep or staying asleep, or if you’re consistently tired after a night’s sleep, you may have a sleep disorder, and it’s time to
talk to your doctor about treatment.
Manage Your Sleepless Nights:
Natural Sleep Solutions
In our 24/7 society, far too many of us see sleep as a luxury rather than a necessity. We have no problem spending long hours at work and then adding other activities that can turn a busy day into a positively grinding experience. Something’s got to give, so we delay our mental and physical recharge and skimp on sleep. When we finally do lie down, our busy minds aren’t always so willing to rest. Insomnia is a complex condition often caused by a number of factors, addressing those factors often requires lifestyle and environmental changes. No matter what its cause, insomnia is the most common sleep complaint among us. According to the US National Sleep Foundation, 30% to 40% of adults say they suffer from occasional insomnia. And 10% to 15% of Americans say they have trouble sleeping all the time. When insomnia strikes, one option is to try prescription sleep aids. But there are a number of other effective natural sleep remedies available to you. Lifestyle changes, as well as foods, supplements, and herbal supplements may help you get restful sleep.
Here are a few to try when you’ve counted your last sheep:
Natural Insomnia Remedies: Foods, Herbs, and Supplements
Warm milk. You can put a tasty spin on your grandmother’s natural insomnia remedy by sipping warm milk before bed. Almond milk is an excellent source of calcium, which helps the brain produce melatonin. Plus, warm milk may spark pleasant and relaxing memories of your mother helping you fall asleep.
Sleepy-time snacks
The best sleep-inducing foods include a combination of protein and carbohydrates. We suggest a light snack of half a banana with a tablespoon of peanut butter or a whole wheat cracker with some cheese. Eat one of these snacks about 30 minutes before hitting the hay.
Magnesium
Magnesium apparently plays a key role in the regulation of sleep. Research has shown that even marginal magnesium deficiency can prevent the brain from settling down at night. One of the most absorbable forms of magnesium is magnesium citrate powder, available in health food stores. Try taking two doses, following label directions, a day, with the second dose right before bed. You can also get magnesium from food. Good sources include green leafy vegetables, wheat germ, pumpkin seeds, and almonds
Lavender
Research has shown that lavender oil is calming and can help encourage sleep in some people with insomnia. “Try taking a hot bath with lavender oil before bed to relax your body and mind,” Harris says.
Valerian root
The medicinal herb valerian root has been used to treat sleep problems since the time of ancient Rome and Greece. Valerian can be sedating and may help you fall asleep,
Research on the effectiveness of valerian for insomnia are mixed, however. If you try valerian as a sleep remedy, be patient. It can take a few weeks for its sedating properties to
take effect. Talk to your doctor before taking valerian and follow label directions.
L-theanine
An amino acid found in green tea leaves, L-theanine can help combat anxiety that interferes with sleep. A 2007 study showed that L-theanine reduced heart rate and immune responses to stress. L-theanine works by increasing production of the feel-good hormone serotonin. It also induces brain waves that correlate with relaxation. Before taking L-Theanine, talk to your doctor about possible drug interactions. Melatonin. Melatonin is a hormone that helps regulates the sleep/wake cycle, an internal pacemaker that regulates the timing and our drive for sleep in humans. It causes drowsiness, lowers body temperature, slows metabolic functions, and puts the body into sleep mode. Research on melatonin in people with insomnia is mixed. One study showed that taking melatonin restored and improved sleep in people with insomnia. Other studies show that melatonin does not help people with insomnia stay asleep. Melatonin is not regulated by the FDA and can have problems with purity. It is only advised for people with circadian rhythm issues, and it should never be given to children or taken by someone on other medications. You should only use melatonin under close supervision by a doctor.
L-tryptophan
An essential amino acid and it is a percussor to (i.e. it in our body converts to): Serotonin (neurotransmitter): which affects mood & Melatonin (neurohormone): which affects sleep. Current research finding suggest supplemental administration of tryptophan might help to remediate the reduction in serotonin and melatonin that normally occurs as we age, and be consequently beneficial in the treatment of sleep problems and alterations in the innate immune response and it is a safer options than direct Melatonin supplementation .
Natural sleep remedies: Lifestyle changes
Make lifestyle changes to improve your sleep
- Try not to worry about sleep when you go to bed.
- Avoid clock-watching. Turn your clock around and use only the alarm.
- Make your bedroom comfortable for sleep. Keep it dark, quiet, and not too cold or warm. Use a sleeping mask to block light or earplugs or a fan to block noise.
- Relax before bedtime by reading, listening to relaxing music, bathing, or doing another relaxing activity.
- Don’t eat a heavy meal late in the day; a light snack before bedtime may help with sleep, though.
- If you can’t sleep and don’t feel drowsy, avoid lying in bed. Get up and read or do something that’s not stimulating until you feel sleepy. The following changes to your lifestyle and environment can also help combat sleep problems:
Turn off the TV.
In some people, night time light can inhibit melatonin and create “social jetlag,” which mimics symptoms of having travelled several time zones. To keep your sleep surroundings as dark as possible, we recommends moving the TV out of your bedroom and using a DVR or TIVO to record favourite late night shows for later viewing. Put other appliances to bed, too. If you want a good, restful sleep, turn your appliances away from your bed. Or better yet, turn them off altogether. If you must use bedroom electronics, choose those illuminated with red light, which is less disturbing to melanin production than blue light. Give it up. If you don’t fall asleep within 30 minutes, sleep specialists recommend you get up and leave your bedroom or read. Then return to your bed to sleep when you feel tired again. Exercise early. It’s no secret that exercise promotes restful sleep and good overall health. However, a study published in the journal Sleep showed that the amount of exercise and time of day it is done makes a difference. Researchers found that women who exercised at a moderate intensity for at least 30 minutes each morning, seven days a week, had less trouble sleeping than women who exercised less and/or later in the day. Morning exercise seems to affect body rhythms that affect sleep quality. One of the reasons for this interplay between exercise and sleep may be body temperature. Your body temperature rises during exercise and takes up to 6 hours to drop back down to normal. Because cooler body temperatures are associated with better sleep, it’s important to give your body time to cool off before bed. Your bedroom should feel like a sanctuary. Piles of clothes thrown on your bed, stacks of bills staring at you, or other random clutter will hamper you emotionally and lead to sleep problems. A tranquil and organized space will help you feel more relaxed. To create the perfect sleep environment, try the following:
- Wear pyjamas to bed. This can be your birthday suit, but it signals your mind that it’s bedtime.
- Keep your room cool, between 65 and 72 degrees — the optimal temperature range for sleep.
- Make your room dark. Consider installing room-darkening shades. Or wear eye covers to block light from the street or LED displays.
- Purchase a good mattress. You spend 1/3 of your life in your bed, so it’s worth the investment.
- Use a pillow that supports your head and neck. Give the pillow the bend test; if you bend it in half and it stays in position, it’s too floppy.
- To filter unwanted sounds, use a white noise machine. Your brain still hears things when you sleep.
- Sleep on breathable linens. They will reduce sweat, body odor, and skin irritation — all of which can disrupt sleep. Natural sleep remedies can do wonders for the occasional bout of poor sleep. However, they shouldn’t be used for chronic sleep problems, If you have insomnia that lasts for a few weeks or more, be sure to consult your doctor. You Can Train Yourself to Sleep You can train your body to associate certain restful behaviours with sleep. The key, of course, is consistency. Read for an hour or take a warm bath before bed. Maybe meditating or daydreaming will help you drop off to sleep. Find what works for you, and then make those rituals a regular part of preparing for bed every night.
Supplementary notes:
Tryptophan, Serotonin, Melatonin, and sleep/wake cycle
What is melatonin? Melatonin is a hormone made by the pineal gland in the brain.
Melatonin helps control your sleep and wake cycles. Very small amounts of it are found in foods such as meats, grains, fruits, and vegetables.
What does natural melatonin do in the body?
Your body has its own internal clock that controls your natural cycle of sleeping and waking hours. In part, your body clock controls how much melatonin your body makes. Normally, melatonin levels begin to rise in the mid- to late evening, remain high for most of the night, and then drop in the early morning hours.
Light affects how much melatonin your body produces. During the shorter days of the winter months, your body may produce melatonin either earlier or later in the day than usual. This change can lead to symptoms of seasonal affective disorder (SAD), or winter depression. Natural melatonin levels slowly drop with age. Some older adults make very small amounts of it or none at all.
Melatonin used as a dietary supplement
Melatonin supplements are sometimes used to treat jet lag or sleep problems (insomnia). Scientists are also looking at other good uses for melatonin, such as:
- Treating seasonal affective disorder (SAD).
- Helping to control sleep patterns for people who work night shifts.
- Preventing or reducing problems with sleeping and confusion after surgery.
- Reducing chronic cluster headaches.
Is taking a melatonin dietary supplement safe?
In most cases, melatonin supplements are safe in low doses for short-term use. But be sure to talk with your doctor about taking them. Children and pregnant or nursing women should not take melatonin without talking to a doctor first. Melatonin does have side effects. But they will go away when you stop taking the supplement. Side effects may include:
- Sleepiness.
- Lower body temperature.
- Vivid dreams.
- Morning grogginess.
- Small changes in blood pressure.
In adults, melatonin is taken in doses from 0.2 to 20.0 mg, based on the reason for its use.
The right dose varies widely from one person to another.
Tryptophan:
An essential amino acid Percussor to (i.e. it in our body converts to):
-
• Serotonin (neurotransmitter): affects mood
• Melatonin (neurohormone): affects sleep