Insomnia is an inability to sleep well. It is a common problem, affecting almost everyone at one time or another. A person with insomnia may have difficulty falling asleep or staying asleep, wake up frequently during the night, or wake up earlier than desired the next morning, resulting in symptoms such as daytime fatigue, irritability, poor memory, loss of productivity, and decreased enjoyment of family and social life. Most people have an occasional restless night, often related to short-term stress. For some people, however, poor-quality sleep is a recurring or even a lifelong problem. Temporary insomnia, lasting days to weeks, affects about 50% of adults. Insomnia that lasts more than 6 weeks may affect up to 10% to 15% of adults.
What causes insomnia?
Temporary insomnia, which can last anywhere from a night or two up to several weeks, may be caused by:
- A single stressful event
- A period of emotional stress
- Temporary pain or discomfort
- Disturbances in the sleeping environment, such as noise, light, or sleeping in a different bed
- A change in the normal sleep pattern, such as might be caused by jet lag or working a late shift
Temporary insomnia usually resolves in less than a month. Nevertheless, it is important to pay attention to it since excessive daytime sleepiness can have serious consequences, such as accidents while driving or at work. Also, temporary insomnia can develop into chronic poor-quality sleep, particularly if you begin to worry about your inability to sleep.
Chronic insomnia can last months or even years, and may be caused by:
- Mental or emotional conditions, such as depression or anxiety, or stress are the leading causes of insomnia in adults.
- Poor sleep habits, such as watching television in bed or keeping an irregular bedtime schedule, or apprehension or excessive worry about falling asleep, which often plagues people with insomnia.
- Breathing problems
- A heart condition
- Hormonal or digestive disorder
- Chronic pain.
- Use of stimulants such as tobacco and caffeine
- Alcohol use
- Lack of regular physical activity
- Prescription, nonprescription, or illegal drugs
- A different sleep disorder, such as sleep apnea
The symptoms of insomnia vary. You may have difficulty falling asleep, so you may toss and turn for what seems like a long time. It’s possible you may wake up and have trouble falling back to sleep, perhaps several times during the night. Also, you may wake up too early and feel unrefreshed in the morning or tired or irritable during the day.
How is insomnia diagnosed?
Insomnia is not a disease, and no specific test can diagnose it. But since an inability to sleep well is often related to an underlying cause, your doctor will probably assess your current health, medical history, and any medications you may be taking. A physical exam, blood tests (which may include thyroid testing or hormonal testing for menopause), and, in some cases, sleep studies may be done to help identify or rule out medical problems that may be causing insomnia.
Your insomnia may improve or disappear when the underlying cause is treated. Your doctor may also ask you about your sleep history: how well you sleep, how long you sleep, bedtime habits, and any unusual behaviors. You may be asked to keep a sleep diary, which is a record of your sleep patterns for a week or two. If your symptoms point to mental health concerns, you may be assessed by a mental health professional.
Who is affected by insomnia?
Insomnia can affect people at any stage in life. One recent study reported that about 1 out of 5 children have insomnia. It is more common in women and older people. About 45% of seniors are affected by sleeping difficulties and up to 14% use sleeping pills. Sleep patterns also change as you get older, and many older adults sleep less than younger adults. It may be harder to get to sleep, and your sleep may not be as deep. Health problems and medicines can also affect how much or how well you sleep. But having trouble getting to sleep or not sleeping well is not normal, no matter what your age. If you are having trouble sleeping, discuss it with your doctor at your next checkup.
Herbs and Supplements
Valerian Valerian (Valeriana officinalis) is a herb that has been long used as a remedy for insomnia. Today, it is an accepted over-the-counter insomnia remedy in Germany, France, Switzerland, Belgium, and Italy. Exactly how valerian works in the body is still not well understood. Some studies suggest that like conventional sleeping pills, valerian may affect levels of the calming neurotransmitter GABA.
Unlike many other sleep medications, valerian is not believed to be addictive or cause grogginess in the morning. However, Valerian does not work for everyone. Although studies in labs have been encouraging, clinical trials are still inconclusive.
Valerian is usually taken an hour before bedtime. It takes about two to three weeks to work. It should not be used for more than three months at a time. Side effects of valerian may include mild indigestion, headache, palpitations, and dizziness. Although valerian tea and liquid extracts are available, most people do not like the smell of valerian and prefer taking the capsule form.
Valerian should not be taken with many medications, especially those that depress the central nervous system, such as sedatives and antihistamines. Valerian should not be taken with alcohol, before or after surgery, or by people with liver disease. It should not be taken before driving or operating machinery. Consultation with a qualified health practitioner is recommended.
Relaxation techniques are one of the most effective ways to increase sleep time, fall asleep faster, and feel more rested in the morning. They require a minimum of 20 to 30 minutes before going to bed. There are many different techniques: Visualization involves imagining a relaxing scene. You can try it in bed before falling asleep. Involve all your senses. If you are imagining yourself on a tropical island, think of the way the warm breeze feels against your skin. Imagine the sweet scent of the flowers, look at the water and listen to the waves…you get the picture.
The more vivid the visualization and the more senses you involve, the more effective it will be. Yoga is ideal because it combines deep breathing, meditation, and stretching. A Harvard study found that daily yoga for eight weeks improved total sleep time, the time to fall asleep. If you have never tried yoga before do not to worry because there are many gentle yoga styles you can do. Progressive Muscle Relaxation is one of the most promising natural remedies for sleep. If you have never tried a relaxation technique before, this technique is easy to learn and simple to master.
Cut out caffeine: Caffeine can have a pronounced effect on sleep, causing insomnia and restlessness. In addition to coffee, teas, and soft drinks, look for hidden sources of caffeine such as chocolate, cough and cold medicine, and other over-the-counter medicine. Avoid sweets: Although sugar can give a burst of energy, it’s short-lived and can cause uneven blood sugar levels. This can disrupt sleep in the middle of the night as blood sugar levels fall.
Eat foods that help you sleep
Tryptophan is an amino acid that is a precursor to serotonin, which is then converted to melatonin. Carbohydrate snacks such whole grain crackers before bedtime may help to promote sleep. Just be sure to stay away from sweets. Eat magnesium-rich foods: Magnesium is a natural sedative. Deficiency of magnesium can result in difficulty sleeping, constipation, muscle tremors or cramps, anxiety, irritability, and pain. It has also been used for people with restless leg syndrome. Foods that are rich in magnesium are legumes and seeds, dark leafy green vegetables, wheat bran, almonds, cashews, blackstrap molasses, brewer’s yeast, and whole grains. If you take magnesium as a supplement, take it 1 hour before bed.
The scent of English lavender has long been used as a folk remedy to help people fall asleep. Research is starting to confirm lavender’s sedative qualities. It has been found to lengthen total sleep time, increase deep sleep, and make people feel refreshed. It appears to work better for women, possibly because women tend to have a more acute sense of smell. The good thing about lavender is that it begins to work quickly.
Try putting a lavender sachet under your pillow or place one to two drops of lavender essential oil in a handkerchief. Or add several drops of lavender oil to a bath — the drop in body temperature after a warm bath also helps with sleep. Other aromatherapy oils believed to help with sleep are chamomile and ylang-ylang. Light If you have trouble falling asleep at night, you may need more light in the morning. Light exposure plays a key role in telling the body when to go to sleep and when to wake up. Try taking a walk first thing in the morning. Just be sure to wear sunscreen to protect your skin from ultraviolet rays. On the other hand, if you find you are waking up too early in the morning, you may need more light in the afternoon.
Try taking a walk in the late afternoon. Music Gentle, slow music is another remedy that can help to improve sleep without medication. Music has been found to improve sleep quality, decrease nightly awakening, lengthen sleep time, and increase satisfaction with sleep. Acupuncture may help with insomnia. A University of Pittsburgh analysis concluded that acupuncture may be an effective treatment for insomnia. A preliminary study found that five weeks of acupuncture increase melatonin secretion in the evening and improved total sleep time.
Traditional Chinese Medicine
In traditional Chinese medicine, insomnia often stems from kidney energy weakness. This syndrome is not necessarily related to kidney disease in Western medicine. A few signs of kidney energy weakness are low backache, tiredness and fatigue, and a burst of energy at about 11 pm in the evening. Women in menopause often experience this type of insomnia. People who are taking anti-estrogenic drugs such as tamoxifen also experience this type of insomnia, however, they should not take herbal combinations such as the herbal formula Liu Wei di Huang that may increase estrogen levels.
In Ayurvedic medicine, insomnia is often associated with a Vata imbalance. Vata regulates breathing and circulation. People with a Vata imbalance often notice irritability, anxiety, and fear with insomnia. One Ayurvedic treatment is the application of oil on the head and feet. For the pitta type, room temperature coconut oil is used, for the vata type, warm sesame oil is applied, and for the Kapha type, warm mustard oil is often applied.
Lack of exercise can contribute to poor sleep. Muscle tension and stress build in the body. Exercise can promote deep sleep that night. However, intense exercise too close to bed can increase adrenaline levels, leading to insomnia. Other remedies For hot flashes, a thin, flat foam pillow insert, called a Chillow, can help to cool the head throughout the night. Chamomile, hops, passionflower, lemon balm, and ashwagandha are other herbs that are often used for insomnia. Some people may find benefit from simply having a cup of chamomile tea one to two hours before going to bed. Chamomile can reduce anxiety, calm the digestive system, and relieve muscle tension.
Feng shui, which originates in the Chinese philosophy of Taoism, instructs on how to arrange rooms, furniture, offices, houses, and other arrangements to maximize favorable energy flow throughout living spaces. Here are some recommendations that may help promote relaxing sleep:
- Try not to have the bed in a corner of the room. The corners are where energy tends to be stagnant.
- Avoid putting your bed next to a window. Energy can be drained this way.
- The foot of the bed should not face the doorway.
- When lying in bed, you should have a full view of anyone coming in the door. If you can’t do this directly, hang a mirror to reflect the entrance way.
- Try to avoid facing sharp corners from desks, bookcases, and other pieces of furniture.
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