Insomnia

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Who has ever experienced tossing and turning in bed counting sheep, unable to fall asleep?

For the majority of people this happens very rarely, however for people suffering from insomnia (9-15% of the population ) this can be their routine.

People experiencing insomnia normally report difficulties in initially falling asleep and/or the maintenance and length of sleep. Due to this problem they do not sleep for a sufficient amount of hours each night and therefore don’t feel refreshed the next morning.

Under a bio-molecular view point, insomnia and sleeping disorders are generally caused by abnormalities in varied pathways involving GABA receptors and the levels of certain substances such as cortisol, citochines, melatonin secretion and excitatory amino acids.

Everyone at any age can suffer from insomnia; however it is definitely more common in the elderly.

What causes insomnia can be just a single factor or, more often a mix of factors.

The top 9 causes of insomnia are:

  • High stress levels.
  • Suffering from anxiety.
  • Having problems (at work, in the family).
  • Suffering from diseases (both physical and mental).
  • Consuming stimulants before going to bed such as caffeine, drugs and alcohol.
  • Taking medications that affect sleep.
  • Not having the appropriate nutrition.
  • Having a poor sleeping environment (i.e: too much light, noise).
  • Having a poor sleep routine: nap during the day and the habit of going to bed at inconsistent times.

The consequences of persistent insomnia are often severe and have a negative impact on the quality of life.

The principal consequences are:

  • Impairment in normal daily activities.
  • Cognitive deficits.
  • Increased irritability.
  • Increased risk of developing future mental disorders and use of substances.
  • Lack of concentration.
  • Fatigue.
  • Decline in energy.

If you are experiencing insomnia you could try and put in practice these easy tips that should help to manage this condition:

  • Try to not consume large and rich meals before going to bed.
  • If you are obese or overweight, try to lose weight.
  • Do not use stimulanting substances before going to bed: alcohol, caffeine, nicotine or other drugs.
  • Avoid doing sport and physical activity before going to bed.
  • If you have problems or worries try to solve them before going to bed. If you can’t resolve them, you could find useful to list them and write a possible solving strategy.
  • Use the bedroom mainly for sleep. Try to avoid eating or working in it.
  • Ensure you have a comfortable mattress and room temperature.
  • Try to eliminate any sources of light and noise that could disturb your sleep.
  • Try to establish a routine: wake up and lie down at defined hours.
  • Do not nap during the day (also if you are tired).
  • Try to relax yourself before going to bed.
  • Go to bed only when you feel tired.

Even though undertaking physical activity is important for everyone, it is of particular importance for people suffering from insomnia. Doing physical activity helps to spend energy and naturally tire out the body, consequently helping the individual to sleep better. However try to do not do physical activity before going to bed as it can have a stimulant effect.

If you have already tried this advice and you are still having problems it could be useful to seek the help of your GP. He/she is probably able to help you; sometimes cognitive behavioural therapy may be recommended as it can be helpful in eliminating insomnia.

Sleeping tablets are sometimes suggested even though they are not always free from side effects. However they do solve the causes of insomnia, but can create withdrawal symptoms later on.

Supplements

It is difficult to find scientific evidence regarding the efficacy of supplements to improve sleeping disorders. However the principal supplements available on the market are:

  • 5 HTP: It is a precursor and an intermediate in the synthesis of serotonin and melatonin. Both these substances play an important role in the quality of sleep. In particular melatonin is the hormone that regulates the circadian rhythm.
  • Valeriana officinalis
  • Sage leaf: it can be useful in reducing hot sweats in menopausal women.

By decreasing the number and the severity of hot sweats, the sleep quality can be improved.

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  1. Escott-Stump, S. (2015). Nutrition and diagnosis-related care. Wolters Kluwer.
  2. Liu, L., Liu, C., Wang, Y., Wang, P., Li, Y., & Li, B. (2015). Herbal medicine for anxiety, depression and insomnia. Current neuropharmacology13(4), 481-493.
  3. Petramfar, P., Zarshenas, M. M., Moein, M., & Mohagheghzadeh, A. (2014). Management of insomnia in traditional Persian medicine. Forschende Komplementärmedizin/Research in Complementary Medicine21(2), 119-125.
  4. Shi, M. M., Piao, J. H., Xu, X. L., Zhu, L., Yang, L., Lin, F. L., ... & Jiang, J. G. (2016). Chinese medicines with sedative–hypnotic effects and their active components. Sleep medicine reviews29, 108-118.
  5. http://www.nhs.uk/Conditions/Insomnia/Pages/Introduction.aspx

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