Insomnia
Not being able to get to sleep can be extremely frustrating. As well as being constantly tired, your mood is usually also affected. Insomnia is the difficulty in falling asleep, remaining asleep, and waking earlier than usual. Around 50% of adults will experience insomnia at least once in their life, to varying degrees.
Symptoms
- Difficulty falling asleep
- Trouble remaining asleep
- Waking early
- Fatigue/tiredness
- Irritability
- Impaired motor coordination
- Lack of concentration
Causes
Many factors can affect sleep and quality if sleep. Most commonly, psychological conditions such as stress, anxiety, and depression, are the main causes of sleep disturbances associated with insomnia. Other medical conditions can cause insomnia such as chronic pain, hyperthyroidism, and respiratory diseases such as sleep apnea. Disruption of the sleep-wake cycle from activities such as jet lag, shift work, and day sleeping may cause insomnia.
Treatment
Benzodiazepines have traditionally been used in sleep disorders such as insomnia, as they produce a strong sedative effect. Temazepam is the most commonly prescribed benzodiazepine for insomnia. Unfortunately, temazepam is addictive and should not be taken over long periods of time. Other newer pharmaceuticals have become available such as zolpidem and zopiclone, which are less addictive and do not produce morning sedation. However, temazepam remains the most commonly prescribed. Pharmaceutical therapy for insomnia is not recommended as first line treatment, and should not be used for long term sedation as they may produce dependence.
Natural Therapies
As psychological causes of insomnia are the most common, psychotherapy remains an important therapeutic avenue. Talking through the cause of the problem may provide relief from insomnia. Valerian root herb has been known for its effects on improving sleep quality for more than 2,000 years. Several studies have shown that Valerian induces sleep and improves sleep quality. Music therapy has also shown to be beneficial of sleep quality as it improves mood and emotional well-being.
Note: Pregnant women should seek professional health advice as many of these therapies are contraindicated during pregnancy.
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References
Bent, S., et al. (2006). Valerian for sleep: a systematic review and meta-analysis. American Journal of Medicine, Volume 119(12):1005-1012.
Extracts of the roots of valerian (Valeriana officinalis) are widely used for inducing sleep and improving sleep quality. A systematic review of randomized, placebo-controlled trials of valerian for improving sleep quality is presented. An extensive literature search identified 16 eligible studies examining a total of 1093 patients. Most studies had significant methodologic problems, and the valerian doses, preparations, and length of treatment varied considerably. A dichotomous outcome of sleep quality (improved or not) was reported by 6 studies and showed a statistically significant benefit (relative risk of improved sleep = 1.8, 95% confidence interval, 1.2-2.9), but there was evidence of publication bias in this summary measure. The available evidence suggests that valerian might improve sleep quality without producing side effects.
