Insomnia : by Ray Sahelian, M.D., insomnia treatment, cause of insomnia and sleep

Insomnia Cause and Insomnia Cure by Ray Sahelian, M.D. ( natural health supplement info )

Natural Insomnia Remedy

Cause of Insomnia
There is not one cause of Insomnia, but many. Any of the following factors can be a cause for insomnia:
     Medical conditions that cause insomnia -- alcohol withdrawal, asthma or lung disease, chronic pain, heart failure, enlarged prostate, gastroesophageal reflux, menopause, paroxysmal nocturnal dyspnea, sleep apnea, pruritis or chronic itching, restless legs syndrome, hyperthyroidism, lack of exercise, and pheochromocytoma. Those with chronic insomnia are more likely to also be suffering from depression or an anxiety disorder.
     Medications that cause insomnia -- ephedra, amphetamines, theophylline, pseudoephedrine, cocaine, and caffeine. High doses of hormones -- such as DHEA, testosterone, progesterone, pregnenolone -- can also cause insomnia. Even certain herbs can cause insomnia. I have listed a few possible culprits below.
     Psychiatric disorders that cause insomnia can include anxiety disorder, depression, stress, and mania.
     Poor sleep hygiene is a common cause of insomnia.

Good Night Rx - For occasional sleepless nights

Physician Formulas

Developed by Ray Sahelian, M.D.

Good Night Rx Supplement Facts:

Suggested Use: Take one capsule of Good Night Rx one to three hours before bedtime on an empty stomach no more than 3 nights a week. Good Night Rx does not work as well when taken with a meal.

For more information regarding Good Night Rx
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Insomnia Symptoms
Fatigue, daytime sleepiness, low mood, and poor motivation and productivity and common symptoms of insomnia. Insomnia is one of the major causes of low libido. Click libido to find out how to improve sex drive and enjoyment.

Insomnia Treatment
There are a number of steps you can take in order to reduce your risk of insomnia. A good night's sleep enhances energy, mood, vitality, sex drive, and reduces the risk for chronic medical conditions.
Here are some practical steps to reduce insomnia, perhaps some of these suggestions may offer you an insomnia cure, and help you avoid overly relying on pharmaceutical insomnia medications. If not an insomnia cure, at least they will provide insomnia help. However, certain insomnia medications can have serious side effects such as car accidents the next day. This has occurred with Ambien.

1. Stick to a schedule, and don't sleep too late on weekends. If you sleep late on Saturday and Sunday mornings, you'll get Sunday night insomnia. Instead, go to bed and get up at about the same time every day. You may not need to rely on an alarm clock to wake up when you get enough sleep.

2. Don't eat or drink a lot before bedtime sleep. Eat a light snack about 2 to 4 hours before sleep. If you drink too much liquid before sleep, you'll suffer insomnia by waking up repeatedly in the night for trips to the bathroom.

Don't eat too many spicy or fatty foods. They may cause heartburn and insomnia.

If you get the munchies, eat something that triggers serotonin, which makes you sleepy. Carbohydrates (whole grain bread, pasta, potatoes, lentils, barley, fruits, or cereal) with small amount of foods containing the amino acid L-tryptophan (milk, tuna, or turkey) will do the trick. A fruit salad and vegetable soup are good options. Another idea is whole grain bread with tomatoes (or salsa) and melted cheese .

Don't drink more than one or two ounces of alcohol before sleep. It may cause insomnia since you may wake up repeatedly, snore and possibly develop sleep apnea.

3. Avoid caffeine, nicotine, and stimulants. Caffeine may keep you perky in the morning, but it can lead to insomnia, even if you drink coffee in the early afternoon. Some people are so sensitive that even a cup of coffee at lunch can lead to insomnia.
   Caffeine is found in tea (including green tea), certain soft drinks, chocolate, cocoa, and of course coffee. Caffeine is also found in certain herbs such as guarana and kola nut.
   Smokers experience withdrawal symptoms at night, and they have a harder time both falling asleep and waking up.
   Diet pills that contain ephedrine type chemicals and citrus aurantium can lead to isomnia. So can the nutrients phenylalanine, tyrosine, certain hormones, ginseng and other adaptogenic herbs, tongkat ali, and the anti-depressants St. John's wort and SAM-e. High doses of vitamins may act as stimulants, interfering with sleep. Take most of your supplements early in the day, before or with breakfast.

4. Exercise. If you're trying to sleep better, the best time to exercise is in the afternoon. Physical activity enhances the deep, refreshing stage of sleep. My best sleeps have been after a full day of walking, hiking, or biking. Also, take a 20 minute walk in the morning to expose yourself to morning light which will help reduce your insomnia.

5. A slightly cool room is ideal for reducing insomnia. This mimics your internal temperature drop during sleep, so turn off the heat and save on fuel bills.

Take a cool or cold shower before bed if your body temperature is high. Good sleep is better achieved while the body temperature is cool.
If you overheat at night, wear light nightclothes and sleep under a single sheet. If you are still hot in the middle of the night, take a cool shower.
If you have athlete's feet, or fungal infection of the nails or toes, keep your feet out of the blanket and expose it to the cool night air.
Use an air conditioner or fan to keep the room cool.
Use a dehumidifier if you are bothered by moist air. Use a humidifier if you are bothered by dry air. Signs of dry air irritation include a sore throat, nosebleeds or a dry throat.

6. Sleep only at night. Daytime naps can certainly make it more likely to have insomnia. Limit daytime sleep to 20-minute, power naps. Don't take a nap after 2 PM.

If you work nights, keep window coverings closed so that sunlight, which interferes with the body's internal clock, doesn't interrupt your sleep.
If you have a day job and sleep at night, but still have trouble waking, leave the window covering open and let the sun's light wake you up.

7. Keep it quiet. Silence is more conducive to prevent insomnia. Turn off the radio and TV. Use earplugs, a fan or some other source of constant, soothing, background noise to mask sound that you cannot control, such as a busy street, trains, airplanes or even a snoring partner. Double-pane windows and heavy curtains also muffle outside noise.

8. Make your bed comfortable.

If you share your bed, make sure there is enough room for two.

Use your bed only for sleep and sex.

Go to bed when you are tired and turn out the lights. If you are feeling like you're going to have insomnia, get up and do something else. Go back to bed when you are tired.

Do not agonize about falling asleep. The stress will only cause worse insomnia.

9. Soak and sack out. Taking a hot shower or bath an hour or two before sleep helps bring on sleep because they can relax tense muscles.

10. Don't overly rely on sleeping pills. Check with your doctor before using sleeping pills. Make sure the pills won't interact with other medications or with an existing medical condition.

Use the lowest dosage and never mix alcohol and sleeping pills. The occasional use of prescription sleep pills should not be harmful but regular use can lead to rebound insomnia.

If you feel sleepy or dizzy during the day, talk to your doctor about changing the dosage or discontinuing the pills.
Melatonin at a dose of 1 to 2 mg an hour or two before bed can help induce sleep. Limit use to once a week. Sometimes a lower dose such as 0.3 mg taken earlier in the evening, about 6 or 7 PM works better than a higher dose taken later.
The herb Hops in tea or pill can also help with sleep. Hops is taken about an hour or two before bed. A Valerian/Hops combination 500mg/100mg may also work well.
Kava taken a few hours before bed can also be helpful, so can the occasional use of 5-HTP at a dose of 50 mg an hour before bed on an empty stomach or half an hour before dinner.
Tryptophan is now available over the counter.
Passion flower can help relax if taken several hours before sleep.

11. Use ear plugs and eye shades to block noise and light. You may be amazed on how much better you'll sleep and feel in the morning when you use ear plugs since you will be able to get a deeper sleep without frequent overnight interruptions from traffic noise, airplanes, dogs barking, roommates snoring, etc. Being woken up and exposed to bright light at night can throw off a person's biological clock for the next few days, a new study shows. What's more, the researchers found that being woken up at night at all--even in a dark room--also disrupts the body's timing, although to a lesser degree.

12. Use sleep relaxation techniques to reduce insomnia.
Once you are in bed, take a deep breath and gradually let it out. Do this a few times. Then, lightly shake one of your feet, and go back to taking a couple of deep breaths. Lightly shake the other foot and then take a couple of deep breaths. Move up to your legs, hips, arms, neck, muscle around the mouth, eye muscles, etc., while going back to the breath after shaking each body part. Soon you'll be in la la land.

13. Aromatherapy
The smell of jasmine in the bedroom has been found to help reduce insomnia. Lavender may also help slightly.

14. Soft Music
In a paper published in the February issue of the Journal of Advanced Nursing, a team from Taiwan’s Tzu Chi University said they studied the sleep patterns of 60 people aged between 60 and 83 who had insomnia. Half were given relaxing music to listen to for 45 minutes at bedtime and half were given no help to sleep. The team found that those who listened to a selection of soft, slow music experienced physical changes that aided restful sleep, such as lower heart and respiratory rates, and their insomnia improved.

Insomnia Medication
Most insomnia medications require a doctor's prescription because they may be habit-forming or addictive, and overdose is possible. Many insomnia medications can lose their effectiveness once a person has become accustomed to them. Both over the counter and prescription Insomnia medications are available. I prefer to use prescription insomnia medications only on rare occasions. There are several categories of insomnia drugs : Benzodiazepines. These are the most common hypnotics. They include lorazepam (Ativan), alprazolam (Xanax), triazolam (Halcion), and temazepam (Restoril), among others. Non-benzodiazephines. These insomnia medications may pose less of a risk of dependence. They include zolpidem (Ambien), zopiclone, and zaleplon. Rebound insomnia could also occur after stopping insomnia medications.

Rebound Insomnia
Rebound insomnia, a worsening of sleep compared with pretreatment levels, has been reported after discontinuation of sleeping pills, mostly the benzodiazepine hypnotics. Some of these benzodiazepines include triazolam, temazepam, and flurazepam. The risk of rebound insomnia is greater with the short half-life as compared with the long half-life benzodiazepines.
To reduce the risk of rebound insomnia, you could consider a gradual withdrawal. This could mean taking, let's say, 9/10 of dose one night, then 8/10 of a dose the next night, and gradually taking less each night. Also, make sure you have full days of physical activity and lots of exposure to sunshine in order to minimize the rebound insomnia. Also, eliminate all supplements and herbs, and all caffeine and stimulants.

Cause of Chronic Insomnia
The causes of Insomnia are numerous:
     Medical conditions -- alcohol withdrawal, paroxysmal nocturnal dyspnea, pain, sleep apnea, pruritis or chronic itching, restless legs syndrome, hyperthyroidism, lack of exercise, and pheochromocytoma.
     Medications -- ephedra, amphetamines, theophylline, pseudoephedrine, cocaine, and caffeine. High doses of hormones -- such as DHEA, testosterone, progesterone, pregnenolone -- can also cause insomnia.
     Psychiatric disorders -- anxiety disorder, depression, mania.
     Poor sleep hygiene is a common insomnia cause.

Insomnia in Elderly
In the elderly, chronic insomnia is complex and often difficult to relieve because the physiologic parameters of sleep normally change with age. There is a controversy regarding the origin of insomnia in elderly. Are they only due to a senile process of sleep functioning or due to other associated comorbidities? Considering the objective assessment of sleep in elderly (by polysomnography), it has been shown an increasing sleep latency, decreasing total sleep time and sleep efficiency, a lower percentage of slow wave sleep. The circadian clock is also modified by age with phase advance and a decreased amplitude of the circadian rhythms.

Insomnia Prevalence
Insomnia affects 20% of the adult population in western countries and its prevalence increases with age.

Adolescents and Insomnia
Adolescent girls appear to be at greater risk of insomnia after they begin menstruation, suggesting that hormonal changes play a role in some girls' development of the sleep disorder.

Insomnia Research Update
Insomnia related to disease - Insomnia affected hormonal levels. Men and women had a 40% to 60% average increase in the inflammatory marker interleukin-6 (IL-6), while men alone showed a 20% to 30% increase in another marker for inflammation, tumor necrosis factor (TNF). Both IL-6 and TNF are cytokines, which are proteins the body releases in response to injury. The findings indicate that getting a full night's rest of eight hours is not a nice bonus, but necessary. In addition, the finding that insomnia may stimulate an increase in chronic, low-level inflammatory response is worrisome, because that state has been linked to conditions such as high blood pressure, heart disease and most recently, diabetes.

Insomnia Emails
Q. The purpose of this email is to ask a question about Valerian and Hops for sleep. Right now I am taking 1000 mg of Valerian and 150 mg of Hops for insomnia. I had been taking a sleeping pill called Ambien and did not like the hung over feeling I had in the morning so I weaned myself off of Ambien - slowly; and then I slowly started to introduce Valerian and Hops. So far so good - but here are some nights that I simply do not sleep well. Can "tolerance" develop with these herbs?
And, Dr Sahelian, thank you so much for your hard work, dedication, and pioneering spirit in nutritional medicine! I am indeed a fan.
A. I appreciate the positive feedback. There are several herbs and nutrients that can help with insomnia, such as hops, valerian, kava, melatonin, 5-HTP, etc., unfortunately, tolerance can develop with most of them, and they are not as consistent as pharmaceutical medicines. I recommend to my patients to alternate various nutrients and herbs, and sometimes I will prescribe the occasional use of a prescription sleeping pill. It's also a good idea to take breaks and not use any pills for sleep for at least a couple of nights.

Q. I have suffered from insomnia. Have tried treatments prescribed by doctors that are not suitable for daily living. It became a rather harsh experiment trying different sleeping pills and relaxing pills that just made things harder to focus during awake time and to remain a successful professional and mother. So I have decided to give Melatonin Sustain a try. I plan on starting out with 0.3 mg two or three times a week. I have ordered the 1 mg, 60 tab bottle. I know that for each person the product varies on how it reacts. Has your research shown that the product at 0.3 mg dosage to work better, for insomnia, taken 1 hr before bedtime or 3-4 hrs before bedtime? Is there a better time to take melatonin that increases absorption such as with a meal or with empty stomach? Aside from the questions asked above, do you have any suggestions on a pill cutter to give me the measurement of 0.3 mg? I'm looking forward to hopefully see some positive results in a battle I have thought to be never-ending with both the migraines and insomnia.
A. It is impossible to predict which dosage of melatonin will work for insomnia and how many hours before. It is trial and error and it does not have to be exactly 0.3, there can be a wide range of dosages from 0.2 to 0.7, more or less. Melatonin is better absorbed on an empty stomach.

Insomnia Cause