INSOMNIA

WHAT IS INSOMNIA?

Insomnia is a common sleep disorder that can make it difficult to fall asleep or stay asleep at night.  It may cause people to feel tired after they wake up and can limit a person’s energy for the day.  Experts recommend that the average adult receives 7-9 hours of sleep every night.  Unfortunately, many do not reach this recommended amount.  Many people will face insomnia at some point in their lives.  There are two different types of insomnia, acute and chronic, depending on how long it persists.

• Acute Insomnia: lasts for a few days to a few weeks.  It is usually caused by a stressful or traumatic event.
• Chronic Insomnia: when disrupted sleep occurs for at least 3 nights a week for 3 months.  It may be caused by a health condition, medications, or shift work (1,2).

Can Head Injuries Cause Insomnia?

The traumatic occurrence of a head injury in itself can trigger acute insomnia, but sometimes this kind of injury can lead to chronic insomnia. Cell communication issues can occur, the impact of such issue being influenced by the severity and location of the head injury. After head trauma, it is possible that certain neurotransmitters needed for sleep might not be produced(14).

RISK FACTORS FOR INSOMNIA

• Allergies
• Caffeine
• Certain health conditions like gastrointestinal reflux, hyperthyroidism, asthma, Parkinson’s disease
• Pain
• Some medications for high blood pressure, heart and thyroid disease, birth control, asthma, and depression (1)

 EFFECTS OF INSOMNIA ON BODY AND MIND

Insomnia affects the body and mind in any situation, so it will certainly impact your recovery from a head injury. Your body heals as you sleep, so insomnia slows the healing process. What results is a vicious cycle of pain, depression, insomnia, fatigue, confusion, and back to pain and depression again. This prolongs the recovery period and can lead to other health concerns, such as:

• Difficulty falling asleep at night
• Waking up multiple times during the night
• Waking up too early
• Irritability
• Not feeling well-rested after a night’s sleep
• Sleepiness or tiredness during the day
• Depression or anxiety
• Difficulty paying attention, focusing, or remembering
• Worries about sleep (1)

For more information on insomnia and diagnosis:  1. Talk to you doctor  2. Visit the National Sleep Foundation website  3. Visit the Mayo Clinic website  4. Visit the MedlinePlus website

Can Insomnia Kill You?

In a simple and reassuring answer, “No.” Insomnia itself cannot kill you, but as we just reviewed, it can have serious health effects as it progresses, so should not be ignored.

How Rare Is Sporadic Fatal Insomnia?

There is an extremely rare disease known as “Fatal Insomnia.” Only 1 in 1,000,000 will be among the affected population(15). The two forms of fatal insomnia are Fatal Familial Insomnia and Sporadic Fatal Insomnia, the difference between the two being at a genetic level.

INSOMNIA FACTS AND STATISTICS

According to the National Institutes of Health, an estimated 30% of Americans suffer from sleep disruption, and about 10% have “associated symptoms of daytime functional impairment consistent with the diagnosis of insomnia.”

A 2005 poll conducted by the National Sleep Foundation found that over half of participants reported at least one symptom of insomnia a few times every week within the previous year.  A staggering 33% said that they had at least one symptom almost every night in the past year.

Other polls have found that 68 percent of adults ages 18 to 29 reported experiencing symptoms of insomnia, compared with 59 percent of adults ages 30 to 64, and only 44 percent for those over 65 (2).

CDC reported about 4% of US adults or 13 million Americans are used prescriptions sleep aids in the past month (3).

MEDICAL TREATMENT OF INSOMNIA

There are only a few FDA-approved prescriptions for long-term use for insomnia.  All fall into the following 3 categories (4).

• Benzodiazepines (estazolam, flurazepam, quazepam, temazepam, and triazolam): appears to affect neurotransmitters in the brain.  Side-effects include dizziness, weakness, loss of orientation, headache, and unsteadiness (5).
• Nonbenzodiazepine hypnotics (eszopiclone, zaleplon, and zolpidem): Some possible side-effects include daytime drowsiness, dizziness, weakness, lightheadedness, “drugged” feeling, tiredness, and loss of coordination (6).
• Selective melatonin receptor agonist (ramelteon): Some possible side-effects include dizziness, sleepiness or unusual drowsiness, body aches or pain, change in taste, chills, cough, and difficulty in breathing (7).

NATURAL WAYS TO SUPPORT HEALTHY SLEEP

Practices That Help Support Sleep:

• Atmosphere: before bed, disconnect close range electronic devices such as cell phones, computers, tablets.  Avoid bright lights, darken the environment, block sounds. Create a relaxing atmosphere: read a book, listen to quiet music, meditate, do breathing or relaxation exercises.
• Keep your bedtime and wake time consistent from day to day
• Exercise
• Avoid or limit naps
• Avoid or limit caffeine, alcohol, and nicotine
• Avoid large meals and beverages before bedtime (1)

What Food is Good for Insomnia?

Your diet may help to calm your mind and relieve insomnia. Try a diet of foods rich in magnesium, calcium, tryptophan, Vitamin B6, and melatonin, and eliminate processed foods, greasy fried foods, and simple carbohydrates.

Natural Supplements That Help Support Sleep:

• Melatonin (N-Acetyl-5-Methoxytryptamine/Pineal Hormone) (8)
• Valerian (Valeriana officinalis) (9)
• Passion Flower (Passiflora incarnata) (10,11)
• Chamomile (Matricaria recutita) (12,13)

REFERENCES

1. Insomnia. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/insomnia/symptoms-causes/syc-20355167. Accessed July 10, 2018.
2. Insomnia. National Sleep Foundation. https://sleepfoundation.org/insomnia/content/what-is-insomnia. Accessed July 10, 2018.
3. Prescription Sleep Aid Use Among Adults: United States, 2005–2010. Centers for Disease Control and Prevention. https://www.cdc.gov/nchs/products/databriefs/db127.htm. Accessed July 10, 2018.
4. Understanding Insomnia – Treatment. WebMD. https://www.webmd.com/sleep-disorders/understanding-insomnia-treatment#1. Accessed July 10, 2018.
5. BENZODIAZEPINES. RxList. https://www.rxlist.com/benzodiazepines/drugs-condition.htm. Accessed July 10, 2018.
6. AMBIEN VS. LUNESTA. RxList. https://www.rxlist.com/ambien_vs_lunesta/drugs-condition.htm. Accessed July 10, 2018.
7. Ramelteon (Oral Route). Mayo Clinic. https://www.mayoclinic.org/drugs-supplements/ramelteon-oral-route/side-effects/drg-20067544. Accessed July 10, 2018.
8. Ferracioli-Oda E, Qawasmi A, Bloch M H. Meta-Analysis: Melatonin for the Treatment of Primary Sleep Disorders. PLoS One. 2013; 8(5): e63773. doi:10.1371/journal.pone.0063773.
9. Bent S, Padula A, Moore D, Patterson M, Mehling W. Valerian for Sleep: A Systematic Review and Meta-Analysis. Am J Med. 2006 Dec; 119(12): 1005–1012. doi:10.1016/j.amjmed.2006.02.026
10. Guerrero F A, Medina G M. Effect of a medicinal plant (Passiflora incarnata L) on sleep. Sleep Sci. 2017 Jul-Sep; 10(3): 96–100. doi:10.5935/1984-0063.20170018
11. Ngan A, Conduit R. A double-blind, placebo-controlled investigation of the effects of Passiflora incarnata (passionflower) herbal tea on subjective sleep quality. Phytother Res. 2011 Aug;25(8):1153-9. doi:10.1002/ptr.3400
12. Adib-Hajbaghery M, Mousavi SN. The effects of chamomile extract on sleep quality among elderly people: A clinical trial. Complement Ther Med. 2017 Dec;35:109-114. doi:10.1016/j.ctim.2017.09.010
13. Chang SM, Chen CH. Effects of an intervention with drinking chamomile tea on sleep quality and depression in sleep disturbed postnatal women: a randomized controlled trial. J Adv Nurs. 2016 Feb;72(2):306-15. doi:10.1111/jan.12836.
14. Hvingelby, Eva, NP, PhD. Insomnia After Head Trauma: A Common Complaint. Verywellhealth. https://www.verywellhealth.com/insomnia-after-head-trauma-1720043. Accessed June 11, 2019.
15. NORD (National Organization for Rare Diseases). Fatal Familial Insomnia. https://rarediseases.org/rare-diseases/fatal-familial-insomnia/. Accessed June 11, 2019.