About Insomnia
Insomnia is a common sleep disorder that translates into difficulties falling asleep, maintaining sleep, or inability to fall back asleep after waking up during the night. Poor sleep quality and duration, after a while, can cause daytime impairment, headaches, mood changes, memory issues and increased risk for cardiovascular disease, diabetes, and all-cause mortality. Chronic insomnia is defined as sleep issues that occur more than three times per week for at least three months and can affect all age groups, with an increased incidence in the older population.
What are the causes of insomnia?
The most common causes of sleep issues are stimulants (caffeine, alcohol, nicotine, certain drugs), health concerns (sleep apnea, asthma and other cardiovascular or respiratory conditions, pain, urinary frequency, restless leg syndrome, etc), mental health issues (stress, anxiety, depression, bipolar disorder) and unhealthy sleep habits (going to bed late or at different times each night, screen exposure before sleep).
How is insomnia managed?
Commonly, sleep disorders are treated with prescription medication such as Trazodone, Zopiclone, Zolpidem, Doxepine, Ramelteon, benzodiazepines (triazolam), etc. More often than not, the underlying causes of insomnia are missed or not thoroughly explored.
“According to IMS Brogan, a private company that monitors the pharmaceutical industry, pharmacists across Canada filled nearly 7 million prescriptions for sleeping pills last year alone, amounting to $162 million in sales. Most recent statistics show that 60 percent of those prescriptions were written for women” – 2011, Via Best Health.
While prescription drugs are a great short-term tool that can make a huge difference in people’s quality of life, long-term use of these drugs increases the risk for addiction or falls in older adults.
Cognitive behavioral therapy (CBT) is also recommended as first-line treatment and can be very useful in treating insomnia.
Tips to improve insomnia naturally
Sleep hygiene
Maintaining a good sleep hygiene is the first step to improve your sleep:
- Go to bed around the same time every night
- Sleep in a dark, cool room
- Reduce or avoid daytime napping
- Avoid screens (TV, computer, cellphone) before bed
- Increase physical activity, however, avoid exercising at night
Diet and lifestyle
A healthy diet and lifestyle improve sleep latency and quality as well as underlying causes of insomnia such as anxiety, depression, obesity, etc.:
- Eat plenty of whole foods (organic meats, wild-caught fish, fruits, vegetables, nuts and seeds) and avoid refined sugars, processed and packaged foods
- Avoid stimulants before bedtime (caffeine, nicotine and alcohol); alcohol is sometimes used as a sedative to help with sleep initiation; however, it affects the ability to reach deep sleep and causes morning fatigue
- Exercise moderately 3-5 times per week
- Spend time outdoors/ in nature to expose yourself to natural light
Meditation
Just 20 minutes of daily mindfulness meditation can improve fatigue, insomnia, and depression in older adults according to research:
- Start with 5 minutes daily and increase the duration progressively until reaching 20 minutes
- Find a comfortable space and focus on your breathing; bring your awareness to the present moment and avoid judging or engaging with your thoughts
Herbal medicine
Lavender, chamomile, valerian, and passionflower are some of the herbs that have been proven to improve anxiety and insomnia with less side effects and low potential for addiction
Supplements
- Melatonin can improve the natural sleep-wake cycle and benefit children with insomnia, shift workers, and travelers for jet lag
- GABA and L-theanine mixture has been shown to improve sleep initiation and quality
- Magnesium has been studied for insomnia in elderly and proven to improve sleep onset, quality, duration, and early morning awakening
If you experience sleeping issues, consult your naturopathic doctor for an individualized treatment plan that may include dietary and lifestyle changes, nutritional and herbal recommendations, and acupuncture.
References:
1. https://www.sleepfoundation.org/insomnia
2. JAMA Intern Med. 2015;175(4):494–501. doi:10.1001/jamainternmed.2014.8081
3. Bent S, Padula A, Moore D, Patterson M, Mehling W. Valerian for sleep: a systematic review and meta-analysis. Am J Med. 2006;119(12):1005-1012. doi:10.1016/j.amjmed.2006.02.026
4. Kate Louise Fismer, Karen Pilkington, Lavender and sleep: A systematic review of the evidence, European Journal of Integrative Medicine, Volume 4, Issue 4, 2012, Pages e436-e447
5. Guerrero FA, Medina GM. Effect of a medicinal plant (Passiflora incarnata L) on sleep. Sleep Sci. 2017;10(3):96-100. doi:10.5935/1984-0063.20170018
6. Srivastava JK, Shankar E, Gupta S. Chamomile: A herbal medicine of the past with bright future. Mol Med Rep. 2010;3(6):895-901. doi:10.3892/mmr.2010.377
7. https://www.nccih.nih.gov/health/melatonin-what-you-need-to-know
8. Kim S, Jo K, Hong KB, Han SH, Suh HJ. GABA and l-theanine mixture decreases sleep latency and improves NREM sleep. Pharm Biol. 2019;57(1):65-73. doi:10.1080/13880209.2018.1557698
9. Abbasi B, Kimiagar M, Sadeghniiat K, Shirazi MM, Hedayati M, Rashidkhani B. The effect of magnesium supplementation on primary insomnia in elderly: A double-blind placebo-controlled clinical trial. J Res Med Sci. 2012;17(12):1161-1169.
