How to cure  insomnia

(Insomnia Treatment continued - See previous page)

If insomnia is a symptom of a more serious underlying condition, the most important part of treatment will of course be diagnosing and treating the underlying problem. In the meantime, a doctor may prescribe any number of pharmaceutical remedies to help the patient sleep while the underlying condition is being effectively addressed.

If insomnia is not associated with an underlying disease process or an emotional disorder, most physicians and mental health professionals recommend starting out with the least invasive treatment options and using drug therapy only as a last resort.

Not all drugs for insomnia are physically addicting, but psychological dependence on sleeping pills can become a problem even with OTC medications. Some drugs for insomnia have significant negative side effects. Others produce effects that wear off over long periods of time, so that if they are used every night for month after month, they eventually stop working.

The least invasive treatment option is to educate the insomniac on proper sleep hygiene. Sleep hygiene is a term that refers to the ideal conditions for inducing 7-8 hours of restful sleep without drugs.

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Setting up good sleep hygiene may include a review of the patient’s diet and caffeine use, (caffeine may be reduced or cut out entirely, heavy or sugary foods before bed may be eliminated), alcohol use (alcohol before bed can actually cause sleep problems even though it is often used as a cure), and sleep environment.

The hour before bed will be examined for activities that cause arousal rather than relaxation, and the patient will be instructed about activities (reading, meditation, soothing music) that help induce sleep. The room in which the patient sleeps should be comfortable, dark, and cool, with no television or computer in it.

Sources of daytime stress will also be addressed and a strategy for stress management created. Many people who struggle with insomnia have undiagnosed anxiety disorders or at the very least, poor stress management skills. Learning to deal with anxiety and reduce stress (though exercise, meditation, self-hypnosis, etc.) can be a big part of curing insomnia.

If a review of sleep hygiene with appropriate lifestyle changes does not cure the insomnia, the next step up is cognitive therapy combine with temporary drug therapy. Cognitive therapy helps patients ‘reframe’ stressful thoughts and events and their feelings and thoughts about sleep so that good, restful sleep comes easier. Hypnotherapy can also help, although its effects tend to wear off over time for chronic insomnia.

Drugs that may be prescribed include zolpidem (Ambien), various antidepressants, the hormone melatonin, or natural substances such as 5-HTP and L-tryptophan (found in milk and turkey). The antihistamine diphenhydramine (found in OTC medications like Tylenol PM) can usually be safely taken for as long as needed so long as the dose stays under 50mg per night.

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One serious problem with drug therapy for insomnia is something called ‘rebound insomnia’. Many insomniacs don’t realize they have become dependent on medication to sleep. When they stop taking the medication, the insomnia returns and is more troublesome than it was before the drug therapy.

Ideally, drug therapy of any kind, including OTC medications, should only be used as a temporary measure. Natural foods and herbal substances can be safely used before bed instead. These include Valerian (available in capsule, tincture, or tea form), warm milk, Turkey (contains L-tryptophan), chamomile tea, lavender, hops, and passionflower tea.

Some evidence suggests that magnesium deficiency can contribute to insomnia. Improving one’s diet to contain foods rich in magnesium such as nuts, dark chocolate, deep green leafy vegetables, and legumes can also help.

Other considerations

Most people have had short bouts of insomnia at some point in their lives, usually as a result of stress or lifestyle changes. If however you find that insomnia has become a chronic problem, the first step is to talk to a doctor and rule out any physical problems or undiagnosed disease.

By far most cases of insomnia are caused by chronic anxiety related to poor diet, stressful work situations, and lack of exercise. Simply adding 30 minutes of brisk exercise to each day (a treadmill, a brisk walk, a bike ride to work), and learning some basic techniques to release fear and anxiety can make a dramatic difference in sleep quality and duration.

Insomnia is treatable, and often the cure is much more simple than the insomniac imagines. Start with simple changes: a calmer environment, stress management, regular exercise, better diet—then ask for professional help if you need it. Cognitive behavioral therapy (CBT) has a very high success rate when used for insomnia, and usually the course of treatment is short term.

Save drug treatment for a last resort. While it’s easy to get a prescription for sleep medication these days, over the long run it’s much more effective and much less costly to cure the problem at the root.

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