Description Insomnia is the inability to achieve a complete night's sleep over one or more days, weeks, or months. It is not necessarily a decline in the quantity of sleep, but rather the quality of sleep. If you take quite some time to fall asleep or wake up several times during the night, you still may be getting adequate amounts of quality sleep. The characteristics of your sleep cycle determine the quality of your sleep. There are five basic stages of sleep. These range from a relaxed wakefulness (pre Stage 1 / Stage 1) to deep sleep (Stage 4) to a dream or Rapid Eye Movement (REM) state. A complete cycle takes up to three hours and occurs several times a night. As the night goes on, the periods of REM sleep increase while deep-sleep periods grow shorter. You tend to have a lighter sleep in the second half of the night. This is also the period when most people awaken. Your first half of the night is often spent in "core sleep" -- a period of deep, restful, sleep. Even though you may wake up at dawn, if your core sleep was well spent, you will be alert and ready for the day ahead. There are three categories of insomnia: transient, intermittent, and chronic. Transient insomnia occurs from one day to a few weeks. Intermittent insomnia is occasional instances of transient insomnia. Chronic insomnia occurs almost every night for one month or more. Women, especially those over 40, tend to experience insomnia 40% more often than men. Elderly people also have a higher incidence of insomnia. However, this may be caused by illness or drug interactions.
Symptoms and Signs:Symptoms and signs of insomnia are rather direct. Waking up repeatedly or failing to fall asleep are the primary signs. A lack of alertness, attention span, and generally lowered performance during the day may also be signs of insomnia. Though it is not always the case, "looking tired" may also be a sign of sleeping difficulty.
Causes: Transient insomnia may just be temporary. We all experience periods of sleep difficulty due to temporary anxiety, stress, illness, personal loss, or some medications. However, there are a number of other situations that can lead to intermittent and chronic insomnia. A high stress lifestyle is usually the prime cause of chronic insomnia. Accompanied by constant anxiety over the daily demands of life, a good night's sleep is often seen as a dream for a many people. College/university students often have difficulty sleeping as they "burn the candle at both ends" trying to balance a variety of educational/personal/social demands. Those with hypoglycemia may also experience insomnia as a side effect of this condition. The consumption of stimulants (coffee, sugar, nicotine), and certain drugs can also hinder sound sleep. Calcium and magnesium deficiencies can also cause insomnia as well.
What to Expect: Sleep is like food. If you miss one or two meals, you are usually all right. Similarly, missing several meals a week, while not desirable, should not have an overall adverse affect. However, if you are experiencing chronic insomnia, or persistent bouts of it, you will find that your mental and physical abilities will become compromised over time. Though researchers are still divided as to the true purpose of sleep, lack of it can result in decreased alertness, mental function, and general performance, increased anxiety and irritability, mood swings, and depression. If you experience chronic fatigue, consult your naturopath or other health practitioner to determine the root cause of the problem. The remedies outlined below are intended primarily for transient/ intermittent insomnia.
Remedies
Conventional Approaches Avoid over the counter sleeping pills, as they cause undesirable consequences. These include lack of REM sleep (your dream state -- a sleep cycle essential), "hang-overs", and decreased effectiveness over time from increased tolerance. Amino Acids 5-Hydroxytryptophan (5-HTP) is an amino-acid that acts as a precursor to tryptaphon -- an amino acid that stimulates serotonin production in the brain. This hormone will elevate mood levels and help deal with anxiety. Take 50mg three times a day. Use enteric (coated) capsules to reduce the risk of nausea. You can also obtain tryptaphon by eating carbohydrate foods such as potatoes (see Foods, below). A B-50 Complex vitamin (see Vitamins, below) will help ensure the synthesis of tryptophan to serotonin. Foods Sleep-inducing foods include bananas, whole grain crackers, dates, figs, milk, nut butter, tuna, turkey, and yogurt. These foods contain high levels of tryptophan -- an amino acid that promotes sleep. Herbs NOTE: Do not use herbal sleeping aids in combination with anti-depressant drugs Chamomile has an overall calming effect on the body. Enjoy a cup of this yellow-coloured tea one hour before bed. Use 2 to 3 heaping teaspoons of flowers per cup of boiling water. Let steep 5 to 10 minutes. You can also add a handful of chamomile flowers to a hot bath (see Lifestyle, below). Gotu kola is considered a "balancing" herb that both promotes relaxation and increases alertness. It contains natural sedatives B vitamins. Take 1 teaspoon dried herb in one cup of hot water. Let steep for 10 to 15 minutes and drink 30 to 45 minutes before bed. If using capsules, take up to eight 400 or 500mg capsules daily. For hundreds of years, hops have been taken as a powerful sedative via an infusion or stuffed into a pillow. Studies suggest that when sleeping on the pillow, the volatile oils are released and affect the brain through the olfactory centre. To prepare an infusion that calms the central nervous system, add 1 teaspoon herb to 1 cup boiling water and infuse for 10 minutes. Kava kava has been used in the South Pacific for centuries for its calming properties. If using capsules, take up to 120mg daily. Passionflower has a number of calming properties useful for sleep aid. If using a tincture, take 20 to 30 drops in one cup of warm water. If using capsules, take 2 capsules up to four times daily. Scullcap is also known to promote sleep and is often found in sleep-related herbal combinations. Use 1 to 2 teaspoons dried herb per cup of boiling water. Let steep 10 to 15 minutes. To improve the bitter taste, add lemon or a small amount of honey (honey can act as a stimulant in some people). Valerian is a traditional sleep aid that has been used for more than 1,000 years. Most notable for its smell, this herb also works very well for most people. Take 1/2 to 1 tsp. in 1 cup of boiling water 45 minutes before bed. If using capsules, take 150 to 300mg 30 to 34 minutes before bed. Capsules are often standardized to 0.8% valeric acids Homeopathy Certain remedies can be used in acute situations if your symptoms fit the symptom picture of the remedy. For dosages, see the dedicated section on Homeopathy. Consult your homeopath or naturopath to determine your constitutional remedy: the remedy that best fits you as a whole person. Your homeopath or naturopath will take a complete case history considering all of your mental and physical ailments and match these symptoms with the symptom picture of the remedy. Argentum Nitricum: Sleeplessness from anticipatory nervousness, anxiety, nervousness of going to public places. Person is dizzy and trembles. Coffea: Sleeplessness from constant unusual activity of the mind and body, sudden emotions, flow of ideas, nervous excitability, or sleep disturbed by dreams. Lachesis: Person is sleepy but cannot fall asleep. Sleeplessness from being overexcited. Sudden attacks of suffocation on falling asleep. Metallum Album (Arsenicum): Person is anxious and restless. Head must be raised by pillows. Presence of fearful dreams and is sleepless particularly after midnight. Nux Vomica: Sleeplessness after 3 AM toward morning. Overflow of thoughts about work and how to complete tasks. Person is anxious and irritable. Pulsatilla: Sleepiness in the afternoon and wide awake in the evening. Sleep is disturbed by a particular thought running through the mind. Has difficulties falling asleep after. Person sleeps with hands over head. Lifestyle Do not have any stimulants several hours before bed. This includes soft drinks, sugar, and coffee. Ideally, you should not have any of the above after 4:00 PM. Take a relaxing bath (not shower) one hour before bed. Use this as downtime. Add fragrant oils or chamomile flowers to the bath.be creative! Establish a routine before finally greeting your pillow. Many people choose to read, meditate through deep breathing, or relax with a cup of tea before bed. And keep consistent. Such routines will act as triggers for yourself that you are now ready for bed. Once in bed, do not mull over what must be done tomorrow, or that next big bill, or what will be for dinner, or how you are going to finish that report, or whether your child will make the team, et cetera. These problems cannot be solved at this moment and they always seem larger than life come 12:00 or 3:00AM. Put these concerns aside, for now. At this moment, it is time to sleep. If you cannot sleep for a long time, sleep for a short time. If eight hours is a struggle, try six for a week and look at the results. Establishing a pattern may help reset your circadian rhythm/internal clock. If your period of insomnia continues, determine the root cause of the situation. Analyze your lifestyle and try to reduce or eliminate those elements that cause a high degree of anxiety and stress. Look at your diet. Ensure you are providing your body with the nutrients it needs to function properly. Resolve underlying social/community/relationship stresses. But be sure to do your searching during the day. Save the evening for some much needed shut eye . Minerals As well as helping to build healthy bones, calcium has a calming effect on the body. Take 1,500 to 2,000mg daily in divided doses, after meals and before bed. Use a chelated form for best absorption and avoid calcium carbonate, which may contain lead. Magnesium should be taken to aid calcium absorption, usually in a 2:1 ratio of calcium to magnesium. Take 1,000mg daily. Miscellaneous Melatonin is a natural hormone that encourages a good sleep. Take 1.5mg 2 hours or less before bedtime for several days. If you do not see results, increase the dosage gradually until you find an optimal dose. Do not exceed 5mg daily. Therapies, Healing Aids, and More Exercise regularly. Workouts help promote restful sleep, in addition to many other benefits. Be sure your routine is not too close to bedtime, however. Meditation and yoga are both calming and relaxing forms of daily maintenance and healing. Vitamins A B-50 complex vitamin will help your nervous system cope with stress and anxiety. Take one 50mg capsule one or two times daily. Avoid 100mg capsules as your body cannot easily absorb this amount at one time. Inositol can enhance REM sleep. Take 100mg daily, at bedtime.
Actions and Remedy Listings
For More Information ... The National Center on Sleep Disorders
(a division of the National Heart, Lung and Blood Institute Information Center): NHLBI Information Center
P.O. Box 30105
Bethesda, Maryland
20892-0105 Tel.: 301.592.8573
Fax: 301.592.8563 Web: www.nhlbi.nih.gov
Email: nhlbiic@dgsys.com
National Sleep Foundation
1522 K Street, NW, Suite 500
Washington, DC
20005 Tel.: 202.347.3471
Fax: 202.347.3472 Web: www.sleepfoundation.org
Email: nsf@sleepfoundation.org
See also Anxiety Disorder, Hypoglycemia, and Stress
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