Insomnia cause and cure, supplements vitamins and herbs that are of benefit, natural remedy by Ray Sahelian, M.D.

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

Good Night Rx - For occasional sleepless nights, developed by Ray Sahelian, M.D.

 


Suggested Use: Take one capsule of this natural sleep product 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 and the supplement fact panel natural pill for deeper sleep
 

 

Symptoms of inadequate sleep
Fatigue, daytime sleepiness, low mood, poor motivation and productivity are common symptoms of insomnia. Chronic lack of a deep resit is one of the major causes of low libido. See this article on libido to find out how to improve sex drive and enjoyment naturally.

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

Avoid electronics an hour or so before bed
Many people might be losing valuable shut-eye because they spend the hour before bedtime in front of the electronic glow of a television, cell phone or computer. Many experts experts recommend an "electronic curfew" an hour before bedtime, when people should dim lamps and avoid checking their e-mail or watching late-night TV.


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.

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.

Avoid caffeine, nicotine, and stimulants, including sodas such as diet Coke, diet Pepsi, and others
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. Diet Coke and Pepsi can be a problem to those who are sensitive.
   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. Many people do not realize that drinking green tea, at least more than two cups a day, may be a cause for their lack of rest at night.
   Smokers experience withdrawal symptoms at night, and they have a harder time both falling asleep and waking up.

Natural dietary supplements as cause
Diet pills that contain ephedrine type chemicals can lead to insomnia. So can the nutrients phenylalanine, tyrosine, alpha lipoic acid, certain hormones such as DHEA and pregnenolone, ginseng and other adaptogenic herbs, tongkat ali, and the anti-depressants St. John's wort and SAM-e. High doses of B vitamins and certain nutrients, such as CoQ10 and alpha lipoic acid, act as stimulants. High doses of fish oils or krill oil could also be a cause in some individuals. Take most of your supplements early in the day, before or with breakfast.

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.
   Acute moderate-intensity aerobic exercise appears to reduce pre-sleep anxiety and improve sleep in patients. J Clin Sleep Med. 2010 June.Effect of acute physical exercise on patients with chronic primary insomnia. Universidade Federal de São Paulo, São Paulo, Brasil.

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. 

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.

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.

Make your bed comfortable.

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.

I just read Dr. Christiane Northtrup's book, "The Wisdom of Menopause: Creating Physical and Emotional Health and Healing During the Change". She recommends 5-HTP and kava for insomnia. She also recommends two Chinese herbs, tian wang bu xin wang, and chai hu long gu mu li wang. I was not able to find either on your website. If you have them available I would be interested in trying those two as well.
    I am not familiar with tian wang bu xin wang and chai hu long gu mu li wang formulas. According to one website, the former has this composition: sheng di huang 120g, wu wei zi , dang gui, tian dong, mai dong, bai zi ren, suan zao ren, 30 g each, ren shen, xuan shen , dan shen, bai fu ling, yuan zhi, jie geng 15 g each. The latter formula Chai Hu Jia Long Gu Mu Li Tang was used in one study to treat 32 cases of neurosis. It significantly improved restlessness, insomnia, anxiety, tendency towards fatigue, and insecure feelings, etc. I am very familiar with a formula I created called Good Night Rx which works quite well when taken 2 to 4 hours before bed.

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.

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. 


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

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.

Prescription 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, 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.

Insomnia in elderly and seniors
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 natural therapy emails
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.
   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.

I 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.
   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.

I am living in Bali and I am far from any efficient doctor, or specialist for natural product such as yours. I can not consult for my problem and needs. The only solution I have is through internet and emails. My problem is about insomnia. I have no problems to fall in sleep but I wake up all nights around 2 or 3 am and can not sleep again until 6 am. I wake up tired and all along the morning. I recover some energy after lunch and afternoon. I never take sleeping drugs and don't want. I prefer to manage with natural supplements or products. I recently tried Melatonine, and a few months later, 5HTP with same results. They did not work have strong agitation and sleep even less!! I tried just 2 nights for each and then stop regarding the results. Please note, that I have a healthy life style, I do sport (surfing, boxing)
almost every days, and don't drink really (maybe a few beers a week, and even not, every weeks). do you have an explanation for the reverse effect I face? Do you think I should try more than 2 nights to help the body to use to theses products? Do you think Good Night Rx can have a different result? Can you delivery your products to Indonesia?
    Early morning light exposure is very important, such as taking a walk for 20 minutes as soon as you wake up. Being active certainly helps. One should stop all supplements or medications that are not needed and stop all caffeine, herbal teas or sodas. A good option is to take Good Night Rx 3 to 4 hours before bed and then half an hour or an hour later to eat a meal with pasta, spaghetti, with some tomato sauce and small amount of cheese. Another option is to make a fruit smootie with several fruits including banana, and add a little bit of milk or soy milk, and a good amount of maple syrup or agave syrup. The carbohydrate load in the evening will help with sleep. This can be done 2 or 3 nights a week. Also, avoiding afternoon naps is a good idea. The products can be shipped to Indonesia.

I think it is great that you recognize that many supplements can be activating and cause insomnia. I was reading on the OCD page and noticed that no one seemed to mention coffee. I have anxiety and the potential for OCD. However, I find that my use of coffee is what makes all the difference. I have full-fledged OCD if I drink coffee, yet I simply have GAD without obsessive thoughts if I avoid those drinks. I can have a little black tea without a problem, but I would be suffering terribly if I drank coffee daily (as I once did). Coffee also makes all the difference in my skin (clear versus acne).