DESCRIPTION
Insomnia is the inability to get adequate sleep. It can be either the inability to fall asleep, (sleep-onset insomnia) or the inability to stay sleep, (sleep maintenance insomnia). Insomnia as a condition may occur temporarily, occasionally, or chronically over an extended period of time.
The quality of sleep is more important that the amount of sleep. Some people can function fine with as little as 4 hours of sleep per night. Other people need much more.
Sleep is important for many reasons, not just for he obvious one of rejuvenation from tiredness, proper sleep is necessary for good health.
When we sleep there are chemical changes that occur cyclically in the brain and in the body. One chemical process that is important is the release of growth hormone that occurs shortly after falling asleep. Growth hormone is not just necessary for growth, but also for the proper function of the thymus, for T-cell immune function that helps protect the body against bacteria, viruses, chronic degenerative diseases, and autoimmune disorders. Inadequate GH levels in the young will stunt growth, in the older individual, it will short-circuit the body into unexpected health problems, and symptoms of premature aging.
Sleep is a complex state. It is mediated by the chemical environment in the brain. As we get older these chemicals are made available in decreased amounts. At the same time the brain becomes less sensitive to them.
The causes of insomnia can be mental anguish, depression, breathing and other physical problems, digestive disorders, drug and alcohol misuse, and many other related problems.
The cholinergic nervous system in the brain controls movement and sensory sensitivity during sleep. As we age, there is a decline in the activity of this system. This leads to faulty sleep patterns, resulting in restlessness and frequent awakenings.
The need to urinate increases as we age. This can happen because of insufficient release of the pituitary hormone vasopressin which controls urine volume. In men, an enlarged prostate can lead to increased urinary urgency. Kidney disease, possibly resulting from hypertension, could also be a cause of frequent nighttime urination.
TREATMENT
Specific causes of insomnia can be addressed with specific remedies; waking for urination could be address simply by restricting fluid intake close to bedtime. Breathing problems, including sleep apnea can be resolved.
Unspecific causes of insomnia might need to be addressed from a multidisciplinary approach.
Over the counter and prescription medications encourage sleep by cutting down on brain activity. These drugs include:
antidepressants
antihistamines used for their sedative effect
barbiturates
benzodiazepines
choral hydrate
These types of drugs should be used with caution because they can cause confusion, daytime sleepiness they can be habit forming, and they can decline in effectiveness with use.
As a society we look too often outside ourselves and to science for a quick easy solution to our problems. As a solution to insomnia; lifestyle changes should be tried first - before either over the counter or prescription drugs - to see if the problem of insomnia can be solved easily, things to try include:
Choose a relaxing, peaceful place to sleep
Take a warm bath, possibly with epsom salts, before bedtime
Remove noise, distractions and make sure your sleeping surface is just right for you
Relaxation techniques including talk therapy and guided imaging can be helpful
Eliminate dietary causes of insomnia such as coffee, other foods high in caffeine
Minimize alcohol consumption
Rule out food allergies
Reduce or eliminate tobacco use
Maintain a consistent easy to maintain schedule
Avoid naps during the day
Exercise
Acupuncture
Wave and light therapy; if you work using artificial light by day, try using full light spectrum bulbs
Reduce anxiety in your life
Hypnotherapy
Melatonin is a hormone that regulates the biological clock of the body. As we get older, actually as we approach middle age - over 50 years of age - the body makes less. Melatonin (1-10 mg per night, most people need only 2 mg - taken an hour or two before bedtime) has been demonstrated to improve the sleep quality in the majority of people tested.
The amino acid L-tryptophan, which is converted to the messenger seratonin in the brain, has been well documented to improve sleep characteristics. Unfortunately, L-tryptophan is no longer available in the United States. The related compound 5-HTP is available and may be helpful, though its effectiveness has not been as thoroughly documented as 5-HTP.
Restless leg syndrome is often associated with insomnia. Magnesium (300mg) taken each evening will reverse this problem.
Vitamin B12 (1,500-3,000 mcg) per day appears to restore the normal sleep-wake rhythm in some people.
Niacinamide (1 gram at bedtime) is a natural activator of the benzopiazepine receptor in the brain. Inositol also works on the same brain receptors and is recommended. These supplements address the same brain receptors as many of the most popularly prescribed drugs such as Valium, Librium and Dalmane.
Herbs have been used extensively throughout history to help people relax and fall asleep.
The herb most commonly used for insomnia is valerian (600mg 1/2 hour before bedtime. Valerian may be combined with lemon balm extract. Herbal sleeping pills are available that may contain valerian, chamomile, hops, passion flower, American skullcap, bitter orange and catnip.
An herbal tea may be prepared from either chamomile, linden, lavender or passionflower. (listed here is ascending order or strength) Make an infusion using from 1 to 2 heaping teaspoons per cup of water and take before bedtime.
Mix between 10 and 40 drops of tincture of hops in a glass of water and drink before bedtime.
Herbs that are stimulants can surprisingly be effective when the body suffers from nervous exhaustion. Recommended herbal remedies are eating oats as a hot cereal daily or taking a teaspoon of oat tincture with a glass of water 3 times a day. Ginseng, ether chewed or taken as a decoction is effective.
Finally the compound BHT, an antioxidant food preservative enhances sleep time for some people. Phenylalanine also has a similar effect for some people.
SOURCES
Gaby, M.D., A.R. "The Natural Pharmacy" 2006 Healthnotes
Chevallier, Andrew, FNIMH "The Natural Health Encyclopedia of Herbal Medicine"
2000 Dorling Kindersley London
Hendler, S.S. “The Doctor’s Vitamin and Mineral Encyclopedia”
1990 Fireside Division, Simon & Shuster, New York
Althoff, Williams, Molvig & Shuster "Guide to Alternative Medicine":
1997 American Association of Naturopathic Physicians - Publications International Ltd.
Lincolnwood Ill
Shaw, S., Pearson, D. "Life Extention, a Practical Scientific Approach"
1982 Warner Books, New York
Werbach, M.D., Melvin R. "Nutritional Influences on Illness - A Sourcebook of Clinical Research" 1988 Third Line Press Tarzana CA
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