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Treating Insomnia
So which treatments work best?
Perlis says that insomnia of a few days duration should be ignored as much as possible.
"If you don't compensate in
any way by changing your habits, the ship is likely to right itself," he says. "But if you change your habits, by either sleeping
later, going to bed earlier, or forcing yourself to stay in bed when you're wide awake, you are laying down the foundation
for a more chronic disorder."
If the insomnia persists beyond five days or so, it should definitely not be ignored, Perlis says. He recommends trying
one of the new generation of prescription hypnotic sleep drugs, such as Ambien, Sonata, or Lunesta,
new generation of prescription hypnotic sleep drugs, such as Ambien, Sonata, or Lunesta, or trying behavioral therapy that specifically targets insomnia.behavioral therapy that specifically targets insomnia.
In a report issued last week,
an expert panel convened by the National Institutes of Health endorsed the behavioral therapy approach. Panel members also
expressed concern about the widespread use of over-the-counter & prescription medications that have no clear benefit in
the treatment of insomnia, such as antidepressants & antihistamines.
While conceding that the new
generation of insomnia drugs has fewer & less severe side effects than other sleep medications
& shows promise for long-term use, the panel concluded that long-term safety hasn't been proven.
The experts noted that relaxation training combined w/therapy targeting erroneous, anxiety-producing beliefs about sleep loss has been shown to be an effective treatment for insomnia.
"We know that patients can
struggle for years w/insomnia & we know that they use a variety of over-the-counter
& prescription drugs to deal w/it," panel chairman Alan Leshner, PhD, says, in a news release. "Unfortunately, we found
insufficient evidence to recommend most of these treatments for long-term use. There's a clear need for more research to fill this gap."
  
Short term
Short term or temporary insomnia happens to almost everyone. It happens when you can't get to sleep because of the "big
day tomorrow," such as an exam, a big game, or even a wedding.
After the event has taken
place, the insomnia is no longer a problem. Short term insomnia can also be the result of
a major crisis such as a death in the family or financial trouble. In this case, as soon as the problem is dealt with, the
insomnia generally will disappear.
Tackling Sunday night insomnia
Posted: 02/27/2004 03:47 pm
Last Updated: 02/27/2004
03:47 pm
For lots of people, falling
asleep on Sunday night is harder than other nights of the week. In many cases, that's because they're coming off the weekend
& starting to think about the dreaded workweek.
It's called Sunday night insomnia & it can affect you all week long.
Some
people make the situation worse by going out late Friday & Saturday nights & shifting their sleep schedules &
internal clocks.
Over time, that can affect
your health.
Dr. Gary Zammit, a sleep researcher
says, "We do know that there are strong linkages between the regular rhythm of sleep & wakefulness, body temperature,
metabolic rate & the production & release of many hormones.
People who are shift workers
have a sense of malaise, gastrointestinal disturbances are higher in those groups & they may experience other types of
health problems."
Experts say there are some
things you can do to avoid the Sunday blues:
- Exercise to relieve stress
- Avoid alcohol on Sunday night. It disrupts your normal sleep
cycle.
- Make more time for leisure activities during the regular work
week.
- Wake up Saturday & Sunday at the same time you'd get up
during the week to keep your cycle consistent.
Secondary
Secondary insomnia happens when there
is a background reason for the insomnia. If you are suffering from insomnia
& need help, the first step is to get a physician. The doctor will help you search for primary problems that cause insomnia & that may be treatable.
Some causes for secondary insomnia
include:
- Depression
- Fibromyalgia
- Gastroesophageal reflux
- Arthritis
- Other chronic illnesses or disorders, especially those dealing w/pain
People w/delayed
or advanced sleep phase syndrome, a circadian rhythm disorder, also suffer from insomnia. Psychological stress, nightmares, & inactivity during the
day can contribute to insomnia as well.
Study finds hospitals too loud for sleep
Posted: 02/04/2004 04:22 pm
Last
Updated: 02/04/2004 04:22 pm
A hospital may be the best place to get well, but if you have
ever been a patient, you know it can be the worst place to get sleep.
In a new study, a group of nurses measured noise levels from
patient rooms & found that at peak times, hospital noise can rival the noise of a chain saw.
Measurements averaged 45 decibels & peaked at 113 decibels.
The EPA recommends no more than 35 decibels for a sleep setting.
Nurses were able to reduce the noise level significantly by
making simple changes like padding the bottoms of metal charts, posting quiet signs & reminding staff to close patient
room doors.
In fact, the average noise level dropped to 42 decibels &
the nurses received fewer sleep complaints from patients.
Primary insomnia occurs when all possible explanations for insomnia
seem to be wiped out.
It is also called psychophysiological insomnia because there is psychological
& physiological documentation involved. This insomnia is considered an intrinsic sleep disorder because the insomnia is
due to the patient's surroundings.
Another intrinsic insomnia is Sleep State Misperception. People w/sleep
state misperception often feel that they are awake when they are actually sleeping. Sometimes they are still aware of their
surroundings as they sleep. Interestingly, even normal "Good sleepers" can misperceive sleep & wakefulness. In one study,
after five minutes of stage 2 sleep, about 40 % of good sleepers thought they were still awake & 84 % of insomniacs were
"certain" that they were awake. Even in this "subjective" insomnia, it should be recognized that there are some "polysomnographic
abnormalities," such as more stage 1 sleep & much less slow-wave sleep, even when their total sleep hours is the same
as that of normal sleepers.
Healthy Dos & Don'ts
Here are a few eating tips to keep in mind when you're suffering
from insomnia. Do:
- Drink warm milk before bed
- Drink chamomile tea, if you'd prefer to skip your late-night snack
- Enjoy complex carbohydrates
- Eat like a king at breakfast & a pauper at dinner
Don't:
- Drink caffeine, including caffeinated coffee, tea & sodas, throughout the day, & especially during the evening
- Use alcohol as a sleep aid; it actually causes restless sleep & should be avoided
Eliminate Insomnia Diet
If you are reading this at 4:00 a.m. in the morning, you aren't alone; approximately half of all adults experience
insomnia at some point in their lives. Diet, believe it or not, has plenty to do with how we sleep. Consider trying this change
in diet for a few weeks and visit the sleep page to see what else you can do as well! Your sheep-counting days may come to
an end. Here's why:
- The carbohydrates in food help our bodies produce serotonin, a sleep-inducing hormone. This meal plan incorporates plenty
of healthy carbohydrate-rich foods like fruit, pasta, potatoes, oatmeal & brown rice.
- Milk contains tryptophan, an amino acid that promotes sleep. This diet includes skim milk w/meals & as a before-bed
snack.
- Digesting a big dinner can prevent you from resting comfortably. W/that in mind, this meal plan promotes eating more for
breakfast & lunch & less in the evening.
Try the sleep-enhancing meal plan
Examining & Changing Your Diet can be a part of the puzzle of
solving your problems w/insomnia. It is important to check w/your doctor who is treating you before making any changes because
of medications you may be taking & their interactions w/food. Trying to piece together a plan that will help you beat
insomnia mean, changing habits in your lifestyle that could promote insomnia symptoms to occur in your life.
Here is a simple menu from ivillage.com that will offer some guidelines
in how diet can help you to get that insomnia under control.
BREAKFAST
Option one:
- Plain oatmeal cooked w/skim milk
Option two:
- Whole-grain toast spread w/peanut butter
Option three:
- High-fiber breakfast cereal
LUNCH
Option one:
- Low-fat macaroni & cheese
Option two:
- 3 ozs. lemon herb chicken
Option three:
- 1 slice whole-wheat bread
- 2 cups tossed salad w/low-fat dressing
DINNER
(Remember to eat this meal at least 3 hours before you plan to go to bed. When you eat can also affect your
body as well as your sleep patterns.)
Option one
- 1/2 cup baked potato w/low-fat sour cream
Option two:
Option three:
- 1 cup spaghetti w/turkey meatballs
- 1 cup tossed salad w/low-fat dressing
(Choose one of these relaxing treats to prepare you for sleep)
- 1 cup skim milk w/2 graham crackers
- Banana smoothie made w/1 cup skim milk, one banana & vanilla flavoring
- vanilla yogurt & a rice cake
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other sleep disorders that may also occur with insomnia...
Restless Leg Syndrome Posted: 03/12/2004 04:25 pm
Last Updated: 03/12/2004 06:01 pm
Millions of Americans
suffer from Restless Legs Syndrome. It's a disorder that causes uncontrollable leg movements.
The most common way to relieve the feeling is to get up & stretch
or walk around the house.
There are no treatments approved specifically for Restless Leg Syndrome,
but many patients respond to drugs for Parkinson's disease or by taking iron supplements.
"People who have this problem need to be tested for iron deficiency
right off the bat," says Dr. Robert Sack of Oregon Health & Science University.
One couple that experiences this syndrome is Ouida & Newt.
When they got married Newt told Quida he had a jumpy leg. Little did Ouida know that the constant kicking would
make for a number of sleepless nights.
But now Newt takes a Parkinson's drug called Mirapex a few hours
before bed & he & his wife get a lot more sleep.
A recent study showed that more than 50% of patients w/ RLS improved
after taking another Parkinsons drug called Ropinirole.
New treatment for the overly tired Posted: 02/03/2004 02:19 pm
Last Updated: 02/03/2004 03:20 pm
If you suffer from excessive sleepiness, a new eye-opening treatment
can help.
It's called Provigil & it's now FDA approved. The medicine
was approved in 1998 only for patients w/ narcolepsy but now it treats two other disorders.
The pill improves wakefulness for people who have problems adjusting
to shift schedule changes.
It can also prevent sleep apnea, a breathing disorder that causes
a person to stop breathing during short periods in their sleep. Doctors say excessive sleepiness if left un-addressed can affect both your work & personal life.
Narcolepsy drug for night shift workers
Posted: 03/04/2004 04:09 pm
Last Updated: 03/04/2004 04:09
pm
Anyone who has worked the night shift knows how hard it is to
adjust to that schedule, no matter how much coffee you drink. Doctors are now prescribing a medication they say keeps you
awake & alert regardless of your hours & w/ few side effects.
A drug called Provigil has been prescribed
in the US for 5 years for narcolepsy.
Dr. Leslie Lundt, a psychiatrist, says, "It activates the wake
promoter in the brain so that when you are supposed to be awake you're more awake it works w/ the brain chemicals that help
w/ wakefulness in the brain. But it really doesn't interfere w/ your sleep cycle."
Lundt says the drug was even used by US soldiers in Iraq
during the march into Baghdad because soldiers had to be alert & awake for long periods of time.
Like any drug,
there are risks. There is a small chance that people that could abuse it in some of the animal studies animals liked it better
than water, which is problem when you're doing research so it is a slight possibly of addictive behavior w/ it.
There are concerns that people might use the drug to replace
sleep, which is not the intent of the drug. Some insurance does cover Provigil, which goes for $6 a pill.
As
w/any medication, consult your doctor.
Insomnia is considered
extrinsic when it occurs due to the sleeper's surroundings. This includes sleep hygiene, sleep environment (like the room temperature or the comfort of the bed) & drugs. Often
the sleep of an extrinsic insomniac can be improved by adjusting & improving the cause
appropriately.
Many insomniacs recognize they can fall asleep more
easily elsewhere than their bedrooms. They
may fall asleep easily in a recliner in front of the t.v., or on vacation in a cool, dark cabin by a quiet, peaceful lake.
These individuals need to work on their bedroom "cues for sleep." Many insomniacs will lie awake in bed for a long time, therefore
associating their beds with being awake.
If one eats, does homework,
or watches television in bed, the brain will then associate the bed with being awake. It is therefore very important to use
the bed explicitly for sleeping, so that the brain will associate the bed w/sleep & sleep only.
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Music: Does a radio replace the lullaby? People generally think they sleep better w/music or that they could
not sleep w/out their customary city noises, such as airplanes overhead.
In reality, despite what most people believe
- people generally sleep better in a quiet environment. A continuous "masking" or "white noise" may be helpful if there
are a lot of unavoidable external stimuli, but that is not as good as no noise. If people listen to music before going to
sleep to help them relax, as the baby does to the mother's voice at bedtime, it is best for them to use a timer to turn off
the music, as music actually disturbs the quality of sleep by continuing to "register" in the brain.
Why not? The reason is that music demands arousal of stimuli in the brain,
even w/out the person's knowing it. This arousal makes it more difficult for the person to get good sleep. This
is also why it is important to have the area as dark as possible as the light involves more stimuli. Room
temperature & sleeping surface can also affect the person's ability to sleep.
W/exceptions of obvious extremes (boiling hot or concrete surface), these two factors
seem to contribute to insomnia according to the sleeper's general preferences. People prefer a variety of temperatures &
surfaces for sleeping.
Other Factors
Taking stimulants & going off depressants can cause insomnia. Many drugs, including caffeine, nicotine,
alcohol, hypnotizers, tranquilizers, can be a cause of insomnia. Disruptions in circadian rhythms, such as shift work &
jet lag, also tend to cause insomnia. Naps or inconsistent sleep/wake schedules often lead to insomnia.
Role of sleep in child's well-being
Posted: 02/09/2004 04:21 pm
Last Updated: 02/09/2004 04:21
pm
Sleep may play a bigger role in a child's well being than previously
thought, according to new research.
Researchers say 6th graders who reported getting less sleep
had lower self-esteem, were more depressed & had lower grades than their peers who reported getting more sleep.
During the middle school years, the amount of sleep continued
to decline as well as self esteem, mood & grades.
Researchers surveyed more than 2,000 middle school students
from 23 Chicago area schools during the mid 1990's.
The 6th through 8th graders were asked about how many hours they
slept each night, their mood & their grades.
Girls reported more sleep trouble than boys.
Researchers
say may be due to time spent by girls grooming on weekday mornings.
The researchers say the findings underscore
the need for students to get enough sleep each night.
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