FEATURE ARTICLE: INSOMNIA

Insomnia is a global term indicating several sleep disorders which consist of troubles ranging from difficulty falling asleep and/or staying asleep, either for a short period or on a long term basis. It is the 4 ^th most important reason, after colds, gastric issues and headaches, that people consult a doctor. It is therefore a very common disorder. It varies in intensity, can be occasional only lasting for a few nights; moderate, lasting for a few weeks; or chronic, including complete sleepless nights over a long period at least 3 times a week. Chronic insomnia can have serious consequences on your health. How long we sleep can vary from one person to another and that’s normal. Experts agree that seven to eight hours of sleep per night is a good average but some people live well with only five hours per night, whilst others will need ten hours. It is not the number of hours of sleep per night that determines insomnia but rather the side effects that a lack of sleep may create. We need quality sleep versus many hours of sleep considering that how long we sleep is not the main element to determine if we have insomnia. What really counts is how you feel in the days following a sleepless night. Who is at risk? A third of the adult population suffers from insomnia. Women are more often affected than men and people over 60 are often light sleepers. Insomnia also affects people with certain health issues: restless legs syndrome, hyperthyroidism, sleep apnea, asthma, digestive problems, tinnitus and many other chronic health problems. Do I have insomnia? Do you recognize yourself in the following descriptions?

• You are agitated during sleep and have periods of sleeplessness during the night;
• You have serious difficulty falling asleep;
• You wake up earlier than usual;
• You can’t sleep anymore.

  A sleepless night every now and then should not be considered as insomnia. However, if the sleep cycle is disturbed during a long period, the situation may worsen, causing physical and social problems. How does it start?  Insomnia generally begins with sleepless nights due to an injury or a minor emotional upset. These few sleepless nights then become a habit which eventually turns into a long term problem. For example, if you have a nap during the day, if you don’t sleep much during the night, if you watch television in bed or you eat in the kitchen at 2 a.m., you are slowly heading towards insomnia.  This would be behavioural insomnia. You have developed bad sleep habits that keep you from sleeping. What are the symptoms?

• Fatigue and sleepiness;
• Difficulty falling asleep;
• Waking early and still feeling tired;
• Waking intermittently during the night and periods of sleeplessness during the night;
• Lassitude during the day with or without feeling the need to sleep;
• Reduction in the level of vigilance and performance at work or at school;
• Trouble concentrating and paying attention;
• Memory loss;
• Irritability;
• Accidents driving or at work;
• A weak immune system;
• Anxious anticipation at night, worrying about not sleeping.

  What are the causes?

• Smoking, especially in the evening;
• Mental disorders such as: anxiety, stress, phobias, panic attacks, nervous tension and depression;
• Illness or pain;
• Lack of exercise;
• A noisy environment;
• Moving, especially if moving to a new time zone;
• Irregular work shifts, a change in work hours or workload;
• A noisy environment , too much light, too hot or too cold, insufficient air circulation;
   
• Excessive stimulation before bed;
• Drinking too much before bed that may provoke the need to urinate during the night;
• A late supper that makes us go to bed on a full stomach. It’s making gravity work against us, acid and gastric gases tend to go up the oesophagus causing heartburn that will disturb sleep;
• A disruption in the sleep cycle, like taking a nap every day, going to bed at a different time every night or changing work shifts;
• Eating a heavy meal, foods rich in fats, foods that provoke heartburn or are difficult to digest can make you agitated and result in poor sleep quality;
• Ingesting too much energising foods or drinks such as: coffee, tea, cola, yerba-mate, guarana, chocolate. Studies have shown that people suffering from insomnia absorb more caffeine than others. It is preferable to stay away from these in the afternoon and evening;
• Drinking alcohol in the evening, even though a small dose can help to fall asleep, its metabolisation may disrupt sleep and risks aggravating insomnia. It disrupts delta sleep which has restorative properties. It also causes dehydration which gives the impression of feeling tired when waking;
• Certain medications, notably bronchodilators, certain decongestants, analgesics, weight loss products, antidepressants, antihypertensive medication and corticosteroids can disrupt sleep patterns. When taking a prescribed medicine regularly, ask your doctor what the side effects may be. He may change the medication or change the time at which it is to be taken if he thinks it can be the cause of your insomnia;
• Psychic illnesses such as chronic pain, heartburn or diabetes may lead to insomnia;
• Quitting smoking, stopping sleeping pills, antidepressants, sedatives or tranquilizers can also disrupt sleep patterns.

  How to cure or prevent insomnia? Change certain habits:

• Avoid tea or coffee (or any other food containing caffeine such as chocolate, etc.) especially towards the end of the day (after 3 p.m.);

• Relax as much as possible before going to bed and only go to bed when you actually feel tired. Have quiet conversation, massages to release tension, do yoga or use any other relaxation technique that will have the same effect;
• Do not deal with problems on your pillow, rather have these conversations after supper and then forget about them until the next day. Clear your mind before bed;
• Take a hot bath before bed to relax your muscles and warm yourself up. It will help attain a deeper level of sleep says Susan Jaffe, doctor and clinical director of the sleep program at the Hollywood Medical Centre in Florida. Adding a little lavender oil to the water will also help to relax;
• Read in bed, listen to relaxing music, meditate, take deep breaths, find your own method of relaxing;
• Wear loose and comfortable nightwear;
• Only use the bedroom for sleeping or intimacy and not for working, watching TV or playing video games;
• Create an appropriate atmosphere for sleeping by making the bedroom dark, otherwise, wear a mask. Make the bedroom calm and quiet or wear earplugs, make it comfortable by regulating the temperature so that it is neither too cold (or use an electric heating blanket), nor too hot;
• Respect a fixed schedule to regulate your circadian rhythm (internal clock) by getting up at the same time every morning, no matter what time you got to bed the night before. When you’re up, open the blinds and take full advantage of the natural sunlight which will help to reprogram your sleep cycle. Also, always go to bed at the same time and respect a regular routine to prepare for bed every night to create adequate sleep hygiene;
• Go for a walk outside for 30 minutes;
   
• Avoid naps during the day;
• If you are still awake after 15-20 minutes, get up; because forcing yourself to sleep for a few hours will only make you nervous. Get out of the bedroom and do something else like read a magazine, a book or do some knitting but avoid activities that may excite you (video games, etc.). Go back to bed as soon as you start to feel sleepy;
• Make sure your mattress and pillows are comfortable;
• Never go to bed on a full or empty stomach. A light snack before bed may help you get to sleep but a big meal just before bed can cause digestive issues that will lead to insomnia.

  Exercise: Exercise promotes restorative sleep that the body needs to keep its forces up.

• Exercise in the late afternoon or early evening if you can. Take a 30 minute walk every morning, this walk signals to your body that it’s time to get active for the day ahead and will lead to sleep later on;
• Make love! Researchers have discovered that hormones released during sexual intercourse predispose us for sleep. If however, the sexual activities are a source of stress or anxiety for you, it is preferable to abstain.

  And what about sedatives?

• Pharmaceutical sedatives are also effective but they have the inconvenience of creating dependencies; they also disrupt natural sleep patterns. Natural options are becoming more available. Try them;

  Are there natural options?

• Potassium: If you are hungry before bed, eat a banana. It contains an amino acid, tryptophan, which has an appeasing effect;
• Group B vitamins  nourish nervous system cells and gives them balance;
• Calcium and magnesium before bed;

 

• [caption id="attachment_799" align="alignleft" width="180" caption="Chamomile"][/caption] Chamomile: sedative and relaxing, it eases spasms, inflammations, agitation and insomnia due to nervousness;
• Linden: sedative and antispasmodic, it is used to treat sleep disorders;
• Passion flower, sedative, relaxing and antispasmodic thanks to flavonoids and beta-carbolines that it contains. Its sedative and antispasmodic qualities are explained by its natural content of maltol (depressant) and beta-carbolines. They stimulate the central nervous system. It is used for insomnia, nervous tension, sleep disorders, anxiety and neuro-vegetative dystonia (problems with the nervous system) and palpitations.
• Valerian, the perfect remedy for insomnia, sedative, antispasmodic and slightly hypnotic, it acts on the central nervous system and relaxes smooth muscles. Its virtues have been proven by many studies. It reduces the time it takes to fall asleep and increases the quality of sleep, without creating dependency. It is rich in valepotraites, substances which seem to have a direct effect on the brain. Highly recommended for stress, nervousness, panic, nervous agitation and sleep disorders, it also calms heart palpitations;
• [caption id="attachment_800" align="alignleft" width="135" caption="Hops"][/caption] Hops: sedative, hypnotic and calming, they are recommended for fighting insomnia, anxiety, agitation and sleep disorders. They can also be combined with other plants such as valerian. Their effectiveness is recognized for nervous problems;
   
• Minerals seem to have a certain importance in relation to quality of sleep. It is easy to determine their link to insomnia considering that they are often slightly deficient. Simply avoiding mineral deficiency should suppress problems sleeping. If they continue anyways, a light supplement of minerals (MINERALEX) can help regulate sleep cycles;  

  It is important to try these suggestions simultaneously and to be patient. A good night of sleep cannot happen on the first night. Results are not immediate but it is worth persevering. It is like sticking to a diet to get results. When and why to consult? The following situations could lead you to consult a health professional:

• When your symptoms last for more than a month or when the prescribed treatment stops being effective;
• When you are tired during the day and are not fully functional;
• When you depend on drugs or alcohol to help you sleep;
• When you put off going to bed because the difficulty of falling asleep is making you nervous;
• When occasional insomnia, which usually disappears when your body adapts to new conditions, stays, even with the help of these suggestions.

  With traditional medicine, they will start by examining you for any physical problems that are troubling you, such as a hyperactive thyroid gland. If nothing is found, they will ask about emotional issues that may be keeping you from sleeping; will refer you to a psychotherapist and prescribe medication to deal with the symptoms. These medications (sleeping pills), generally benzodiazepines, if taken long term, eventually lose their effectiveness, risk causing undesirable effects and create dependency. For moderate or chronic insomnia, a natural health professional will observe your lifestyle and immediate environment, will search for a global point of view of your life in general (healthy lifestyle, activities, exercises, emotions, nutrition, vitamin and/or mineral deficiencies, environment). Insomnia is always a sign of other underlying problems, whether they are due to illness or an emotional issue. And that is what they will determine when consulting.

 

References: Guide des vitamines et suppléments, Dr Mindell, Ed. Modus ; Vitamines et Minéraux, Ed. Goelette ; Guide pratique de la phytothérapie, Andrew Chevallier, Ed. HMH ; Vitamines et Minéraux, Amanda Ursell, Ed. HMH ;  Bien se soigner, Caroline Green, Ed. Trécarré ; Symptômes, causes et guérisons, ed. Modus Santé ; Les médecines de la nature, 200 plantes pour se soigner, Ed Reader’s Digest ; Aliments Santé, Aliments Danger, ed. Reader’s Digest  Guide des Interactions médicaments, nutriments et produits naturels, Les Presse de l’Université Laval, Alice Locong et Danielle Ruel ; La Pharmacie Verte, Ed Modus Santé, James A Duke Ph. D.; Remèdes maison des médecins, Ed. Modus Santé ; Les aliments contre la maladie, Suzannah Olivier, Ed. Caractere ; www.Passeportsanté.net