Insomnia's Treatment Corner

INSOMNIA: What is it?

2006-07-21T10:47:00.000-07:00

Insomnia is the perception or complaint of inadequate or
poor-quality sleep because of one or more of the following:

* Difficulty falling asleep

* Waking up frequently during the night with difficulty
returning to sleep

* Waking up too early in the morning

* Unrefreshing sleep

Insomnia is not defined by the number of hours of sleep a
person gets or how long it takes to fall asleep.
Individuals vary normally in their need for, and their
satisfaction with, sleep. Insomnia may cause problems
during the day, such as tiredness, a lack of energy,
difficulty concentrating, and irritability.

Insomnia can be classified as transient (short term),
intermittent (on and off), and chronic (constant). Insomnia
lasting from a single night to a few weeks is referred to as
transient. If episodes of transient insomnia occur from
time to time, the insomnia is said to be intermittent.
Insomnia is considered to be chronic if it occurs on most
nights and lasts a month or more.

Note: The above information is intended to supplement, not substitute for, the expertise and judgment of your physician, pharmacist, or other healthcare professional. It is not intended to diagnose a health condition, but it can be used as a guide to help you decide if you should seek professional treatment or to help you learn more about your condition once it has been diagnosed.

Insomnia Research

2006-06-26T14:55:00.000-07:00

People suffering from insomnia are more likely to experience various daytime symptoms, including a lack of alertness, negative mood and sleepiness.

This research was presented at the 20th anniversary SLEEP meeting of the Associated Professional Sleep Societies (APSS) at Salt Lake City’s Salt Palace Convention Center from June 17-22.

Researchers of the University of Pittsburgh School of Medicine studied 47 subjects with primary insomnia and 18 good sleepers. It was discovered that the primary insomnia group had significantly worse scores than good sleepers in the categories of termed alert cognition, negative mood, positive mood and level of fatigue/sleepiness.

Insomnia is a classification of sleep disorders in which a person has trouble falling asleep, staying asleep or waking up too early. These disorders may also be defined by an overall poor quality of sleep.

Insomnia is a condition that is suffered by thirty percent of the U.S. population. Some medical conditions cause insomnia, or it may be a side effect of a medication. A person with insomnia may feel tired during the day, have trouble concentrating at work or fall asleep during the day.

For most people, insomnia lasts only a few days and goes away without treatment, but stress or depression can cause a higher level of insomnia that may last for several weeks. This kind of insomnia may not go away on its own. In this case, persons are advised to consult with their primary care physician, who will determine whether a visit to a sleep specialist is necessary.

Eyes wide shut: sleep aids

2006-05-09T13:13:00.000-07:00

Nationwide, insomnia affects approximately 30% of the population within any given year. The frequency of insomnia increases with age and is more common in women. As adequate sleep is an important part of good mental and physical health, it is important for consumers to treat insomnia and not just "live" with it. Cost estimates related to absenteeism and traffic accidents related to insomnia are approximately $100 billion annually.

Nonprescription (OTC) medications are available to treat insomnia but there are differences between them:

Sleep aid products containing diphenhydramine are the best choice for the treatment of insomnia. Examples of these products include Unisom Sleep Gels, Sominex, and generic diphenhydramine products. The dose is 25-50mg at bedtime. Start with the lower dose and if necessary increase to 50mg.

READ the label. The amount of active ingredient varies from product to product. For example, Sominex contains 25mg of diphenhydramine while Unisom Sleep Gels contain 50mg of diphenhydramine. Generic products may save you money.

Doxylamine is another active ingredient available OTC to treat insomnia. It is contained in Unisom Tablets. Do not get confused between the two products. Doxylamine has been studied less than diphendydramine and is not the preferred treatment.

Some sleep aids like Tylenol PM also contain a pain reliever as well as diphenhydramine. These products are helpful when sleeplessness is accompanied by aches and pains.

All of the Over the Counter products are for short-term use. If insomnia persists more than 7-10 days, see your doctor.

Talk to your pharmacist about OTC sleep medications - he/she can help you choose the best one for your situation.

PRESCRIPTION MEDICATIONS

Prescription medications are available from your doctor

Medications with a fast onset and short duration of action (to avoid excessive day time sedation) are usually preferred

Some examples are: Lunesta, Ambien, Sonata, Roserem

Other, older medications are available but they may cause residual sedation

Dietary supplements are also available OTC for the treatment of insomnia

Buyer beware - these products are not regulated by the FDA

Examples include melatonin and valerian

Studies evaluating these products have had variable results

TITLE: HEALTHY SLEEP HABITS

Eliminate naps

Follow a regular sleep pattern

Complete exercise at least 3 hours before bedtime

Avoid heavy meals or big snacks before bedtime

Avoid alcohol later in the evening

Avoid caffeine later in the day

Do relaxing activities before bedtime

Make your bedroom comfortable for sleeping

Leave the bedroom & relax activity for 20-30 minutes

Insomnia Can Trigger Depression, Study Shows

2006-01-16T14:06:00.000-08:00

June 24, 2005 -- Insomnia has long been thought of as a symptom of depression, but new research shows it may actually trigger the mental disorder.

In one study, depressed seniors with insomnia were 17 times more likely to remain depressed after a year than patients who were sleeping well. The findings were presented Tuesday at the 19th Annual Meeting of the Associated Professional Sleep Societies in Denver.

In a separate study, seniors with insomnia and no history of depression were six times more likely to experience an episode of depression as seniors without insomnia. The association was strong for women and for people who suffer from a particular insomnia pattern that awakens a person repeatedly during the night.

Both studies were conducted by researchers from the University of Rochester Sleep and Neurophysiology Research Laboratory. Lab director Michael Perlis, PhD, tells WebMD that while the research focused on seniors, the findings could apply to anyone with chronic insomnia.

Self-treatment could worsen insomnia

2006-01-13T13:19:00.000-08:00

Few people, including sufferers, health professionals and health authorities, recognize insomnia as a serious problem requiring treatment.
The kind of treatment that usually does take place is self-medication -a sleeping pill here, a little melatonin there, perhaps downed with some alcohol.
However, Prof. Hussain Habil, head of the Department of Psychological Medicine at University of Malaya, cautions that self-medication could worsen insomnia and cause more side effects than good ones.
"I have patients who became addicted to sleeping pills before they managed to get proper treatment from my clinic," Habil said.
The biggest problem with self-medication is that it overlooks one major aspect, which is identifying the cause of the insomnia. It could be caused by a multitude of factors, including medical conditions, psychological problems or environmental changes.
Psychiatrists treating insomnia usually prescribe non-pharmacological treatments first, before resorting to medication.

Non-pharmacological treatments include:

-Stimulus control therapy: to help the patient associate the bedroom with sleep and relaxation only.
-Paradoxical intention therapy: making the patient stay awake as long as possible to reduce anxiety about sleeplessness.
-Relaxation therapies: relaxation of muscles to reduce anxiety-associated arousal that could inhibit sleep.
-Cognitibehavioralral therapy: changing faulty beliefs and attitudes about sleep to reduce emotional stress and dysfunctional cognitions.
-Sleep restriction therapy: increasing sleep efficiency by restricting naps and time spent in bed not sleeping.
-Temporal control therapy: getting up at the same time every day, even during weekends.
-Sleep hygiene: tips to improve sleeping habits may be effective when used together with other therapies.

Medications are considered second-line treatment, because they tend to produce more side effects and have short-term benefits only.
Nonetheless, over-the-counter medications like antihistamines, or prescription medications like non-benzodiazepines and benzodiazepines, are sometimes needed in managing insomnia.

Treatment for insomnia

2006-01-13T11:09:00.000-08:00

Many insomniacs rely on sleeping tablets and other sedatives to try to get some rest. Others use herbs such as valerian, chamomile, lavender, hops, and/or passion-flower.

Some traditional remedies for insomnia have included drinking warm milk before bedtime; taking a warm bath in the evening; exercising vigorously for half an hour in the afternoon; eating a large lunch and then having only a light evening meal at least three hours before bed; avoiding mentally stimulating activities in the evening hours; and paradoxically, making sure to get up early in the morning and to retire to bed at a reasonable hour.

Traditional Chinese medicine practitioners have been treating insomnia sufferers for thousands of years. A typical approach may utilize acupuncture, dietary and lifestyle analysis, herbology and other techniques, with the goal to resolve the problem at a subtle level.

Although they may seem unscientific, many of these remedies are sufficient to break the insomnia cycle without the need for sedatives and sleeping tablets. Warm milk contains high levels of tryptophan, a natural sedative. Using aromatherapy, including Lavender oil and other relaxing essential oils, may also help induce a state of restfulness.

The most commonly used class of hypnotics prescribed for insomnia are the benzodiazepines. This includes drugs such as diazepam, lorazepam, nitrazepam and midazolam.

The more relaxed you are the greater the likelihood of getting a good night's sleep. Relaxation techniques such as meditation have been proven to help sleep. They take stress from the mind and body which leads to a deeper more restful sleep.