Treatment Options For Insomnia
KALYANAKRISHNAN RAMAKRISHNAN, MD, and DEWEY C. SCHEID, MD, MPH, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
Am Fam Physician. 2007 Aug 15 76:517-526.
Patient information: See related handout on insomnia, written by the authors of this article.
The American Academy of Sleep Medicine defines insomnia as unsatisfactory sleep that impacts daytime functioning.1 More than one third of adults report some degree of insomnia within any given year, and 2 to 6 percent use medications to aid sleep.2 Insomnia is associated with increased morbidity and mortality caused by cardiovascular disease and psychiatric disorders and has other major public health and social consequences, such as accidents and absenteeism.3 Risk factors for chronic insomnia include increasing age, female sex, psychiatric illness, medical comorbidities, impaired social relationships, lower socioeconomic status, separation from a spouse or partner, and unemployment.4
SORT: KEY RECOMMENDATIONS FOR PRACTICE
Exercise, cognitive behavior therapy, and relaxation therapy are recommended as effective, nonpharmacologic treatments for chronic insomnia.
A = consistent, good-quality patient-oriented evidence B = inconsistent or limited-quality patient-oriented evidence C = consensus, disease-oriented evidence, usual practice, expert opinion, or case series. For information about the SORT evidence rating system, see page 483 or .
Can Melatonin Help Me Sleep
Your body produces a hormone called melatonin that promotes sleep. Some people take melatonin supplements as a sleep aid. But theres no proof that these supplements work. Because the U.S. Food and Drug Administration doesnt regulate supplements the same as medications, you should talk to your healthcare provider before taking one.
Lifestyle Changes To Cure Insomnia Without Medication
Regardless of whether youre an acute or chronic insomniac theres a lot you can do on your own to deal with the problem of sleeplessness. As an insomniac nobody knows better than you about the obstacles you face in your everyday life. So use the following self-help solutions to gradually cure insomnia:
- Manage your body cues. Our body has an internal clock: it depends on light, food, and our energy levels to go into sleep.
- Light: Put off the lights in your bedroom before going to bed
- Food: Have your dinner 2-3 hours before sleeping and eat breakfast at the right time
- Energy level: Engage in extremely light physical activities before bed. Dont do a vigorous workout.
- Have a consistent bedtime routine. You can read, write in your journal, take a bath and so on. But dont do anything stimulating.
- Stick to a regular sleep and wake up time.
- Keep potted plants on the bedrooms window sill.
- Do relaxation yoga
- Unwind at your own pace
- Track your thoughts using a journal
- Tune in to your favorite songs
- Go trekking or camping: Being out in the woods exposes your body to the natural rhythms of light and is very effective at fixing your sleep cycle.
- Read books before retiring to bed
- Inhale and exhale for 5-7 minutes while in bed
There are many interesting ways you can cure your sleeping problems. So be patient with the process, try the self-help solutions and if nothing works see a sleep specialist.
Don’t Miss: Causes Of Oxygen Desaturation During Sleep
Insomnia: Restoring Restful Sleep
Nearly everyone has spent at least one night lying in bed wishing for sleep. But for many men, it’s a nightly struggle. A lucky few get relief from counting sheep, watching late-night movies, or sipping warm milk but most people with insomnia need more assistance. Fortunately, lifestyle changes and behavioral treatment can help many sufferers, and medication is available for those who need it.
Cognitive And Behavioural Treatments
If changing your sleeping habits doesn’t help, your GP may be able to refer you for a type of cognitive behavioural therapy that’s specifically designed for people with insomnia .
The aim of CBT-I is to change unhelpful thoughts and behaviours that may be contributing to your insomnia. It’s an effective treatment for many people and can have long-lasting results.
CBT-I may include:
- stimulus-control therapy which aims to help you associate the bedroom with sleep and establish a consistent sleep/wake pattern
- sleep restriction therapy limiting the amount of time spent in bed to the actual amount of time spent asleep, creating mild sleep deprivation sleep time is then increased as your sleeping improves
- relaxation training aims to reduce tension or minimise intrusive thoughts that may be interfering with sleep
- paradoxical intention you try to stay awake and avoid any intention of falling asleep it’s used if you have trouble getting to sleep, but not maintaining sleep
- biofeedback sensors connected to a machine are placed on your body to measure your body’s functions, such as muscle tension and heart rate the machine produces pictures or sounds to help you recognise when you’re not relaxed
CBT-I is sometimes carried out by a specially trained GP. Alternatively, you may be referred to a clinical psychologist.
Read Also: Filing A Va Claim For Sleep Apnea
Alternative And Herbal Medications
Alternative and herbal medications have also been tried in the treatment of insomnia. Valerian root extract is the most widely used and studied of these agents. A 2006 meta-analysis of 16 randomized, controlled trials of valerian for the treatment of insomnia had conflicting results. The pooled data did seem to show evidence of improved sleep however, the authors noted a possible publication bias that may have contributed to this result.
A 2010 met-analysis of 18 randomized, controlled trials of valerian for the treatment of insomnia detected no publication bias. However, although the results suggested that valerian may be effective for subjective improvement of insomnia, its effectiveness has not been demonstrated with quantitative or objective measurements.
A randomized, placebo-controlled trial by Taavoni et al found that valerian improves the quality of sleep in women with menopause who are experiencing insomnia. Patients in the treatment arm received 530 mg of concentrated valerian extract twice a day for 4 weeks.
Other herbal remedies such as chamomile and St. Johns wort have not shown efficacy for insomnia. Furthermore, potential risks have been associated with the use of some OTC remedies, such as dogwood, kava kava, alcohol, and L-tryptophan. For these reasons, the 2017 AASM guideline states that valerian and other alternative or herbal medications are not recommended for treatment of chronic insomnia.
Can Insomnia Be Treated
There are many treatments available for Insomnia. But the main problem with insomnia is that it can be caused due to some other condition. This cause can be diagnosed by your doctor for giving you the proper treatment. Treatment options may include Alternate Therapies, Sleep Hygiene, prescription sleep aids, over the counter medications or cognitive behavioral therapy.
Don’t Miss: High Oxygen Variation During Sleep
Meditation And Relaxation Techniques
A regular meditation practice may help to promote sleep by slowing breathing and reducing stress hormone levels. Meditation is a technique that involves consciously directing one’s attention to an object of focus in order to increase awareness, relax the body, and calm the mind.
Some types of meditation include guided meditation, vipassana meditation, yoga nidra, or body scan. Also try:
- Visualization: Visualization involves actively imagining a relaxing scene. You can try it in bed for 20 minutes before falling asleep. Involve all your senses. If you’re 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. The more vivid the visualization and the more senses you involve, the more effective it will be.
- Relaxation response: This is a mind/body response that occurs after following specific instructions patterned closely after Transcendental Meditation.
- Mindfulness: This type of meditation essentially involves focusing on your mind on the present.
Early evidence suggests that meditation techniques may improve sleep. The National Center for Complementary and Integrative Health says relaxation techniques have enough evidence to say they can be helpful for insomnia. But further research is still needed.
Negative Effects Of Insomnia
You may hear some people bragging about needing less than six hours of sleep. But we really all need between seven and nine hours. Getting less than what we need can be bad for our health. If you are not getting enough sleep you might find yourself suffering from the following:
A weakened immune system so you get sick more often
Elevated blood pressure
Increased risk of heart disease and diabetes
You May Like: Fitbit For Sleep Apnea
How To Prevent Insomnia
Unfortunately, there is no cure for insomnia. However, its extremely preventable and treatable. The best way to improve sleep and avoid insomnia is to prevent it from happening in the first place.
Commonly referred to as Sleep Hygiene, creating healthy sleeping habits and implementing strategies to help get a good nights sleep is the first step in preventing insomnia.
Some steps you can take to help prevent insomnia include:
- Create a night and morning routine Go to sleep and wake up at the same time each day to create a routine and keep your body on a consistent sleep schedule.
- Avoid caffeine and nicotine before bed Both of these stimulants may cause you to have trouble sleeping at night.
- Create a comfortable space Keeping a comfortable space thats used strictly for sleeping is a great way to get a good nights sleep.
- Implement a sleep aid Sleep aids such as CBD oil can be taken before bed to relax and relieve anxieties that may cause insomnia.
Sleep Regulation In Older Adults: The Two
According to the two-process model of sleep regulation , two biological mechanisms control sleep: the homeostatic drive for sleep , that is, the longer one is awake, the more likely one is to fall asleep and the circadian drive for sleep , a separate process by which the propensity for sleep varies across the 24-hour day. The two-process model can be used to conceptualize sleep disturbance in older adults. First, as sleep architecture changes and the ability to sleep solidly at night decreases, the homeostatic drive for sleep may increase during the daytime hours. If the person then naps, the homeostatic drive will be reduced at night.
Endogenous circadian rhythms also change in timing and quality with advancing age. In particular, circadian rhythm amplitude is reduced, which may result in a weaker daytime alerting signal from the biological clock. Also, the timing of circadian rhythms typically shifts to an earlier time, which can result in sleepiness at undesirable times . shows a schematic diagram of Process S and Process C in a healthy younger adult , and an older adult with reduced circadian rhythm amplitude and earlier timing with alterations in sleep homeostasis .
The two-process model of sleep regulation. Panel A depicts a healthy adult. Panel B depicts an older adult, with altered circadian timing, reduced circadian rhythm amplitude and alterations in sleep homeostasis resulting from daytime sleeping. W=wake S=sleep.
Don’t Miss: S Health Sleep Tracking Gear S2
General Information On Insomnia
If you find yourself counting sheep at night with no resolve, you are not alone. According to the Sleep Apnea Association, more than 50 million Americans suffer from sleeping disorders. The American Academy of Sleep recommends seven hours of sleep and most people are not getting that much.
Many people who suffer from insomnia know the exact cause of their sleep disturbances. It is often a stressful day or even work-life, a fight with a partner, etc. When insomnia is caused by identifiable situations such as these you dont need any medication, all you need is to fix the problem.
However, when there is no clear cause for your insomnia it can be very frustrating to deal with. You may even be looking for a miracle cure. When you lose sleep, the consequences can be very serious. If you find yourself sleeping less than 7 hours per night you are at increased risk of stroke, diabetes, heart disease, high blood pressure, and death. Not getting adequate sleep also increases your risks of having accidents, whether at home, in the workplace, or while driving.
Insomnia affects people of all ages and stages of life, not just adults. Adolescents and even children are affected too. So it is paramount to develop good sleep habits for yourself and your entire family.
What Are The Risk Factors For Insomnia
Insomnia occurs more often in women than in men. Pregnancy and hormonal shifts can disturb sleep. Other hormonal changes, such as premenstrual syndrome or menopause, can also can affect sleep. Insomnia becomes more common over the age of 60. Older people may be less likely to sleep soundly because of bodily changes related to aging and because they may have medical conditions or take medications that disturb sleep.
Read Also: Va Claim Insomnia And Sleep Apnea
Common Psychological And Medical Causes Of Insomnia
Sometimes, insomnia only lasts a few days and goes away on its own, especially when it is tied to an obviously temporary cause, such as stress over an upcoming presentation, a painful breakup, or jet lag. Other times, insomnia is stubbornly persistent. Chronic insomnia is usually tied to an underlying mental or physical issue.
Anxiety, stress, and depression are some of the most common causes of chronic insomnia. Having difficulty sleeping can also make anxiety, stress, and depression symptoms worse. Other common emotional and psychological causes include anger, worry, grief, bipolar disorder, and trauma. Treating these underlying problems is essential to resolving your insomnia.
Medical problems or illness. Many medical conditions and diseases can contribute to insomnia, including asthma, allergies, Parkinsons disease, hyperthyroidism, acid reflux, kidney disease, and cancer. Chronic pain is also a common cause of insomnia.
Medications. Many prescription drugs can interfere with sleep, including antidepressants, stimulants for ADHD, corticosteroids, thyroid hormone, high blood pressure medications, and some contraceptives. Common over-the-counter culprits include cold and flu medications that contain alcohol, pain relievers that contain caffeine , diuretics, and slimming pills.
The Natural Cure For Insomnia
All orders are protected by SSL encryption the highest industry standard for online security from trusted vendors.The Natural Cure For Insomnia is backed with a 60 Day No Questions Asked Money Back Guarantee. If within the first 60 days of receipt you are not satisfied with Wake Up Lean, you can request a refund by sending an email to the address given inside the product and we will immediately refund your entire purchase price, with no questions asked.
The #1 Natural Insomnia Cure
I spent 15 years of my life hindered by lack of sleep. I was pushed from doctor to doctor, pill to pill, counselor to psychologist and eventually to the top insomnia specialist in Europe.
Sleep to me was always a real-life nightmare. I never looked forward to my bedtime because 9 times out of 10 I would get a restless nights sleep and wake up feeling lethargic and gloomy.
I just didnt understand why I couldnt fall asleep instantly, and why when I did fall asleep I couldnt stay asleep for 7 or 8 hours like normal people did.
After numerous courses of sleeping pills, blood tests and more, my luck changed when my doctor referred me to a Sleep Hygiene Therapist at a sleep clinic in Londons Harley Street.
At the time this was a considered a new approach to insomnia, and was slowly being adopted by the medical profession as a way to cure insomnia naturally without benzodiazepines, which by then were renowned for causing rebound insomnia and heaps of side-effects.
Recommended Reading: Apple Watch Series 1 Sleep Tracker
Treating Insomnia Or Other Sleep Disorders With Cbd
Studies show that CBD may be beneficial to those who struggle with insomnia or poor sleep habits.
However, its important to read the packaging labels to learn about the safety and side effects of CBD before taking anything for the first time. Similarly, its always best to take the correct CBD dosage for your body in order to achieve the best results.
CBD can be infused in just about anything, and nowadays, it is. There are many different forms on the market today, ranging from edibles to CBD pill capsules to medicated lotions, CBD extracts, and CBD oil.
Some of the most popular forms of CBD include:
Sometimes Lifestyle Changes Alone Can Help With Insomnia
For a mild case of insomnia thats only been a problem for a few days or weeks, doctors will first likely recommend making a few lifestyle changes to promote better sleep. Rita Aouad, MD, an assistant professor of sleep medicine at The Ohio State University Wexner Medical Center in Columbus, says she always starts with tweaking a persons sleep hygiene, the daily habits and routines you follow that affect sleep.
Good sleep hygiene practices that promote healthy sleep includes:
- Sticking to a Sleep Schedule This means going to bed and waking up around the same time no matter if its Wednesday or Sunday.
- Avoiding Anything That Could Mess With Your Ability to Fall Asleep This means substance as caffeine and tobacco, for instance, that can stay in your system for eight hours. And dont rely on a night cap, either. Some people think alcohol can help with sleep onset, but it actually fragments your sleep, Dr. Aouad says.
- Not Exercising Too Late in the Day Ideally, youll hit the gym more than three hours before bedtime, Aouad says, otherwise the activity can stimulate your body and make it tougher to fall asleep.
- Limiting Daytime Naps to No More Than 30 Minutes Aouad suggests this.
- Turning Off Electronics At Least One Hour Before Bedtime
- Reserving the Bed Solely for Sleep and Sex
- Creating a Sleep-Promoting Environment Thats Quiet, Dark, and Cool
Read Also: Gear S2 Sleep Tracking
What Are The Best Strains Of Cannabis For Helping With Sleep Problems
You might be familiar with the stereotype of cannabis users appearing âsleepyâ or âdrowsy,â and the idea might actually hold some truth.
Thatâs because some strains of cannabis are more calming and sedative than others. There are many strains that are known and popularized for their sleep-inducing properties, such as: Pink Kush, Sedamen, Snowdome, and Bubba Kush Whistler.
While different strains can often deliver varying experiences to patients, indica strains of cannabis tend to be more effective than sativa strains due to higher levels of CBD to balance out the THC content of a given strain.
Recent findings suggest that indica strains are usually more relaxing and soothing than sativa strains. Sativa strains of cannabis, on the other hand, are typically more stimulating varieties of cannabis.
However, identifying the best strain of cannabis to help you with your sleep needs will depend on trying different strains and products to figure out what works best for you.