Do you toss and turn in bed all night? Do you fall asleep only to wake in the wee hours of the morning? Do you sleep ‘normally’, but feel exhausted during the day? It is time for you to discover and explore possible solutions and alternatives to your insomnia.
Insomnia is the difficulty in falling asleep, an inability to maintain sleep, or inadequate sleep quality that results in the sensation of not being refreshed or rejuvenated in the morning and with deteriorating capacity to function during the day.
We all complain about sleeplessness at some points in our lives, but it is usually short term and brought on by stress or illness. With adequate rest, and a healthy state of mind it usually passes with recovery only taking a few days. It is when it goes beyond this period that the downward spiral begins and the fear of not falling asleep becomes the cause of the insomnia. Life often becomes complicated by the frustrations of sleeplessness, ability to function deteriorates, and personal relationships may suffer. This often leads to resorting to addictive sleep promoting drugs or alcohol due to desperation. The problem with sleep aiding medication, also known as hypnotics, is that they effect the sleep cycle, not allowing you to get the restorative sleep you need and in turn causes next-morning hangover effects. Hypnotics also cause dependence (you can not sleep without them) and tolerance (after a while they are no longer effective). There are many alternatives to these medications and it is important to be informed about your options.
A starting point is to determine some common causes of insomnia. Firstly, it is imperative to identifying the root cause of the insomnia.
- Hormonal and thyroid imbalances should be ruled out through blood work.
- A breathing disorder known as sleep apnea, and a movement disorder know as restless leg syndrome greatly effect sleep quality and may need to be ruled out by a few nights of testing at a sleep lab.
- Generalized anxiety disorder and depression can also interfere with sleep and appropriate treatment must be sought.
- The most common cause of insomnia is psychological or emotional stress, i.e. the stresses of daily life, but many other factors can also affect sleep.
- Medications can have a major influence on sleep. Some can directly stimulate the central nervous system and others can cause insomnia upon withdrawal. Drugs used for the treatment of asthma, heart disease, high blood pressure, thyroid dysfunction, arthritis, and even medications for coughs and colds can affect sleep. If a medication is at the root of your insomnia, there may be natural alternatives fro you to explore.
- The use of stimulants such as caffeine even early in the day can interfere with both falling asleep and can trigger awakenings in the night.
- Nicotine is another stimulant and studies have shown that smokers take longer time to fall asleep than non-smokers.
- Alcohol also has an effect on sleep and although it does induce sleep, the sleep is distorted, with little REM (one of the sleep stages important for restorative sleep).
Let’s examine the importance of proper sleep hygiene.
- It is important to have a regular sleep-wake schedule seven days a week. This means going to bed and getting up at the same time every day (even on weekends and holidays) and no daytime napping.
- Use your bedroom for sleep and intimacy only. If the bedroom is used for other activities, such as reading, watching TV etc, this conditions you to be alert in a place that should be associated with sleep.
- It is also very important that the room is as dark and sound proof as possible to create an atmosphere that promotes sleep.
- Plan a quiet relaxation routine before bed. This helps with the transitions from wake to sleep. Have a 10 to 15 minute slow down period in which you do quietening activities. If you do waken during the night and feel wide awake, it is important to leave the bedroom and do something quietly in low lighting until you feel sleepy again. You should never lie in bed for longer that 20 minutes awake.
- Last but not least, if you are having considerable difficulty sleeping, it is important to try completely avoiding caffeine, nicotine and alcohol, and to avoid large meals in the evening.
Diet and exercise have a significant effect on sleep patterns. A diet rich in nutrients including whole grains, fruits, veggies, and lean proteins is not only important for overall health but also for sleep.
- Concentrate on foods high in magnesium. Magnesium is a natural sedative. A high magnesium, diet has been found to be associated with high-quality sleep time and fewer awakenings in the night (Pharmacopsychiatry, 2002;35:135-43). Magnesium-rich foods include whole grains. kelp, wheat bran, almonds, cashews, and blackstrap molasses.
- Regular exercise consisting of 20 to 40 minutes of activity with sufficient intensity to cause sweating, helps to promote sleep. However, exercise should be earlier in the day to prevent the boost in alertness that negatively effects sleep. A recent study has shown that a moderate intensity exercise program significantly improved both objective and subjective dimensions of sleep (J Gerontol A Biol Sci Med Sci. 2008;63:997-1004).
Medicinal herbs are a great alternative to sleeping pills.
- Valeriana officinalis (valerian) has been shown to have sleep-inducing, anti-anxiety, and tranquiling effects. Several clinical trials have shown that valerian before bed improved insomnia by decreasing sleep latency and improving sleep quality (Alternative Medicine Review 2000; 5: 249-260). One study showed that valerian taken three times daily increased delta sleep (a component of deep sleep), and decreased stage 1 or light sleep (Pharmacopsychiatry 1994; 27: 147-151).
- Other herbs that have been demonstrated to induce sleep are Humulus lupulus (hops), Passiflora incarnata (passionflower), Pipermethysticum (Kava Kava), and ginsing to mention as few.
Some physiological agents helpful for sleep are L-tryptophan and 5-hydroxytrytophan (5-HTP). Both are precursors to serotonin and act through increasing serotonin in brain cells to induce sleep. L-tryptophan has been shown to reduced sleep latency and increased sleep time (Martindale: the Extra Pharmocopea 1996; 336-337). 5-HTP has been shown to increase slow wave or deep sleep (Annales Medico Psychologiques 1997: 792-797).
Acupuncture has also been found to be useful for insomnia. Acupuncture can cause endorphin production resulting in relaxation and a sense of well-being. Specific acupuncture sites have been shown to be involved in sleep-wake cycle regulation (Psychiatry and Clinical Neuroscience, 1995; 49; 119-120). A placebo-controlled study showed that acupuncture improved both subjective and objective measures of sleep quality in insomniacs (Forschende Komplementarmedizin, 1999; 18: 185-194)
It is important to be informed of alternative options often not mentioned by medical doctors. It is essential to seek supervision from a physician knowledgeable in alternative approaches to ensure that you are receiving the best care possible for your individual needs. Best of health to you and sleep well tonight.