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Insomnia

Virtually all of us have experienced problems with sleep at some point in our lives. Sleep problems come in a variety of forms. Perhaps you’re unable to fall asleep, or maybe staying asleep is the problem, or perhaps you awaken unrefreshed two or three hours before you’d planned. The end result is that you’re tired the next day, or grouchy, or you can’t concentrate. And the next night arrives accompanied by that lurking fear: What if it happens again? Fortunately, most insomnia is transient, meaning that it clears up by itself.

Long term, or chronic insomnia might take a bit more work. Let’s see what our WholeHealth Chicago integrated approach can offer.

What is Insomnia?
The term insomnia refers to difficulty falling asleep or staying asleep, or to problems waking up earlier than planned. An episode of insomnia that lasts only one or two nights is often due to stress or excitement. But often this condition becomes a chronic disorder that persists for months or even years, especially when the root cause is tension, anxiety, or depression. Some 20% to 40% of all adults report sleeping problems, but the rate rises sharply among older people. About 80% of those over age 60 experience fragmented sleep and often wake up repeatedly during the night. A complicating factor for insomnia is the wide natural variation in individuals’ sleep requirements. One person may need nine or 10 hours of sleep a night to feel rested, while another appears to flourish on five or six. Studies, however, have shown that some of those who claim to function well on five hours’ sleep would in fact benefit substantially from more rest. On the other hand, many people who complain of insomnia are actually sleeping longer than they realize.
No single remedy can be applied to the cluster of sleep disorders known as insomnia. However, a considerable variety of treatments have proved effective–sometimes dramatically so–in minimizing its impact and duration.

Key Symptoms

  • Difficulty falling asleep
  • Fragmented sleep (waking frequently during the night)
  • Waking earlier than expected
  • Fatigue, impaired concentration, mood changes due to lack of sleep

What Causes Insomnia?
Insomnia is essentially a symptom of other conditions or factors. Short-term insomnia may be brought on by jet lag, which upsets the body’s biological clock. Illness or pain can disrupt sleep patterns, as can stressful situations–a divorce, a new job–or such environmental factors as noise or room temperature. Once the specific problem is resolved, sleep usually returns to normal.

Insomnia can also be triggered by numerous other factors, including:

Caffeine and other stimulants. A single cup of coffee or tea during the day can leave susceptible individuals unable to sleep.

Sleeping pills. Within a few weeks they tend to lose effectiveness, leading to withdrawal that may cause rebound insomnia.

Alcoholic beverages. Drinking disrupts normal sleep, causing frequent awakenings. Sleep disorders linked to chronic alcoholism may persist for years, even after drinking is discontinued.

Physical disorders. Heart and lung diseases, hyperthyroidism, hypoglycemia, gastroesophageal reflux, arthritis, adrenal disfunction and other ailments are known to cause insomnia. Prostate disorders, kidney disease, and diabetes may cause frequent awakenings at night to urinate.

Vigorous exercise late in the day.

Pregnancy (especially the last month).

Smoking (tobacco is a stimulant).

A bad mattress. Persistent insomnia can be more difficult to diagnose. Tension, anxiety, and depression are often at the root of insomnia. However, attempts to link sleep disorders with personality traits have been inconclusive.

Whatever its original cause, many experts believe that insomnia is prolonged by such behavior patterns as excessive time in bed, overuse of medications, and habitual napping. Researchers also find, ironically, that the harder individuals try to fall asleep, the more anxious they usually become–making success even more elusive.

Finally, fragmented sleep is sometimes the result of a potentially dangerous disorder called sleep apnea. Someone with this condition temporarily stops breathing numerous times during the night, then breathes very vigorously (with loud snoring) in an effort to recover–making restful sleep nearly impossible to maintain. There are a range of treatments for apnea from a special mask that exerts pressure on the airway to surgery on the soft tissues of the back of the throat which are often involved with creating an upper airway obstruction.

Treatment and Prevention
An array of supplement and self-help measures can be used to alleviate insomnia. And alternative medicine therapies, such as acupuncture and massage, as well as mind-body exercises, such as tai chi and meditation, can all aid in reducing stress, which should lead to sounder, more restful sleep.

In many, if not most cases, these will prove more effective–and have fewer side effects–than prescription sleeping pills. However, if you are taking a prescription drug for insomnia, don’t discontinue it without talking to your doctor.

Just a reminder: If you have a serious medical condition, it’s always a wise idea to talk with your doctor before beginning a supplement program.

How Supplements Can Help
More than 100 studies have proven valerian to be an effective sleep aid. For best results it should be rotated with other sedating herbs such as chamomile, kava, and melissa (also known as lemon balm).

An alternative to valerian (especially for people with chronic pain as the root of their insomnia) is melatonin, a synthetic form of the sleep hormone our bodies produce naturally. Melatonin or valerian can be rotated with GABA (gamma-aminobutyric acid), a neurotransmitter that blocks stress-related nerve impulses to the brain, or with 5-HTP (a form of the amino acid tryptophan), which raises levels of the sleep-producing chemical serotonin.

Deficiencies of calcium or magnesium create sleeping difficulties in some cases; replacing them may thus be beneficial. Magnesium is especially effective when taken with 5-HTP.

If you believe there’s a component of depression to your insomnia, then start St. John’s wort, shown in many studies to be as effective as prescription antidepressants. Understand however, that this herb may take a full month before reaching its full effect.

Get supplement dosages and tips in our WholeHealth Chicago Supplement Recommendations for Insomnia.

Self-Care Remedies
A regular sleep schedule should be closely followed–even on weekends. Resist the temptation to take naps, which can quickly become a substitute for regular sleep.

Avoid alcohol, tobacco, and caffeine, especially in the late afternoon and throughout the evening.

Regular exercise reduces stress and promotes sleep. (Exercise should be avoided in the evening, however, as it can rev up the body, making it more difficult to fall asleep.)

If possible, spend an hour or more relaxing before bedtime. Reading, listening to music, watching TV, or taking a warm bath are all excellent preparations for sleeping. However, just before bed, avoid watching overly stimulating TV shows–”sensationalizing local news or programs with excessive violence.

Your bed should be used only for sleeping and intimacy–not for reading, working, talking on the telephone, or watching television.

If you wake up during the night and cannot fall back to sleep, get out of bed and read (preferably in another room), returning to bed only when tired.

Avoid the herbs ginseng, guarana and kola nut. They all have stimulating effects that can make sleep difficult.

When to Call a Doctor

  • If the insomnia lasts a month or more, and has no obvious cause.
  • If the sleeping problems follow the loss of a job, the death of a loved one, or other life-altering trauma.
  • If you feel tired most of the time or begin to doze off frequently during the day.
  • If tiredness becomes so severe that it interferes with normal activities.

Supplement Recommendations

From David Edelberg, M.D. at WholeHealth Chicago: Probably, no single approach will always be effective for your insomnia. For the best results, you may well need to try several different combinations and frequently rotate the supplements suggested in the chart below.

How to Take the Supplements
Try any of the supplements listed here as a start, but alternate them so you don’t build up a tolerance to one or another. For example, the first night take melatonin, the second valerian, the third 5-HTP, the fourth kava or the amino acid GABA (gamma-aminobutyric acid).

Any of these supplements may provide immediate relief from insomnia, so use them only as needed, and don’t take any of them with conventional sedatives or with drugs (such as some antihistamines) that could make you overly drowsy. The sleep-inducing effects of supplements plus drugs can last too long, and you’ll find yourself “foggy” in the morning from being overmedicated.

Of special note
If nighttime leg cramps are contributing to your insomnia, try adding the essential minerals calcium and magnesium (600 mg of each) at bedtime.

Among the symptoms of mild to moderate depression are sleep disturbances. If you believe your sleep problem has a depression component, consider St. John’s wort (450 mg twice a day or 300 mg 3 times a day). It may take a month or more to experience its maximum effects. Important:

We at WholeHealth Chicago strongly recommend that everyone take a high-potency multivitamin/mineral and well-balanced antioxidant complex every day. It may be necessary to adjust the dosages outlined below to account for your own daily vitamin regimen. All of our supplement recommendations also assume you are eating a healthful diet.

Be aware that certain cautions are associated with taking individual supplements, especially if you have other medical conditions and/or you’re taking medications. Key cautions are given in the listing below, but you need to see the WholeHealth Chicago Reference Library for a comprehensive discussion of each supplement’s cautions and drug/nutrient interactions. The Healing Path for Insomnia provides more extensive therapeutic information about this condition.

For product recommendations and orders click here for the Natural Apothecary or call 773-296-6700 ext. 2001.

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