Lifestyle changes
MELATONIN: HAVE THE BENEFITS BEEN EXAGGERATED?
The hormone melatonin, produced by the pineal gland in the brain, has long been promoted in supplement form as a treatment for jet lag as well as for insomnia. Until recently, scientists were pretty sure that the supplements worked. But there is new evidence to suggest that while melatonin may have some benefits, it's hardly a panacea for interrupted sleep.
The 'darkness hormone' Melatonin has been dubbed the 'darkness harmone' because levels in the body rise at night and fall during the day. It affects the sleep-awake cycle, and researchers have naturally assumed that it might improve sleep and help reset the body's internal clock when travellers pass through multiple time zones.
In the last few years, however, melatonin has lost some of its scientific glow. Researchers now believe that if has no effect on jet lag. Nor does it appear to improve overall sleep.
Internal clock regulator
Recently scientists have looked at melatonin's ability to affect the body's internal clock. They measured the activity patterns of baboons that were given melatonin and kept in a constantly dimmed room. Their findings showed that melatonin had no effect on the 'animals' usual cycles of behaviour, which suggests that its ability to change the body's clock--and reduce the symptoms of jet lag--have been greatly exaggerated.
While melatonin does appear to help people fall asleep more quikly at night, it has little effect on the overall quality of their sleep. And it may cause a 'sedative hangover'.
Using melatonin
Even given these caveats, melatonin does appear to be a safe supplement that may ease insomnia in some people. The optimal dose isn't known, so you may have to experiment a bit to find what works best for you. The only people who shouldn't take melatonin are children and pregnant women, because it may interact with other hormones in the body.
Exercise is another key strategy for achieving better sleep. It tires you out and also lowers levels of sleep-disrupting stress harmones. Just be sure to get your exercise at least three hours before bed.
Another traditional remedy for insomnia is drinking a glass of warm milk, and there's good evidence that it works. Not only does milk help prevent hunger from disturbing your sleep, it also contains an amino acid called trytophan, which is converted in the brain into a 'relaxing' chemical known as serotonin. After the milk, and once you're in bed, try progressive muscle relaxation, a technique that involves tensing then releasing all of the muscles in your body, starting at your feet and moving up towards your head.
Finally, try to get a handle on the stressors in your life. If you're in the throes of anxiety, it's harder to both fall asleep and sleep soundly. Some of the best stress-breathing activities include yoga, meditation and listening to soothing audio tapes.
I take a number of medications for different ailments, including high blood pressure. Could they be causing my insomnia?
Some drugs have drowsiness as a side effect, but others promote sleep-disturbing alertness. Among the common offenders are indeed blood-pressure-lowering drugs, as well as allergy medications, nicotine patches and some medications which are taken for depression.
Whether your insomnia is a recent problem or you've fought it for years, make sure that drugs aren't making things worse. Jot down all those you're currently taking and show the list to your doctor or pharmacist. It could be that changing one or more of your medications might be the solution that you need.
Medications
Good sleep habits are the best way to overcome insomnia in the long run. But when you need fast relief, your doctor may recommend over-the-counter or prescription drugs. These might include:
Older antihistamines. Two popular ones, diphenhydramine (Benadryl) and chlorpheniramine (Demazin), act as mild sedatives and are very effective for occasional sleepless nights.
Analgesics. Aspirin, ibuprofen (Nurofen), naproxen (Naprogesic) or paracetamol (Panadol) often relieve sleep-disturbing pain.
Prescription sleeping pills. It is generally advisable to try other lifestyle methods to help you go to sleep rather than taking medication. However, if these methods have failed, your doctor might prescribe a short-acting hypnotic. It is best not to use these for more than two weeks as they can be habit forming. The most commonly prescribed medication is temazepam (Normison, Euhypnos, Temaze), which belongs to the chemical family known as benzodiazepines. Other benozodiazepines are less frequently prescribed, including nitrazepam (Mogadon) and flunitrazepam (Hypnodorm). Zolpidem (Stilnox) and zopiclone (Imovane) are nonbenzodiazepine hypnotics with a similar action to temazepam. Over recent years this type of hypnotic has become increasing popular.
Antidepressants. These medicines are sometimes used to treat insomnia-caused depression. Some, such as amitriptyline (Endep, Tryptanol) and dothiepin (Prothiaden, Dothep), have drowisness as a side effect.
Hormone replacement. When hot flushes, night sweats or other menopasual symptoms interfere as sleep, your doctor may recommend a course of HRT until symptoms diminsh, (For more information on hormone replacement, see on next)
Natural methods
Certain herbs have been used for centuries to ease insomnia.Available in various forms, from tinctures to teas, they induce sleep and soothe jangled nerves. Valerian is a natural herbal tranquilliser, which can be taken at bedtime to help you sleep. It works best when you rotate its use with other sleep-reducing herbs. Camomile is a sweet-tasting herb that depresses the central nervous system the way anti-anxiety drugs do. Lemon balm (also known as melissa) has a citrusy aroma; its leaves are the plant's medicinal part.
Procedures
Your doctor can probably recognise--and treat-a number of the common causes of your insomnia. Some conditons, however, can be detected only if you spend one or more nights in a sleep laboratory. Don't let the name scare you. Sleep laboratories are like comfortable hotel rooms--except instead of a min-bar next to the bed, you'll see devices that measure everything from heart rate to brain waves and breathing patterns.
You'll arrive at the sleep lab about an hour before your usual bedtime. A technician will attach electrodes and other monitoring devices to your body (nothing is inserted beneath the skin). Then it's light out. The test will reveeal how much (or how little) you sleep and whether you spend enough time in 'deep' sleep. It will also pinpoint any physical problems that interfere with normal sleep, such as sleep apnoea (see on later), limb movements or a curious condition called 'sleep state mis-perception', which means that you feel as though you're getting less sleep than you actually are. Treatment can then be tailored to your specific problem.
MELATONIN: HAVE THE BENEFITS BEEN EXAGGERATED?
The hormone melatonin, produced by the pineal gland in the brain, has long been promoted in supplement form as a treatment for jet lag as well as for insomnia. Until recently, scientists were pretty sure that the supplements worked. But there is new evidence to suggest that while melatonin may have some benefits, it's hardly a panacea for interrupted sleep.
The 'darkness hormone' Melatonin has been dubbed the 'darkness harmone' because levels in the body rise at night and fall during the day. It affects the sleep-awake cycle, and researchers have naturally assumed that it might improve sleep and help reset the body's internal clock when travellers pass through multiple time zones.
In the last few years, however, melatonin has lost some of its scientific glow. Researchers now believe that if has no effect on jet lag. Nor does it appear to improve overall sleep.
Internal clock regulator
Recently scientists have looked at melatonin's ability to affect the body's internal clock. They measured the activity patterns of baboons that were given melatonin and kept in a constantly dimmed room. Their findings showed that melatonin had no effect on the 'animals' usual cycles of behaviour, which suggests that its ability to change the body's clock--and reduce the symptoms of jet lag--have been greatly exaggerated.
While melatonin does appear to help people fall asleep more quikly at night, it has little effect on the overall quality of their sleep. And it may cause a 'sedative hangover'.
Using melatonin
Even given these caveats, melatonin does appear to be a safe supplement that may ease insomnia in some people. The optimal dose isn't known, so you may have to experiment a bit to find what works best for you. The only people who shouldn't take melatonin are children and pregnant women, because it may interact with other hormones in the body.
Exercise is another key strategy for achieving better sleep. It tires you out and also lowers levels of sleep-disrupting stress harmones. Just be sure to get your exercise at least three hours before bed.
Another traditional remedy for insomnia is drinking a glass of warm milk, and there's good evidence that it works. Not only does milk help prevent hunger from disturbing your sleep, it also contains an amino acid called trytophan, which is converted in the brain into a 'relaxing' chemical known as serotonin. After the milk, and once you're in bed, try progressive muscle relaxation, a technique that involves tensing then releasing all of the muscles in your body, starting at your feet and moving up towards your head.
Finally, try to get a handle on the stressors in your life. If you're in the throes of anxiety, it's harder to both fall asleep and sleep soundly. Some of the best stress-breathing activities include yoga, meditation and listening to soothing audio tapes.
I take a number of medications for different ailments, including high blood pressure. Could they be causing my insomnia?
Some drugs have drowsiness as a side effect, but others promote sleep-disturbing alertness. Among the common offenders are indeed blood-pressure-lowering drugs, as well as allergy medications, nicotine patches and some medications which are taken for depression.
Whether your insomnia is a recent problem or you've fought it for years, make sure that drugs aren't making things worse. Jot down all those you're currently taking and show the list to your doctor or pharmacist. It could be that changing one or more of your medications might be the solution that you need.
Medications
Good sleep habits are the best way to overcome insomnia in the long run. But when you need fast relief, your doctor may recommend over-the-counter or prescription drugs. These might include:
Older antihistamines. Two popular ones, diphenhydramine (Benadryl) and chlorpheniramine (Demazin), act as mild sedatives and are very effective for occasional sleepless nights.
Analgesics. Aspirin, ibuprofen (Nurofen), naproxen (Naprogesic) or paracetamol (Panadol) often relieve sleep-disturbing pain.
Prescription sleeping pills. It is generally advisable to try other lifestyle methods to help you go to sleep rather than taking medication. However, if these methods have failed, your doctor might prescribe a short-acting hypnotic. It is best not to use these for more than two weeks as they can be habit forming. The most commonly prescribed medication is temazepam (Normison, Euhypnos, Temaze), which belongs to the chemical family known as benzodiazepines. Other benozodiazepines are less frequently prescribed, including nitrazepam (Mogadon) and flunitrazepam (Hypnodorm). Zolpidem (Stilnox) and zopiclone (Imovane) are nonbenzodiazepine hypnotics with a similar action to temazepam. Over recent years this type of hypnotic has become increasing popular.
Antidepressants. These medicines are sometimes used to treat insomnia-caused depression. Some, such as amitriptyline (Endep, Tryptanol) and dothiepin (Prothiaden, Dothep), have drowisness as a side effect.
Hormone replacement. When hot flushes, night sweats or other menopasual symptoms interfere as sleep, your doctor may recommend a course of HRT until symptoms diminsh, (For more information on hormone replacement, see on next)
Natural methods
Certain herbs have been used for centuries to ease insomnia.Available in various forms, from tinctures to teas, they induce sleep and soothe jangled nerves. Valerian is a natural herbal tranquilliser, which can be taken at bedtime to help you sleep. It works best when you rotate its use with other sleep-reducing herbs. Camomile is a sweet-tasting herb that depresses the central nervous system the way anti-anxiety drugs do. Lemon balm (also known as melissa) has a citrusy aroma; its leaves are the plant's medicinal part.
Procedures
Your doctor can probably recognise--and treat-a number of the common causes of your insomnia. Some conditons, however, can be detected only if you spend one or more nights in a sleep laboratory. Don't let the name scare you. Sleep laboratories are like comfortable hotel rooms--except instead of a min-bar next to the bed, you'll see devices that measure everything from heart rate to brain waves and breathing patterns.
You'll arrive at the sleep lab about an hour before your usual bedtime. A technician will attach electrodes and other monitoring devices to your body (nothing is inserted beneath the skin). Then it's light out. The test will reveeal how much (or how little) you sleep and whether you spend enough time in 'deep' sleep. It will also pinpoint any physical problems that interfere with normal sleep, such as sleep apnoea (see on later), limb movements or a curious condition called 'sleep state mis-perception', which means that you feel as though you're getting less sleep than you actually are. Treatment can then be tailored to your specific problem.
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