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Sleepless Nights No More – Tackling Insomnia

In the era of smartphones and workaholics, sleep has become a luxury rather than a necessity. Sound sleep seems to be an alien concept to many. Almost everyone today is either suffering himself or probably knows someone who struggles with sleep issues, or in other words, is an insomniac. This is truly a rising epidemic.

What is insomnia?
Merriam-Webster’s dictionary defines insomnia as “prolonged and usually abnormal inability to get enough sleep.” Insomnia encompasses both – an inability to fall asleep, despite being tired, as well as the inability to stay asleep throughout the night.

Insomnia can be acute or chronic. Acute or short-term insomnia is usually temporary and lasts only for a few nights. It usually does not have lasting effects. Jet lag is an example. In comparison, chronic insomnia lasts longer than 30 days. This can eventually affect your quality of life and bring forth a host of other health issues such as hypertension, obesity, stroke and others. Depending upon your reference, there are four or five phases of sleep cycles. In a five-phase model, Phase 3, 4, and 5 are where you have an increase in growth hormone. This is where the body repairs or restores itself.

What are the symptoms of insomnia?
The symptomatology of insomnia varies for each person and may include any of the following:
– Difficulty in falling asleep despite being fatigued
– Waking up multiple times throughout the night
– Early morning wakefulness (unintentional)
– Feeling tired and irritable throughout the day
– Reduced focus on concentration in the daytime

What causes insomnia?
Insomnia can occur due to a multitude of causes.

Although your lifestyle habits might seem completely unrelated, they create a major impact on your sleeping. Insomnia can result due to any of the following:
– Excess intake of caffeinated beverages throughout the day or before bedtime
– Ingestion of heavy meals or alcohol before bedtime
– Low blood sugar – when your blood sugar dips too low, it can cause in increase in adrenal stimulation which causes an increase in blood sugar. While I mentioned that eating a heavy meal before bed, not having enough food is an issue also. Eat some healthy protein or fats 2 hours before going to sleep. You can also try eating some almonds if you wake up in the middle of the night to see if it helps you get back to sleep. They can stabilize your blood sugar.
– Lack of physical exercise
– Excessive napping in the day
– Stress – Increases your cortisol levels which can alter your circadian rhythm. Remember, melatonin, the sleep hormone, opposes cortisol. When cortisol goes up, melatonin goes down. Try meditation or yoga before bed. They can really make a difference in clearing your head.

Poor sleep hygiene
Like lifestyle changes, your bedtime habit and rituals are also crucial to your ability to sleep peacefully, the most common of these being the use of electronic devices right before bedtime, which emit blue light. The blue light can stimulate cortisol release by confusing our brains into thinking its day time. Try using glasses that these lights in the evening. Check out my video on Biohacked Truedark glasses. They can make a difference. Also, there are programs you can put on your computer that slowly reduce blue light into the evening. One of them is f.lux. I just got a new cell phone which has night mode built in to the operating system which removes blue light. If your phone doesn’t have it, you can get a app that will do the same thing. Moreover, not having a regular bedtime leads to no fixed sleep pattern and makes it difficult to fall asleep.

Your surroundings also play an important role while sleeping. Bright ambient lights (clocks, electronic devices with power lights, etc), excess noise, uncomfortable bedding or pillows are all responsible for poor sleep.

Pre-existing health conditions
Both psychological and medical disorders can lead to insomnia. Commonly implicated psychological issues are depression, grief, anger, and stress.
Medical disorders include asthma, hyperthyroidism, chronic pain, and cancer. Few other sleep disorders like sleep apnea and restless leg syndrome are also known to cause insomnia.

Several pills are known to affect sleep in humans–the long list includes antidepressants, steroids, medications containing caffeine, diuretics, and much more.

Genetic basis
A study published recently in Nature Genetics, which comprised of more than 100,000 individuals, demonstrated the presence of 7 genes linked to insomnia.

Now that I know what causes it, how do I tackle insomnia?
The treatment for insomnia begins by finding out the cause for it. In some scenarios, eliminating the implicating factor/medication or treating the primary health issue is enough to tackle it. However, it might not be so straight forward every time. Treatment includes lifestyle changes, cognitive behavioral therapy, medications and/or alternative therapies.

One simple test I like to run is cortisol. It is an adrenal hormone that can keep you awake. Remember, when it goes up, melatonin goes down, which can keep you awake. The test is uses samples of saliva throughout the day so we get accurate measurements in how you are dealing with the daily stressors. When I run it for a patient that has sleep issues, I make sure we get additional samples to determine if adrenal issues play a role in your sleep issues.

Lifestyle modification
These range from small lifestyle changes for ensuring a better sleep to more conscious efforts towards the same. Incorporating these will not only treat insomnia but also prevent it. Try the following:
– Sleep and wake up at the same time daily.
– Avoid computers and smartphones just before bedtime. Instead, opt for soft music or light reading or any other relaxing activity.
– If you are stressed, seek help from your loved ones or from professionals. Ignoring it is not the solution.
– Avoid alcohol, caffeinated beverages or heavy meals at dinner. Make sure to eat some healthy proteins and fats 2-3 hours before bedtime. Alcohol, though a relaxant, disturbs the normal sleep cycle and makes it difficult to stay asleep.
– Maintain a sleeping environment that is optimal for you.
– Ensure that the bedroom is a space for sleeping and sex only.
– Creating a relaxing bedtime routine can help your body relax and unwind. An example of this can be having a cup of herbal tea or a relaxing bath.
– Incorporate some form of physical exercise in your daily routine.
– Supplements like ashwagandha, phosphatidyl serine, L theanine, magnesium, tryptophan, Kava, chamomile, and valerian can make a difference. There are many more.
Cognitive behavioural therapy
A type of psychotherapy that can help you take charge of your thought and emotions, cognitive behavioral therapy can help in addressing your sleeping problems. Performed generally by a psychologist, this therapy includes stimulus-control therapy, sleep restriction, biofeedback, and relaxation techniques.

These are only recommended for short-term use and are never the first line of treatment. This is because they are associated with several side effects, and their effects on sleep last only for a short time. These include:
– Benzodiazepines (Diazepam, Lorazepam)
– Non-benzodiazepine sedatives including Zolpidem, Eszopiclone, etc.
– Antidepressants are useful if the cause of insomnia is depression. However, they are also known to cause daytime somnolence.
– Antihistamines – Drowsiness is a side effect of these drugs, which are usually prescribed for allergies.
– Other drugs such as Suvorexant (Orexin receptor antagonist) and Ramelteon.
You need a prescription for all these pills, except for the antihistamines. It is imperative that one is cautious while taking these pills and reports to the doctor any adverse effects or overdose. If you decide to use these, and even natural support, understand that you may not be fixing the root cause of the problem. You are just treating the symptom. Many of these aids leave you unrefreshed as they do not allow you to go into the later important sleep cycle phases.

Sleepless nights no more!
Only by admitting that there is a problem and taking control of the situation will you be able to cure your sleeplessness. A restful, sound sleep is something that everyone deserves, and you can take the first step in that direction by following the simple lifestyle changes mentioned here. If you would like to get to the root cause of your sleep issue, please go to my website – You can take a look at my bog articles to learn more about your health. You can even schedule for a free 15 minute consultation or become a new patient.

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