Insomnia Causes Cures and Sleep Medication Options
Author: Dr. West Conner(i)
Published: 2009-07-20 : (Rev. 2018-03-16)
Synopsis and Key Points:
We take a look into what insomnia is what causes it and tips and medications to help you get to sleep quicker.
The World Health Organization says that one-third of the world's population experience insomnia at some stage in their lives, with approximately five per cent needing medical treatment. Sleep medication is readily available, but there will always be a trade off in terms of side effects and possible long term addiction. Most often, insomnia lasts for just a short period of time, a week at most.
Studies show that insomnia affects approximately 75 million people in the United States. Insomnia can present itself in a couple of different ways; each may require a different medication.
One symptom is a difficulty falling asleep but once asleep, the patient stays asleep. Another symptom is difficulty staying asleep, but an ease of getting to sleep.
The World Health Organization says that one-third of the world's population experience insomnia at some stage in their lives, with approximately five per cent needing medical treatment. Sleep medication is readily available, but there will always be a trade off in terms of side effects and possible long term addiction.
Most often, insomnia lasts for just a short period of time, a week at most. When the difficulty in sleeping lasts for more than six months, it is considered a chronic condition. The chronic insomnia is troublesome because it can affect your work, your health, and your social relationships.
Sleep - sufficient sound, refreshing, healthful sleep - is totally essential to your physical, emotional and mental well-being.
Good sleep can:
- 1. improve your health and looks;
- 2. boost your energy;
- 3. strengthen your concentration; and
- 4. fill you with self-confidence and creativity that can transform your finances and your entire life.
Lack of sleep, on the other hand, causes serious problems if it isn't dealt with.
- 1. Lack of sleep affects your immune system, and makes you more prone to infection and less able to recover from disease;
- 2. Lack of sleep affects your judgment and your concentration, and causes you to make mistakes at work or when you're driving;
- 3. Lack of sleep can make you irritable, and causes problems with your partner, friends and family; and
- 4. Lack of sleep can be a cause of mental illness.
Seriously. The late comedian and writer Spike Milligan traced the bi-polar disorder which devastated his life to an incident in World War II, when during the battle for Monte Casino he suffered total sleep deprivation for a staggering 15 days and nights. He never properly recovered.
How do you know if you're not getting enough sleep:
That's simple - when you're properly rested and refreshed, you wake up naturally. If you need an alarm clock to get you out of bed, you need more, and much more restful, sleep. Here are some simple tips to help you to do that.
The treatment for insomnia should begin with what is known as "sleep hygiene." Sleep hygiene consists of these philosophies:
- 1. Keep a regular sleep schedule - Develop a bedtime routine so your body knows it's time to go to sleep. By winding down your physical activities , your body will start to associate some of these actions with going to sleep. Start with a cup of hot milk. Milk contains a protein called tryptophan, which helps to promote sleep. This can be substituted with chamomile tea, which is known to calm the nerves. Follow this with a hot bath or shower, the heat will help to lower your internal body temperature, again telling your body to go to sleep. If you have a hot tub or Jaccuzzi, these are great ways to relax and feel drowsy.
- 2. Exercise regularly but avoid exercise before bed
- 3. Go to bed when sleepy - There's no point in going to bed just for the sake of it, and hoping that you'll somehow fall asleep. You won't. What you will do is toss and turn, and get annoyed. There aren't many better ways of ruining a good night's sleep than by convincing yourself you aren't going to get one.
- 4. Do relaxing and enjoyable activities before bed - Don't go to bed thinking anxiously about all the stuff you've got to do tomorrow. List it all before you go to bed, and forget about it till the morning. It doesn't matter how important it might be, you won't tackle it effectively if you're too tired - you'll do it all much better when you're rested. Take some time to unwind before you go to bed, and consciously and deliberately release everything that's happened through the day. Be aware of letting your muscles release every bit of tension in them, from your head down to your toes. Fill your mind with pleasant, relaxing images, then let those images drift softly from your consciousness till you're aware only of an enjoyable sensation of comfort and relaxation. Don't fight the feeling of drowsiness as it comes over you - just let it overtake you, and drift gently into sound, refreshing sleep.
- 5. Keep the bedroom quiet and comfortable - Make your bedroom your sleep-room. Don't read, eat or watch television in your bedroom, or do any activity that is not sleep related. Make sure the room is dark and cozy; include extra pillows on the bed and even some stuffed toy animals. Make your bedroom into a sleep sanctuary, no distractions at all, and you'll have a room that you will feel secure and comfortable in, and best of all, that you will crave to sleep in. A stuffy atmosphere prevents you from breathing deeply, which in itself can be a cause of shallow sleep which leaves you tired and un-refreshed next morning. You might want to turn the heating down, or the air-conditioning up. You don't need to make yourself feel cold to get the benefit of this - just make sure the air feels fresh and fairly cool, that's all. If your first thought on entering the room is that it's warm, you need to freshen it. Your sleep will benefit.
- 6. Do not eat a large evening meal - A balanced diet helps to make a balanced mind. If you're lacking in essential vitamins and minerals your body cannot operate at its best. Toss the junk food and soda pop, and make a new start to good physical and mental health. Add in some regular exercise and watch your body respond with some improved sleep. I've found that complex carbs, such as a few saltine crackers with peanut butter can actually help relax your body.
- 7. If you are not sleeping within 20 minutes, get up and return to bed when you are sleepy. - Don't lie in bed if you can't sleep. If you don't feel sleepy enough to drift off, you'll just lay there and feel miserable over the fact that you can't get to sleep. This will only make it harder to get to sleep each time you experience this. Get out of bed and go into a different room. Do something to distract yourself until you do start to feel sleepy and then try to sleep again later.
- 8. If you must take an afternoon power nap, limit it to 30 minutes
- 9. Avoid alcohol, caffeine, and nicotine
- 10. Don't read in bed - To sleep more restfully, you need relax your mind, not fill it full of new ideas. Lots of people read a newspaper last thing at night, then wonder why they can't drift off to sleep. That's just because their mind's too lively. Reading a book is even worse - if it's any good, you'll actually force yourself to stay awake to see what happens next! Do all the reading that you want to do before you go to bed.
- 11. Switch off the TV. - Lots of people have a TV in their bedroom, and believe that watching late at night relaxes them before they go to sleep. It's really just like reading, though - it keeps your mind involved when it needs to be relaxed. If you fall asleep while watching, you rarely wake refreshed next day. That's because even in your sleep a part of your mind has still been listening to the TV - all night long. It doesn't matter how many hours of unconsciousness you have in front of the TV - it's not the same thing as a proper deep, refreshing sleep.
- 12. Allow time to sleep - Instead of trying to cram as much as you can into the day, try to find short cuts or solutions to give a little time back to yourself. Set aside a little bit of chill time. If possible, save the last minute stuff for another time. When you are well rested, chances are that you'll get more done in less time during your working hours.
- 13. Medications may interfere with your sleep. Have your pharmacist check your medications for stimulating drugs - It has been shown that some of the medications below may cause sleep problems. Check with your doctor if you are experiencing insomnia and are also taking any of these medications - amphetamines (diet pills), antidepressants, beta blockers (heart and blood pressure), cimetidine (ulcers), cortisone, diuretics (fluid), levodopa (parkinsons), Prinzide (blood pressure) and bronchial dilators (asthma).
- 14. Hormonal fluctuations - Hormonal fluctuations caused by PMS or menopause can also disrupt a woman's normal sleep cycles. The wide swings in hormone levels affect sleep and mood.
If, after trying sleep hygiene, you are still having difficulties, you can try some over-the-counter remedies.
There are many different sleeping pills you can buy at your local store. This is what I recommend: - find the cheap, generic, store brand diphenhydramine 25 milligrams. It can by found either in the sleeping pill section or in the allergy section. Let me tell you why. Diphenhydramine is the active ingredient in the allergy medication Benadryl. Along with its ability to help with your allergy symptoms, it causes a good amount of drowsiness. So much so that it is the active ingredient in ALL of the following expensive brand name sleeping agents: Simply Sleep Sleepinal Sominex Tylenol PM Unisom Alka-Seltzer PM Excedrin PM Goody's PM Nytol Bayer NightTime Relief Doan's PM GoodNight's Sleep Legatrin PM. All of these are much more expensive and have the exact same active ingredient as the cheap store brand. Why pay more for the exact same thing
The next step to try is melatonin.
Now many people want to go directly to melatonin because they feel it is a "natural" alternative. Melatonin in made in a laboratory just like any other medication. You can get natural melatonin that is made from the pineal gland of animals but this approach is not recommend due to frequent viral contamination. The brain secretes melatonin to supposedly tell our body to go to sleep. The scientific community is still discussing the exact dosage and duration of therapy for melatonin. Until they come up with an answer, start with the one milligram dose. If this is not effective, go to two milligrams. If there are still difficulties in getting to sleep, go for the three milligram dose.
Let me tell you about my own personal experience with melatonin.
When it first came out many years ago, I tried it to help with my sleeping. I took it the first night, fell asleep, and woke up at 3am, wide awake and couldn't get back to sleep. Of course the next night I was tired so I took it again. I fell asleep but was wide awake again at 3am and couldn't get back to sleep. The next night I didn't take it and slept until morning. The fourth night I took the pill and again woke up at 3am, wide awake. I have never taken it since. Why I woke up at 3am, I don't know. It was strange but that is what happened to me.
If sleep hygiene, diphenhydramine, and melatonin are not helpful for you, the next step in the doctor's office.
Don't be intimidated into one of the new, expensive designer sleeping pills. Start cheap.
Your first step should be trazodone.
This is actually an antidepressant that causes sedation as a side effect, similar to diphenhydramine. One of the reasons for using an antidepressant like trazodone is the fact that many people with insomnia are also depressed, whether diagnosed or not.
Trazodone is cheap, reliable, and has been used safely for years. The most common dose for getting a good night's sleep is 50 milligrams. You will never see an advertisement for trazodone because it is an old, dependable drug that is very cheap.
The next step should be temazepam.
This is another old reliable medication that has been used for years. Temazepam is in the same family as Xanax and Valium. It provides the right amount of sedation that lasts about eight hours. The medication is classified as a schedule IV meaning it does have some addictive properties. There are not too many people who get "hooked" on temazepam so I would not worry too much about that.
If, after trying these three medications, you are still having difficulties, you and your doctor may want to try other medications in the same family as temazepam. These are called benzodiazepines. They all work basically the same way and cause drowsiness. They differ in how quickly they work and how long the effect lasts.
Your next step is going to be expensive.
The pricey brand name drugs are going to be your next option. I would recommend starting with Ambien. It is quite popular and will soon be available in generic form. The manufacturer is now focusing on the new formulation called Ambien CR. They are no longer promoting Ambien because the patent will soon expire. The Ambien CR is nothing more than a controlled release form of the drug. You can get a voucher for a free trial at ambiencr.com.
After this, you have many choices but all are costly. You can try Sonata or Lunesta. A free four day trial of Sonata is available at sonata.com and a free four day trial of Lunesta is available at lunesta.com.
A new medication for sleep is called Rozarem.
To make the science easy, it tricks your body into thinking it has a lot of melatonin. This is a new category of medication. They are quite expensive at about $7.00 each.
Most people do not realize how effective the cheap generics are because they don't see them on TV or hear about them on the radio. These established drugs have been working for many years and there is no reason to begin your therapy with expensive prescription drugs.
The recommendations for sleeping pills follow the rest of my suggestions, start over-the-counter and cheap. Begin with simple, proven, and inexpensive remedies and slowly move up in cost. The newer, brand name drugs are heavily advertised and well known to the general public. This advertising and brand name recognition makes them quite expensive.
Don't be tempted into the expensive route right away.
Your doctor is probably going to want to start you on the newest expensive drug. Most people don't realize that he or she is being rewarded by the drug companies for prescribing these expensive medications to you.
A good night's sleep is important. If it really only takes a few cents a night to get it, why pay several dollars?
(i)Source/Reference: Dr. West Conner. Disabled World makes no warranties or representations in connection therewith. Content may have been edited for style, clarity or length.
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