But I can’t sleep at night

Sleep medication is often the reason why many adults visit a medical clinic or pharmacy shop. Sleep problems are common, and the commonest is insomnia. Insomnia is dissatisfaction with sleep that is characterized by one or more of the followings, that occurs three or more times a week for at least one month. They are; problems falling asleep, staying asleep, returning to sleep, unintended early waking up and feeling unrefreshed after a sleep. Insomnia causes significant distress, impair daytime functions and occurs despite adequate opportunity for good sleep. Most adult need 7-8 hours night sleep each day and insomnia that lasted for more than three months is chronic insomnia

Insomnia is more common in women and increases with age from adulthood in both men and women. Statistics Canada stated that 25% of Canadians express dissatisfaction with their sleep, while 10-15% have their daytime activities compromised by poor night sleep. The economic cost of insomnia for Canada is an estimate of $5010 per person per year.

What are other symptoms of insomnia?

Other concerns commonly complained by people with insomnia are; daytime sleepiness/drowsiness, tiredness, mood disturbance/irritability, problem concentrating and/or with memory, proneness to errors, a problem with behavior and inability to function well.

What causes insomnia?

Unlike secondary insomnia, primary insomnia is not attributable to any known cause. The arousal center in the brain of people with insomnia is abnormally more difficult to shut off. This creates a hyperarousal state in people with insomnia. Abnormality in the level and/or function of chemicals that act on this arousal center could be the cause. Orexin and melatonin are examples of these chemicals.

Some conditions that increase the risk and/or causes insomnia are; family history of insomnia , adult-elderly age group, female gender, mental illness (anxiety, depression, etc), pain (headache, joint, etc), breathing problems (sleep apnea, heart failure, asthma, etc), heartburn, menopause, restless leg and leg clamps, overactive thyroid, stress (death, divorce, etc), medication, unfavorable environment (noise, hot/cold, etc), illness, smoking, alcohol use, caffeine, low socioeconomic status, use of street drugs, loneliness, fibromyalgia, enlarged prostate and dementia.

Is there any treatment for insomnia?

Insomnia impairs quality of life, compromise productivity, increase proneness to errors/accident and risk of some health problems. Insomnia increases the risk of depression by 5-folds and is associated with a high rate of healthcare utilization and cost. Many people will benefit from treatment of their insomnia. The treatment is targeted at identifying possible risk/cause and avoiding or treating them. Medication for the treatment works either directly or indirectly on the arousal center of the brain.

The first line of treatment of insomnia is the treatment with no medication by establishing good sleep hygiene. Steps to good sleep hygiene are;

-Go to sleep only when tired and ready to sleep.

-Avoiding reading, watching TV/screen use, or worrying in bed.

-Develop a bedtime routine.

-Use the bedroom for sleep and sexual activities only.

-If you cannot fall asleep after 15 minutes in the bedroom, go to another room. Return to the bedroom when tired and ready to sleep.

-Go to sleep and wake up same time, even on weekends.

-Avoid or restrict napping and never after 3 pm.

-Avoid caffeine and tobacco and never late in the evening

-Avoid eating large food and drinking a lot of fluid late in the evening

-Keep your bedroom at a comfortable temperature

-Keep your bedroom dark, quiet and comfortable.

-Try eating a light snack before bedtime and never too much right before bedtime.

-Exercise regular but not a few hours before bedtime

-Set some time to relax before bedtime. You can do breathing exercise to relax.

Other than above, specialized treatment such as behavioral therapy is also available. Keeping a sleep diary and regular re-evaluation of the progress of sleep treatment using information on the diary is very useful.

Apart from prescription medication, there are several sleep aids available over the counter in pharmacy shops. Both the effectiveness and side effects of these sleep aids vary. Some can interact in a very adverse manner with other medications. It’s a good idea to check with a doctor before you try one and avoid using them for a long term. Many herbs and dietary supplements (e.g., valerian root, melatonin, lavender, passionflower, kava, St. John’s wort, glutamine, niacin, and L-tryptophan) are promoted as sleep aids. Other than melatonin and valerian root, there is insufficient evidence to support both the effectiveness and safety profile of these sleep aids. Talk to your doctor before you try one of these products.

For proper treatment of your insomnia, talk to your doctor today.

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