Insomnia treatments information and
|
|
Sleep aid tips about insomnia treatments for information and remedies for your better sleep which may also cure any mild sleep disorder you may want insomnia treatments for. Adjustment Sleep Disorder Sudden emotional stress, such as a job loss or a hospitalization, can induce transient insomnia. Sudden changes in work shift and travel across time zones can also cause difficulties with sleep.
However, these difficulties usually resolve within a brief period of time, typically a few weeks. Many insomniacs, however, unknowingly intensify the effect of, or unnecessarily prolong, these insomnias by engaging in behaviors that make matters worse. Therefore, proper adherence to sleep hygiene rules can be helpful in producing a more rapid resolution to this type of insomnia. Examples of sleep hygiene measures include:
Maintain a regular bedtime schedule.
Learn strategies to make bedtime as relaxing and tension-free as possible. In general, no formal medical treatment is necessary for such short-lasting insomnia. In certain cases, however, such as when daytime fatigue begins to interfere with daily activities, seeking medical attention is warranted. Medical treatment is also warranted if the insomnia lasts for more than just a few weeks. Although in many insomnia cases, self-help strategies such as those mentioned above are sufficient in overcoming insomnia rapidly, insomnia can escalate and become chronic. In this case, the causes of insomnia may represent more significant medical or emotional disorders. Therefore, sufferers should seek help if their own strategies do not relieve insomnia within a few weeks. The disorders below are examples of some of the more common chronic insomnia conditions that warrant further medical attention.
Psychophysiologic Insomnia Psychophysiologic insomnia can follow a few nights of sleeplessness due to an adjustment sleep disorder. Concern regarding the prospect of facing yet another night of sleeplessness can result in an escalation of tension and anxiety with each successive night. The insomniac begins to dread going to bed and often feels tension increasing as bedtime approaches. He may become preoccupied with insomnia. Sufferers often spend hours in bed awake focused upon and brooding over their sleeplessness.
In severe cases, the focus of their thoughts, and even conversations with others, may begin to revolve around insomnia. Curiously, sufferers often have little difficulty falling asleep during the course of the day when their minds are focused on other issues, such as during meetings. They also may experience relief from their own bedrooms as they fall asleep easily when away from home, such as on vacation on in a hotel room.
Psychophysiologic insomnia is often managed with a combination of behavioral measures and medications. The most commonly utilized behavioral measures are relaxation training with EMG biofeedback training, psychotherapy (cognitive and insight-oriented), and stimulus control therapy (asking patients to use the bed only for sleep and to not stay in bed trying to sleep for more than ten minutes at a time, but to go into another room and to return to bed only after feeling sleepy). Sleep hygiene measures should be closely adhered to during and after the termination of treatment, regardless of type. Hypnotic Agents (Sleeping Pills) Since sleeping pills are commonly used for the adjustment sleep disorder and psychophysiologic insomnia, I will discuss them in this section. Alcohol, one of the most widely utilized agents by insomniacs is a poor choice inasmuch as it alters sleep patterns and often results in further daytime sleepiness. Alcohol can also intensify breathing disorders during sleep, which may affect certain insomniacs. Many of the over-the-counter products contain antihistamines, which are also commonly used in cold preparations. However, these cannot be wholeheartedly recommended either, since they have unpredictable effects on sleep and since they can cause side effects such as constipation, rapid heart rates, urinary retention, and excessive daytime sedation. Although barbiturates and barbiturate-like drugs (chloral hydrate and glutethimide, among others) were utilized as hypnotic agents in the past, they also can no longer be recommended since they have a far greater potential for significant sedation and even death in overdoses when compared to other available medications. Melatonin is a hormone which is released by the pineal gland and whose secretion peaks during sleep. Its blood levels decrease with age. It has long been suspected as being helpful for sleep and has witnessed extraordinary popularity in recent years among insomniacs as an over-the-counter sleep aid. Unfortunately, the evidence for the efficacy of melatonin as a general sleep aid is scant. Melatonin may, however, be useful in circadian rhythm disorders such as jet lag or shift work sleep disorder, although more definitive studies are necessary in these areas as well. Concerns also exist regarding its safety and questions have been raised regarding the purity of certain melatonin preparations. Because of the lack of well-designed dosing studies, the proper dosage is also unknown. Therefore, despite the anecdotal reports of miraculous cures following its ingestion, its use cannot be fully supported by clinical evidence at the present time.
There are many prescription sleeping pills. Most of these agents fall into a class of medications called benzodiazepines. Benzodiazepines that are specifically marketed for sleep include flurazepam (Dalmane), quazepam (Doral), estazolam (ProSom), temazepam (Restoril), and triazolam (Halcion). T hese agents differ from each other by the length of time they stay in the body (referred to as elimination half-life) and selectivity. For example, agents with a longer half-life include flurazepam (Dalmane), and quazepam (Doral); those with an intermediate half-life include estazolam (ProSom) and temazepam (Restoril). The only short half-life benzodiazepine available in the United States is triazolam (Halcion).
Another medication, zolpidem (Ambien) is part of a different class of drugs called imidazopyridines. It also has a short half-life (approximately 2.5 hours). The most recently introduced hypnotic compound is zaleplon (Sonata), also a non-benzodiazepine hypnotic agent. It falls in the pyrazolopyrimidine class. It has the shortest half-life of all the hypnotic agents available in the United States (approximately 1 hour).
It is believed that zolpidem and zaleplon provide their hypnotic efficacy by their activity at GABA-Benzodiazepine receptor complex. This is the same receptor site at which the benzodiazepines act. The binding of hypnotic molecules at this site augments the activity of GABA, an inhibitory CNS neurotransmitter.
However, these two non-benzodiazepine agents, and the benzodiazepine quazepam, preferentially act at a subset of GABA receptors that are distinguished by their geographic distribution in the brain. The possible clinical effects (if any) of this selectivity have yet to be conclusively determined.
Medications with longer elimination half-lives tend to be associated with a greater potential for daytime carryover effect and sleepiness on the day following administration. Triazolam, zolpidem and zaleplon have the least potential for residual daytime carryover effects if administered at bedtime. Furthermore, Zaleplon affords the possibility of being taken following middle-of-the-night awakenings without the production of residual next-day sedation if administered no later that 4 hours prior to morning awakening. Higher dosages of a medication may also contribute to daytime sleepiness, as do longer periods of continued use.
Sleeping pills have been known to have diminished effectiveness after prolonged use, a phenomenon called tolerance. They can also produce escalation of insomnia after rapid discontinuation, referred to as rebound insomnia. Short half-life agents may be more likely to produce tolerance and rebound insomnia, yet there is little evidence for either difficulty with extended use of the short half-life agents zolpidem and zaleplon.
These difficulties, nevertheless, can be minimized by utilizing the medication at the lowest effective dose and for brief periods of time (days to weeks). If prolonged use is warranted, intermittent dosing, (i.e., administration on 4 or 5 nights per week only), may be beneficial.
With a few exceptions, hypnotic medications should be taken as a prophylactic at the beginning of the night, since taking them too close to morning awakening time may lead to daytime sedation. Zaleplon may be an exception to this rule since it can be effective as a “last-minute” medication for patients who wish to attempt to fall asleep of their own accord and take the hypnotic only if they have to. As stated above, however, a minimum of 4 hours in bed are necessary following its administration.
Most studies with zaleplon have focused on its ability to reduce sleep latency (the time it takes to fall asleep) following administration. Most of the other hypnotics, including zolpidem, have been shown to reduce not only the time to fall asleep but also the number and duration of awakenings during the course of the night and the duration of sleep.
Hypnotic agents should be utilized for brief periods of time and at the lowest effective doses. During the course of treatment, physicians should carefully monitor patients for side effects, such as daytime sleepiness, memory difficulties, and performance decrements, and habituation and tolerance. Hypnotics are contraindicated in patients suspected of having obstructive sleep apnea syndrome and other sleep-related breathing disorders, in pregnant women and heavy alcohol users, and should be utilized with caution in any chronic disorder. Although hypnotics can safely be combined with antidepressants, hypnotic agents alone are inappropriate for the treatment of the insomnia of depression.
|
Sleep aid tips web directory is the best way to find information about sleep disorder remedies and insomnia treatments. This web page takes the legwork out of finding great insomnia treatments resources. We have compiled great links to insomnia treatments and sleep disorder remedy information and pages dedicated to insomnia treatments information here. . . On this directory page you will find links to various insomnia treatments information and sleep disorder remedy related pages. There you will find great information about insomnia treatments.
insomnia treatments site links sleep aid
|
Additional insomnia treatments Links | ||
|
sleep innovation |
cause of snoring |
baby sleep |
