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Insomnia

Insomnia
Insomnia.doc
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An estimated 30% of the population suffers from insomnia each year. The majority of those individuals will have symptoms short term, while a small percentage will continue with symptoms for 6 months or longer.

 

Insomnia can be divided into two main categories, difficulty getting to sleep, and difficulty staying asleep.

 

The causes of sleep disturbance are varied, and it is helpful to pinpoint the type of insomnia and then look for a possible remedy.  Insomnia, for the most part is not harmful, with the exception of those suffering from sleep apnea which decreases the oxygen supply to the brain.  Long term health problems such as heart disease, stroke, high blood pressure and psychological disturbances may ensue with sleep apnea.

 

Those having problems getting to sleep (sleep onset insomnia) are frequently suffering from anxiety and excessive stress, leaving them unable to turn off the mind to relax enough to sleep.

 

In the past, sleeping pills containing antihistamines or sedatives were used to induce sleep, but long term use resulted in dependency and disturbed sleep patterns, and disruption for the deeper stages of sleep.  The medicine became a part of the problem.   The newer medications do not have the negative impact on sleep patterns, however are not advised for long term use, and are therefore still not the solution for someone who is chronically suffering from lack of sleep.

 

People who are having a problem staying asleep (sleep maintenance insomnia) may be improved by simple solutions such as correction of low calcium, magnesium, potassium, zinc, and or ferritin levels...

 

Low blood sugar, blood pressure and thyroid replacement medications, decongestants, caffeine consumption, pain, depression, jet lag, and grief, all may play a role in insomnia.  Hormonal disturbances such as low levels of melatonin, DHEA, serotonin, and particularly in women, low estrogen and progesterone may have a causal effect.

 

Restless legs syndrome is characterized by an irresistible urge to move the legs and can resulting in frequent nocturnal awakenings.  Research has linked this syndrome with low iron levels and low folate levels.  The best method to diagnose low iron levels is the measurement of ferritin, or stored iron in the blood.   Folate levels may also be measured easily in the blood.

 

Late night eating too close to bedtime may cause sleep disturbance. Foods containing tyramine like bacon, cheese, chocolate, sausage. spinach, tomatoes, ham, potatoes and wine will result in the release of norepinephine, a brain stimulant.  If you must snack close to bedtime foods high in tryptophan such as turkey, bananas, figs, dates, yogurt, milk, tuna and whole grain crackers or nut butter will help to promote a sound sleep.

 

Effective treatments for insomnia involve identifying the causes and addressing them accordingly

 

Lifestyle changes:

 

Exercise that elevates the heart rate for twenty minutes each day will aid in promoting healthy sleep patterns.  Exercise should be performed in the morning or early evening NOT before bedtime.

 

Avoid the late night news and try to go to bed at the same time each night to establish a regular routine for sleep.

 

Take a hot bath, NOT a shower, to relax the muscles an hour or two before bedtime.

 

Keep the bedroom comfortable and quiet.   If too much quiet is a problem, try running a fan or a sound machine to lull you into a sound sleep.  Use the bedroom for sleep and sex only, not for television or work.

 

Learn to put worries out of your mind.  Try guided imagery, meditation or concentration on pleasant thoughts.

 

Nutritional supplements:

 

Take supplements 45 minutes before bedtime.

 

Niacin 100 mg

 

Magnesium 250 mg

 

5-HTP 100 to 300 mg or Melatonin 1-3 mg

 

Take a multivitamin with calcium during waking hours.

 

Natural sedatives:

 

Serotonin is an important initiator of sleep and is made from the amino acid tryptophan.  Taking tryptophan will raise serotonin levels and promote sleep.

 

Tryptophan is more effective for sleep-onset insomnia and shortens the time required to get to sleep.  A form of tryptophan, 5-HTP has been reported in double blind studies to  decrease the time needed to get to sleep and decrease the number of awakenings.  The tryptophan derivative is available with out prescription at most health food stores.   Recommended dosages are 100-300 mg per day.

 

The key benefit to 5-HTP use is the increase in REM (rapid eye movement) sleep and increase stage 3 and 4 deep sleep.  Adequate levels of vitamin B6, niacin and magnesium are necessary for optimal results because they act as cofactors in the conversion of 5_HTP to serotonin.

 

Melatonin is an excellent sleep aid and has been found to be helpful in both promoting sleep and maintaining sleep.  Melatonin levels naturally rise prior to bedtime.  Melatonin supplementation will only induce a sedative effect if melatonin levels are low.  This hormone is very effective in treating older individuals in which low melatonin levels are common.  Dosages as low as 0.1 mg and 0.3mg have been found to be effective. The time release formulation is the most effective.  Dosages higher that 3 mg per day could conceivably disrupt the normal circadian rhythm and result in altered hormone secretions.

 

Botanicals with sedative properties:

 

Numerous plants have sedative actions on the nervous system and are commonly used and prescribed in aids for promoting sleep.   Passionflower (Passiflora incarnata0. hops (Humulus lupulus), Valerian(Valeriana Offcinalis) skullcap ( Scutellaria Laterifora), chamomile (Matricuria chamomile), and oatstraw ( Avena Sativa) are examples of plants that have a calming effect on the nervous system.  Passionflower and Valerian have research supporting their use.

 

Passionflower was widely used by the Aztecs as a sedative and analgesic.  It contains harmine, a substance that can inhibit the breakdown of Serotonin.  The use of Passionflower with a substance such as 5-HTP would have an additive effect in maintaining serotonin levels.  Higher serotonin levels would result in increased REM sleep and an increase in deep sleep

 

Valerian has been widely used in folk medicine as a sedative and antihypertensive.  In studies using the aqueous form, Valerian showed a significant effect as compared to placebo and showed significant improvement in sleep quality and relief of insomnia.  Valerian, used in conjunction with Melissa extract, showed an effect comparable to benzodiazepines (Valium and its derivatives) as well as an ability to increase deep sleep stages 3 and 4 without daytime sleepiness, diminished concentration or impairment of physical performance.

 

Dosages:

Valerian (Valeriana officinalis) dried root or as a tea, 2-3 grams, tincture (1:5 ratio) 4-6 ml or 1-1.5 tsp., fluid extract (1:1), 1-2 ml (0.5-1 tsp)

 

Passionflower (Passiflora incarnata), best used wit 5-HTP

 

Dried herb, or as a tea: (4-8 g)

 

Tincture (1:5): 6-8 ml or 1.5-2 tsp

 

Fluid extract (1:1): 2-4 ml or 0.5 -1 tsp

 

The above mentioned botanicals are all available to consume as a tea or infusion.

 

Over the counter preparations of homeopathic or botanical sleep aids include Calms Forte by Hyland, Alfalco, Alfalfa Tonic by Boericke and Tafel,

 

Homeopathy is a medical science that promotes balance to the body through the strengthening of the body’s own life force or CHI energy.  Common homeopathic approaches include the restoration of mineral salts to the body like magnesium, calcium, potassium and additional supplements like iron in a fashion that would allow the body to utilize the salts most effectively without the potential of overdosing on the particular substance...These also are necessary for homeostasis on a cellular level and will promote overall well being and health.

 

Bioplasma and Nerve tonic by Hyland are examples of the delivery system.

 

Homeopathy will specifically address the problem that is causing the sleeplessness.  Examples of remedy portraits include;

 

Anxiety and difficulty falling asleep before 1:00AM, fastidious—Arsenicum

 

Caretaking a loved one at night, difficulty sleeping, lying awake listening for that person’s needs---Cocculus

 

Overworked housewives, severe PMS, aversion to sex, screaming at kids wants to be left alone—Sepia

 

Grief, suppressed, anger suppressed, unable to weep except when alone, autoimmune diseases, thyroiditis.—Nat Mur

 

In conclusion, effective non pharmacological treatments are available for insomnia.  The most important treatment involves identifying the causative factor.

 

Dawna L. Jones MD, FACOG, C.Hom

 

Bella Natural Health

99 Longwater Circle, Suite 100

Norwell, MA 02061

P: (781)-829-0930

F: (781)-829-8933


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