Introduction
Insomnia is difficulty falling or staying asleep. It can also refer to lack of quality sleep, resulting in fatigue, poor concentration and irritability, and waking frequently or early due to noise sensitivity, dreams or nightmares.
Most people will experience insomnia at some point in their lives, often as a result of stress. Lasting anywhere from days to years, it can be a factor in car accidents, marital discord, poor work performance, forgetfulness, irritability, listlessness, depression and poor general functioning.
Causes/Risk Factors
Stimulants such as caffeine, found in tea, coffee, chocolate and cola, as well as antihistamines (including the herb ephedra and other drugs), may lead to sleeplessness. Alcohol is believed to induce sleep, but withdrawal symptoms and dehydration cause waking in the night. Eating or exercising late in the evening boosts energy, which can keep you awake. On the other hand, low blood-sugar levels from not eating enough can be a source of problems, too.
Shift work and continually changing schedules are disruptive to any sleep pattern. Napping during the day will also alter this pattern and may keep you awake at night, unless you're overtired.
A noisy or uncomfortable environment that allows too much light or is too hot or too cold for comfort can lead to sleeplessness.
About 10 to 15 per cent of the population has chronic insomnia due to a pre-existing health concern. These conditions include emphysema, heart failure and restless leg syndrome. An overactive thyroid increases metabolism and causes difficulty with sleep.
People with sleep apnea wake frequently throughout the night due to an inability to breathe properly, which is unrelated to a respiratory or heart disease. Although the cause is unknown, it can be related to obesity and high blood pressure, and is worsened by alcohol, sedatives and nicotine.
The most common causes of insomnia are emotional in nature, such as worry or anxiety over an existing problem, or serious grief, stress or depression. Stress can result in feelings of fear or apprehension about specific events or ongoing challenges at work or at home. Depression, anxiety and other mental-health issues can also affect your ability to get proper rest. And worrying about getting to sleep before and while you're in bed only serves to exacerbate the problem.
What You Can Do
Try to get a good sleep every night. Your body needs it to rest, rejuvenate and repair itself. It's during sleep that you process knowledge, create memories and restore your mental and physical energy. Most adults need about seven or eight hours of sleep; children and teens generally need more. Bear in mind, however, that sleep quality normally decreases with age.
Stress, depression and anxiety are leading causes of insomnia. Take care of your emotional health by seeking counselling, if necessary.
Exercise that increases the heart rate, especially if combined with fresh air, will improve sleep quality and quantity and help to regulate sleep patterns. Engage in 30-60 minutes of physical activity daily, but avoid doing it within three hours of your bedtime.
If insomnia is the result of a hectic lifestyle, take time to unwind. Have a light supper in a relaxed atmosphere. Create a soothing pre-bedtime routine, such as having a bath or reading a book.
Avoid stimulants, such as tobacco, caffeine and alcohol. Don�t eat three hours or less before going to bed. Having to get up to urinate disrupts sleep, so abstaining from liquids before bed can help, too.
Try to go to sleep and arise at the same time each day.
Ensure your mattress and pillows are comfortable and that your room is quiet and dark. Turning on the light in the middle of the night disrupts the biological clock.
If you still have problems sleeping, keep a sleep diary and show it to your doctor. They may recommend therapy to help you deal with the problems (especially stress) that are preventing you from getting a good night's sleep.
If you're experiencing pain, difficulty breathing, spasms or other problems affecting your ability to sleep, contact your doctor.
What You Can Take
There are prescription medications to treat insomnia, but these are generally less effective than lifestyle changes. They can also be addictive and should only be used as a last resort. Talk with your doctor to see if medication would be beneficial for you.
A glass of warm milk with honey is one of the oldest and best remedies for insomnia. Milk contains tryptophan which, when converted to seratonin in the body, induces sleep and prevents waking.
Lettuce has a long-standing reputation for promoting healthy sleep. Modern chemical analysis shows that this soporific effect is due to an opium-related substance combined with traces of the anti-cramping agent hyoscyamin. People who suffer from sleepless nights should make lettuce a regular part of their evening meal. The meal should also include legumes, peanuts, nutritional yeast, fish or poultry. They contain vitamin B3 (niacin), which is involved in seratonin synthesis and promotes healthy sleep. Mixed with a little lemon juice for flavour, lettuce juice can be an effective sleep-inducing drink highly preferable to the synthetic chemical agents in sleeping pills.
Further Resources
Visit the College of Family Physicians of Canada's Web page on insomnia at www.cfpc.ca/English/cfpc/programs/patient%20education/insomnia/default.asp?s=1.
