Insomnia is the inability to sleep when sleep should normally occur. Sufficient and restful sleep is a human necessity. The average adult needs slightly more than eight hours of sleep per day and only 35% of American adults consistently get this amount of rest. People with insomnia tend to experience one or more of the following sleep disturbances: Difficulty falling asleep at night, waking too early in the morning, waking frequently throughout the night. Insomnia may stem from a disruption of the body’s circadian rhythm, an internal clock that governs the timing of hormone production, sleep, body temperature, and other functions. While occasional restless nights are normal, prolonged insomnia can interfere with daytime function, concentration, and memory. Insomnia increases the risk of substance abuse, motor vehicle accidents, headaches, and depression. Recent surveys indicate that 50% of people suffer from sleep difficulties and 20 – 36% of them struggle with such difficulties for at least 1 year. Other studies show that one out of three people in the United States have insomnia, but only 20% bring it to the attention of their physicians. Signs and symptoms associated with insomnia include: Not feeling refreshed after sleep, inability to sleep despite being tired, daytime drowsiness, fatigue, irritability, difficulty concentrating, and impaired ability to perform normal activities, anxiety as bedtime approaches.
Primary insomnia is not caused by any known physical or mental condition. There are numerous causes and risk factors. Everyday anxiety and stress, coffee, and alcohol are the most common culprits. Secondary insomnia is often caused by underlying medical or psychological condition such as depression. About 50% of insomnia cases have no identifiable cause. Some conditions or situations that commonly lead to insomnia include: Substance abuse — consuming excessive amounts of caffeine, alcohol, recreational drugs, or certain prescription medications; smoking can cause restlessness and quitting smoking may also cause temporary insomnia. Disruption of circadian rhythms — shift work, travel across time zones, or vision loss; circadian rhythms are regulated, in part, by release of a hormone called melatonin from the brain. Menopause — between 30% and 40% of menopausal women experience insomnia; this may be due to hot flashes, night sweats, anxiety, and/or fluctuations in hormones. Hormonal changes during menstrual cycle — insomnia may occur during menstruation; sleep improves midcycle with ovulation. Advanced age — biological changes associated with aging, underlying medical conditions, and side effects from medications all contribute to insomnia. Medical conditions — gastroesophageal reflux (return of stomach contents into the esophagus; frequently causes heartburn), fibromyalgia, or other chronic pain syndromes, heart disease, arthritis, attention deficit hyperactivity disorder, and obstructive sleep apnea (difficulty breathing during sleep)
Psychiatric and neurologic conditions — anxiety, depression, manic-depressive disorder, dementia, Parkinson’s disease, restless leg syndrome (a sense of indescribable uneasiness, twitching, or restlessness that occurs in the legs after going to bed), post-traumatic stress disorder, certain medications — decongestants, bronchodilators, and beta-blockers, excessive computer work, partners who snore.
A naturopathic approach to treating someone with insomnia starts with a list of all the things they feel could be contributing to their insomnia. Once the underlying cause(s) is identified, clinical nutrition may be prescribed to help the body resolve the underlying cause. Like using specific nutrients to help increase GABA and decreasing glutamate for the person who’s mind spins and cannot fall to sleep. Or decreasing cortisol with adaptogenic herbs for the person who is anxious due to much stress in their life. Or prescribing melatonin for the person who works shift work to establish new circadian rhythms to better match their work life. Lifestyle studies reveal that healthy sleep habits are essential for treating insomnia. The following strategies (in addition to the steps mentioned in the Preventive Care section) may help treat the condition:
- Maintaining a consistent sleeping and waking time
- Establishing the bedroom as a place for sleep and sexual activity only, not for reading, watching television,
- or working
- Avoiding naps, especially in the evening
- Taking a hot bath about two hours before bedtime
- Keeping the bedroom cool, well-ventilated, quiet, and dark
- Avoiding looking at the clock; this promotes anxiety and obsession about time
- Avoiding fluids just before bedtime
- Avoiding television just before bedtime
- Eating a carbohydrate snack, such as cereal or crackers, just before bedtime
- Moving to another room with dim lighting if sleep does not occur within 15 to 20 minutes in bed