|
Page: Treatment
Main article
| Home > Elderly Health > Treatment |
In many cases, insomnia is caused by another disease or psychological problem. In this case, medical or psychological help may be useful.
All sedative drugs have the potential of causing psychological dependence where the individual can't psychologically accept that they can sleep without drugs. Certain classes of sedatives such as benzodiazepines and newer non-benzodiazepine drugs can also cause physical dependence which manifests in withdrawal symptoms if the drug is not carefully titrated down.
Many insomniacs rely on sleeping tablets and other sedatives to get rest. The most commonly used class of hypnotics prescribed for insomnia are the benzodiazepines. This includes drugs such as temazepam, diazepam, lorazepam, flurazepam, nitrazepam and midazolam. These medications can be addictive, especially after taking them over long periods of time.
Recent research has shown that cognitive behavior therapy can be more effective than medication in controlling insomnia. In this therapy, patients are taught improved sleep habits and relieved of counter-productive assumptions about sleep.
Non-benzodiazepine prescription drugs, including Ambien and Lunesta, have a cleaner side effect profile than the older benzodiazepines; however, there are controversies over whether these non-benzodiazepine drugs are superior to benzodiazepines. These drugs appear to cause both psychological dependence and physical dependence, and can also cause the same memory and cognitive disturbances as the benzodiazepines along with morning sedation.
Melatonin has proved effective for some insomniacs in regulating the sleep/waking cycle, but lacks definitive data regarding efficacy in the treatment of insomnia.
Melatonin agonists, including Ramelteon (Rozerem), seem to lack the potential for abuse and dependence. This class of drugs has a relatively mild side effect profile and lower likelihood of causing morning sedation.
The antihistamine diphenhydramine is widely used in nonprescription sleep aids, with a 50 mg recommended dose mandated by the FDA. In the United Kingdom, Australia, New Zealand, South Africa, and other countries, a 50 to 100 mg recommended dose is permitted. While it is available over the counter, the effectiveness of these agents may decrease over time and the incidence of next-day sedation is higher than for most of the newer prescription drugs. Dependence does not seem to be an issue with this class of drugs.
Some antidepressants such as mirtazapine, trazodone and doxepin have a sedative effect, and are prescribed off label to treat insomnia. The major drawback of these drugs is that they have antihistaminergic, anticholinergic and antiadrenergic properties which can lead to many side effects. Some also alter sleep architecture.
Low doses of atypical antipsychotics such as quetiapine (Seroquel) are also prescribed for their sedative effect but the danger of neurological and cognitive side effects make these drugs a poor choice to treat insomnia.
Some insomniacs use herbs such as valerian, chamomile, lavender, hops, and passion-flower. Valerian has undergone the most studies and appears to be modestly effective.
Alcohol may have sedative properties, but the REM sleep suppressing effects of the drug prevent restful, quality sleep. Middle-of-the-night awakenings due to polyuria or other effects from alcohol consumption are common, and hangovers can also lead to morning grogginess.
Some traditional remedies for insomnia have included drinking warm milk before bedtime, taking a warm bath in the evening; exercising vigorously for half an hour in the afternoon, eating a large lunch and then having only a light evening meal at least three hours before bed, avoiding mentally stimulating activities in the evening hours, and making sure to get up early in the morning and to retire to bed at a reasonable hour.
Pomegranates are also believed to help insomniacs sleep.
Warm milk contains high levels of tryptophan, a natural sedative. Using aromatherapy, including jasmine oil, lavender oil, Mahabhringaraj and other relaxing essential oils, may also help induce a state of restfulness. Adding honey to warm milk helps the body to absorb the tryptophan more quickly.[citation needed] Tryptophan absorption is normally inhibited or deterred by other amino acids but in the presence of sugar tryptophan is absorbed more quickly. Horlicks has been shown to help.
Many believe that listening to slow paced music will help insomniacs fall asleep. This theory is currently being studied by professor Jedediah Fajman at the University of Illinois.
The more relaxed a person is, the greater the likelihood of getting a good night's sleep. Relaxation techniques such as meditation have been shown to help people sleep. Such techniques can lower stress levels from both the mind and body, which leads to a deeper, more restful sleep.
Alternative approaches
Traditional Chinese medicine has included treatment for insomnia throughout its history. A typical approach may utilize acupuncture, dietary and lifestyle analysis, herbology and other techniques, with the goal of resolving the problem at a subtle level. Although these methods have not been scientifically proven, some insomniacs report that these remedies are sufficient to break the insomnia cycle without the need for sedatives and sleeping tablets.
In the Buddhist tradition, people suffering from insomnia or nightmares may be advised to meditate on "loving-kindness", or metta. This practice of generating a feeling of love and goodwill is claimed to have a soothing and calming effect on the mind and body. This is claimed to stem partly from the creation of relaxing positive thoughts and feelings, and partly from the pacification of negative ones. In the Metta- Sutta, Siddhartha Gautama, the Buddha, tells the gathered monks that easeful sleep is one benefit of this form of meditation.
There are a number of alternative cures for this disorder that are currently marketed. Often, a combination of dietary and lifestyle changes is claimed to be the most helpful approach. However, it should be noted the reason they are considered "alternative" medical treatments is the lack of empirical evidence to back up such claims. There are always studies going on to either confirm or deny the effectiveness of such medicine, but in many cases even if no effect is shown to exist in a treatment, proponents will still believe in their effectiveness.
The Cure for Insomnia
The Cure for Insomnia is a film, directed by John Henry Timmis IV, that was designed to cure insomnia. It runs for 87 hours and has no plot, instead it consists of artist L. D. Groban reading his lengthy poem A Cure for Insomnia, spliced with clips of heavy metal and pornographic videos. This movie was first shown at The School of the Art Institute in Chicago, Illinois from January 31 to February 3, 1987. It is unknown whether it has been shown after that.
|
Important notice:
The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other
qualified health provider with any questions you may have regarding a medical condition.
|