Dr Tariq Jagnarine
Family Medicine, Endocrinology/Diabetes
Insomnia is a type of sleep disorder, and is a common symptom of many underlying illnesses. Individuals with insomnia find it difficult to fall asleep, stay asleep, or both. People with insomnia often don’t feel refreshed when they wake up from sleeping, either. This can lead to fatigue and other symptoms.
Insomnia is the most common of all sleep disorders, according to the American Psychiatric Association (APA). In fact, the APA states that about one-third of all adults report experiencing insomnia symptoms. Between 6 and 10 percent of all adults have symptoms that are severe enough for them to be diagnosed with insomnia disorder. The APA defines insomnia as a disorder in which people have trouble falling asleep or staying asleep. Doctors make a clinical diagnosis of insomnia if both of these criteria apply:
* Sleep difficulties occurring at least three nights a week for a minimum of 3 months.
* Sleep difficulties creating major distress or functional difficulties in a person’s life.
RISK FACTORS FOR INSOMNIA
Insomnia can occur at any age, and is more likely to affect women than men. According to the National Heart, Lung, and Blood Institute (NHLBI), people with certain risk factors are more likely to have insomnia. These risk factors include:
* High levels of stress
* Emotional disorders, such as depression or distress related to a life event
* Lower income
* Travelling to different time zones
* Sedentary lifestyle
* Changes in work hours, or working night shifts
* Having certain medical conditions, such as obesity and cardiovascular disease, can also lead to insomnia.
* Menopause can lead to insomnia as well.
INSOMNIA CAUSES
The causes of your insomnia would depend on the type of sleeplessness you are experiencing. Short-term insomnia, or acute insomnia, may be caused by a number of things, including:
* Stress
* An upsetting or traumatic event
* Changes to sleeping habits, like sleeping in a hotel or new home
* Physical pain
* Jetlag
* Certain medications
Chronic insomnia lasts for at least 3 months, and can be primary or secondary. Primary insomnia has no known cause. Secondary insomnia occurs with another condition that can include:
* Medical conditions that make it harder to sleep, such as arthritis or back pain
* Psychological issues, such as anxiety or depression
* Substance use
* Sleep apnea
* Diabetes
INSOMNIA SYMPTOMS
People who experience insomnia usually report at least one of these symptoms:
* Waking too early in the morning
* Unrefreshing sleep
* Trouble falling or staying asleep
These symptoms of insomnia can lead to other symptoms, including:
* Fatigue
* Mood changes
* Irritability
* Difficulty concentrating on tasks during the day.
TREATING INSOMNIA
There are both pharmaceutical and nonpharmaceutical treatments for insomnia. A number of different treatment options may need to be used before finding the one that’s most effective.
The American College of Physicians (ACP) recommends cognitive behavioural therapy (CBT) as a first-line treatment for chronic insomnia in adults.
Sleep hygiene training may also be recommended. Sometimes behaviours that interfere with sleep cause insomnia. Sleep hygiene training can help to change some of these disruptive behaviours.
Suggested changes may include:
* Avoiding caffeinated beverages near bedtime
* Avoiding exercise near bedtime
* Minimising time spent on the bed when persons are not specifically intending to sleep, such as watching TV or surfing the Web via the phone.
If there’s an underlying psychological or medical disorder contributing to insomnia, getting appropriate treatment for it can alleviate sleep difficulties.
<<INSOMNIA MEDICATIONS>>
Sometimes medications are used to treat insomnia.
An example of an over-the-counter (OTC) medication that can be used for sleep is an antihistamine such as diphenhydramine (Benadryl) or piraton.
Medications like these can have side effects, especially long-term, so it’s important to talk to a doctor before starting on an OTC medication for insomnia.
Prescription medications that may be used to treat insomnia include:
* zolpidem (Ambien)
Talk with a doctor before using any medications or supplements to treat insomnia.
There might be dangerous side effects, or drug interactions. Not every “sleep aid” is appropriate for everyone.
Making lifestyle changes, or trying home remedies can help effectively manage many cases of insomnia.
Warm milk, herbal tea, and valerian are just a few of the natural sleep aids to try.
<<MEDITATION>>
Meditation is a natural, easy, drug-free method of treating insomnia. According to a 2015 study, meditation can help improve the quality of our sleep, as well as make it easier to fall asleep and stay asleep.
As per the Mayo Clinic, meditation can also help with symptoms of conditions that may contribute to insomnia. These include:
* Stress
* Anxiety
* Depression
* Digestive problems
* Pain
Many apps and videos are available to help you practise meditation. – Smiling Minds, Samsung Health, etc.
<Melatonin>
We naturally produce the hormone melatonin during the sleep cycle. People often take melatonin supplements in hope of improving their sleep. Melatonin is generally thought to be safe for a short period of time, but its long-term safety has yet to be confirmed. It’s always best to work with a doctor when considering taking melatonin. Studies are inconclusive regarding whether melatonin can actually help treat insomnia in adults.
There’s some evidence that supplements may slightly decrease the time it takes to fall asleep, but more research is needed.
<Essential oils>
Essential oils are strong aromatic liquids made from a variety of:
* Plants
* Flowers
* Trees
People treat a variety of conditions by inhaling oils or massaging them into the skin. This practice is called aromatherapy.
Essential oils that are thought to help with sleep include:
* Roman chamomile
* Cedarwood
* Lavender
* Sandalwood
* Neroli, or bitter orange
A review of 12 studies published in 2015 found aromatherapy to be beneficial in promoting sleep. Another study found lavender to be especially useful in promoting and sustaining sleep. The study reported that a mixture of essential oils reduced sleep disturbance and increased wellbeing in older adults.
Essential oils don’t generally cause side effects when used as directed. The Food and Drug Administration (FDA) has classified most essential oils as ‘GRAS’ (generally recognised as safe).
A good laugh and a long sleep are the best cures in the doctor’s book Bottom of Form.
