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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
Recommendation
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