Insomnia is a sleep disorder, characterised by difficulty falling and staying asleep. It requires a doctors diagnosis to determine the underlying cause, and can usually be treated with lifestyle changes, therapy, or medication.
There are two types of insomnia:
To diagnose insomnia, your doctor will ask about your medical history, sleep history, bedtime routine, and lifestyle, and conduct a physical examination to check for other medical problems. After that, your doctor will discuss treatment options.
Anyone with insomnia will be able to improve sleep by making small lifestyle changes, says Minesh Morker, MD, a clinical neurophysiologist and sleep medicine specialist at Northwestern Medicine Kishwaukee Hospital.
These natural remedies for insomnia include:
Additionally, Morker says that having a dark and quiet room to sleep, sticking to consistent sleep and wake times, refraining from naps, avoiding alcohol, and trying relaxation techniques like meditation or deep breathing can all help someone with insomnia.
However, for those with chronic insomnia, these lifestyle changes may not be enough to effectively resolve sleep troubles.
Chronic insomnia is classified in two ways:
Cognitive behavioural therapy for insomnia (CBT-I) is an effective option for those with chronic sleep troubles. During CBT-I, a therapist will help you address harmful thoughts and anxieties that may be disrupting your sleep.
CBT-I often includes:
A 2018 study from Royal College of General Practitioners found that just four to eight CBT-I sessions were effective in reducing both the time it takes to fall asleep and the time spent awake during the night. In fact, the improvements in sleep quality were even maintained for up to 12 months post-therapy.
It also helps you learn new strategies to sleep better, says James Rowley, MD, President of the American Academy of Sleep Medicine (AASM). CBT-I can include techniques for stress reduction, relaxation, and sleep schedule management.
CBT-I may also encompass other types of therapy. For example, stimulus control therapy can teach you how to implement consistent sleep and wake times, avoid naps during the daytime, and what to do if you are not able to fall asleep or wake up too early.
Light therapy can help patients adjust the bodys circadian rhythm, an internal biological clock that responds to light and darkness in order to initiate sleep.
This method of therapy can be particularly useful for those who have insomnia due to circadian rhythm sleep disorders, such as sleep phase delay syndrome.
Studies have found that as people age, circadian rhythms are more likely to be interrupted, and the risk for developing a sleep disorder increases with age. A 2018 study found insomnia in the elderly ranges between 30% to 48%, compared to 12% to 20% in the general adult population.
As a result, light therapy may be one of the best options for older patients with insomnia, as taking medication carries more potential risks, and light therapy can reset circadian rhythms and improve sleep quality safely.
However, Morker warns against treating yourself without a therapist. This can be an effective treatment if done appropriately, but if you dont know what youre doing, you can make things worse by shifting the internal clock in the opposite direction, he says.
Medication is only used to treat insomnia on a short-term basis, as prescription sleeping pills are known to have potentially harmful risks.
Sleeping pills might be prescribed to you to help you adjust to a new sleeping schedule as part of your CBT-I, or for some cases of short-term insomnia triggered by a stressful event.
A few common types of medications for insomnia, called sleeping pills or hypnotics, include:
According to AASMs 2017 Clinical Practice Guideline for the Pharmacologic Treatment of Chronic Insomnia in Adults, eszopiclone and zolpidem were the two hypnotics most recommended for the treatment of insomnia, and Rowley notes both are commonly used by sleep physicians.
Moreover, a 2018 review found that when these medications were used in combination with CBT-I, results were better than with the use of CBT-I alone. The study recommended starting the use of hypnotics early in treatment, and slowly weaning the patient off the hypnotics as they progress with therapy.
However, that study also noted the danger of potential side effects with benzodiazepines and Z drugs such as nausea, headaches, and extended drowsiness that can impair your ability to drive the next day. Even though these medications may be effective in the short-term, the risks often outweigh the benefits.
And even though over-the-counter medication, like melatonin, may seem helpful and harmless, Rowley advises against its use.
There are insufficient studies available on the safety and effectiveness of most over-the-counter sleep aids, including melatonin, says Rowley.
Additionally, Rowley warns against plant-based herbal remedies like kava and valerian root for the treatment of insomnia, because they also lack evidence on their efficacy.
Overall, consulting with a medical practitioner to work out the root of your sleeping problems is the best way to find a treatment path that suits you whether its therapy, lifestyle changes, medication, or a combination of all three.
Rowley recommends speaking to your doctor first, who may then refer you to an accredited sleep centre for further help.
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How to treat insomnia and get better sleep with self-care, therapy, or medication - Business Insider Australia
