Insomnia - Kansas Medical Center

05 Apr Insomnia

Posted at 13:21h in Heath Tips by Jillian Ruffo

Insomnia and not getting a good night’s sleep can be frustrating and impact on your day to day living and quality of life. Sleep problems can be caused by changes in your daily routine, times of worry, a new baby, shift work or sleep apnoea, but the good news is there are many things you can do to help yourself.

Sleep problems

It is estimated some form of sleep disturbance will affect approximately 90% of people at some point in their lives. In most cases the disturbance is temporary and will resolve, but for some people sleep problems don’t go away.

Insomnia & sleep disorders

Insomnia is the name given to the inability to go to sleep or to stay asleep. Insomnia is more common in older people and twice as many women experience insomnia than men.

There are several types of insomnia including:

Type of insomnia/sleep disorder	What happens	When people seek help	How it is treated
Primary insomnia	About 2% of the population need less than 5 hours a night and can still be highly productive, manage to function and are generally not tired when awake.	When you are unhappy to lie awake until 1:30am, or you find it affects your quality of life i.e. you would rather go to bed at the same time as your partner.	This type of insomnia may be very resistant to non-drug strategies. The recommendations are to go to bed for fewer hours and to listen to your body clock for clues about when to go to bed. Some simple lifestyle changes may also have an impact.
Insomnia stimulated by an incident	Sometimes people who have not experienced sleep problems before can begin to experience insomnia because something has triggered a change in sleep patterns including: a period of emotional trauma shift work a new-born baby Habits persist beyond the trigger period because the body learns that this is the norm.	When you feel frustrated or anxious and can’t change the habit.	A range of psychological techniques aimed at ‘unlearning’ the conditioned sleep pattern may be useful Strategies to overcome anxiety or frustration and changing lifestyle habits can help
Disorders of the body clock	When your body clock is disrupted, you have difficulty with timing when to go to sleep so you generally feel sleepy during the day and crave recovery sleep on the weekend. It is common in adolescents and young adults.	If you have trouble getting to sleep and are then unable to get up in the morning.	The body clock can be manipulated with carefully timed exposure to bright light. The timing of light exposure and the form of light used are best managed by a sleep specialist or sleep psychologist Melatonin, a hormone secreted by the brain that regulates the body clock is now available in prescription form (Circadin) –however, light is substantially more potent than capsule forms of melatonin

Type of insomnia/sleep disorder

What happens

When people seek help

How it is treated

Primary insomnia

About 2% of the population need less than 5 hours a night and can still be highly productive, manage to function and are generally not tired when awake.

When you are unhappy to lie awake until 1:30am, or you find it affects your quality of life i.e. you would rather go to bed at the same time as your partner.

This type of insomnia may be very resistant to non-drug strategies. The recommendations are to go to bed for fewer hours and to listen to your body clock for clues about when to go to bed. Some simple lifestyle changes may also have an impact.

Insomnia stimulated by an incident

Sometimes people who have not experienced sleep problems before can begin to experience insomnia because something has triggered a change in sleep patterns including:

a period of emotional trauma
shift work
a new-born baby

Habits persist beyond the trigger period because the body learns that this is the norm.

When you feel frustrated or anxious and can’t change the habit.

A range of psychological techniques aimed at ‘unlearning’ the conditioned sleep pattern may be useful
Strategies to overcome anxiety or frustration and changing lifestyle habits can help

Disorders of the body clock

When your body clock is disrupted, you have difficulty with timing when to go to sleep so you generally feel sleepy during the day and crave recovery sleep on the weekend. It is common in adolescents and young adults.

If you have trouble getting to sleep and are then unable to get up in the morning.

The body clock can be manipulated with carefully timed exposure to bright light. The timing of light exposure and the form of light used are best managed by a sleep specialist or sleep psychologist
Melatonin, a hormone secreted by the brain that regulates the body clock is now available in prescription form (Circadin) –however, light is substantially more potent than capsule forms of melatonin

Sleep disturbance

Managing sleep problems

The following may help you get a good night’s sleep, sometimes a change in routine is all it takes.

Reduce your caffeine intake	Have only two caffeinated drinks per day preferably before lunch – this includes cola, tea, coffee and chocolate Try caffeine-free herbal teas such as chamomile
Avoid heavy meals late at night	Allow 2 hours after dinner before going to bed Sip a glass of warm milk if you need something after dinner
Limit your alcohol consumption	Have no more than 1-2 standard drinks a day (and at least 2 alcohol free days per week), as too much alcohol reduces sleep quality Although alcohol is a sedative and can make you fall asleep faster, it tends to make you wake later in the night
Be physically active	A falling body temperature helps to encourage falling asleep and remaining asleep, so if you exercise you increase your temperature but you need to allow time to cool down. Don’t exercise in the 4 hours before going to bed as exercise is also stimulating.
Maintain a regular time to go to bed and wake up	Try to go to bed and to get up at the same time each day as this helps settle your sleep pattern.
Restrict time in bed	Leave bed for sex and sleep, not eating, reading or watching TV, so as to train yourself to sleep when you get there.
If you are not able to fall asleep, get out of bed	Do a quiet, relaxing task in another room, as frustration at your inability to sleep can make the problem worse.
Hide the clock	Turn any clocks away from view so as to not clock gaze during the night, as this accentuates the sense of frustration.
Try relaxation	Relaxation exercises or meditation can help some people to relax and get off to sleep.

Medications for sleep disturbance

Sleep medications (e.g. benzodiazepines or stilnox) may be prescribed for short-term use. However, these medications may cause you to become too dependent on them so they should be taken with care. Speak to your doctor for more information.

Eating to help you sleep

Some foods are considered to contribute to restful sleep and others contribute to wakefulness.

Tryptophan, an amino acid found in many foods, helps sleep. Tryptophan produces serotonin, which is related to relaxation, restfulness, and sleep. Tryptophan also produces a hormone called melatonin. Serotonin and melatonin send calming messages to the brain to support sleep.

When you eat a meal high in carbohydrates, your blood sugar levels rise and insulin, a hormone, is released. Insulin helps transport amino acids, including tryptophan, into the brain. The best night time meals are those that contain both carbohydrates and protein, and some calcium. Calcium helps the brain use the tryptophan to manufacture melatonin.

Dairy products, which contain both tryptophan and calcium, are considered one of the best foods to induce sleep.

Good sources of tryptophan	Moderate sources of tryptophan
Fish Seafood Chicken Turkey Red meat Legumes Eggs Soy (beans and tofu) Dairy (yoghurt, parmesan)	Nuts Seeds Oats Bananas Spinach Cottage cheese

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