By Dr. Mercola
Nearly 60 million Americans struggle with insomnia. Doctors are still not sure how to treat this disorder that may have devastating effects on your daily routines.1
Chronic lack of quality sleep has been associated with reduced memory and learning, increased risk of dementia and type 2 diabetes and an increased risk of accidents. Losing just one night of sleep may impair your physical and mental status comparable to having a blood alcohol level of 0.10 percent.2
You may have experienced insomnia, or difficulty going to sleep or staying asleep each night. Some physicians believe this difficulty may arise from a physical cause and others from a mental or emotional issue.
In other cases insomnia may be the result of medical conditions, medications, poor sleep habits or other biological factors.
2 Types of Insomnia May Be Addressed Differently
There are two types of insomnia that affect people, but the resulting symptoms are the same. These symptoms include difficulty going to sleep, waking up often during the night or too early in the morning and feeling fatigued or tired when getting up in the morning.3
You may suffer from primary or secondary insomnia. Primary insomnia occurs when the sleep problems you're having are not associated with another health condition.
Secondary insomnia occurs when you have another medical condition that results in poor sleep quality. Those conditions may include asthma, depression, arthritis, cancer or heartburn.4
How often you experience these symptoms define if you suffer an acute issue, happening for a short time, or a chronic issue, lasting for several months. The symptoms may also come and go throughout your life, making the treatment and diagnosis difficult for physicians.
Gayle Greene, author of "Insomnia," describes her journey with insomnia on National Public Radio (NPR), saying:5
"Sleep is the fuel of life. It's nourishing; it's restorative. And when you are deprived of it, you are really deprived of a basic kind of sustenance.
I don't manage this beast, I live with it. I live around it. I bed down with it every night, gingerly, cautiously, careful not to provoke it. I do my best to placate it, domesticate it, dull its claws [and] avoid its fangs, knowing that at any moment it can pounce on me and tear me to bits."
The causes are varied, and the triggers are not the same for every person. However, this might not stop your physician from addressing the issue the same way for each patient.
While a prescription for medication may help you sleep for a couple nights, there are significant side effects to these prescriptions and they typically cause more health problems than they help.
Problems With Prescription Sleeping Medication
The Centers for Disease Control and Prevention (CDC) announced in 2013 that at least 9 million people were using prescription sleep aids.6 The data was based on interviews with 17,000 adults, and found that 4 percent had taken a sleeping pill or sedative in the past 30 days.
They also found that use of sleeping medication increased with age. The lowest age group was between 20 and 39 years old, and the percentage of users continued to rise through senior years.
Although it may be easy to get sleeping pills from your doctor, they come with significant side effects and usually only help you to fall asleep and not to sleep through the night. Side effects of sleep medication may include:7,8
✓ Burning or tingling in your hands, feet, arms or legs
✓ Increased tolerance to the medication
✓ Difficulty weaning off the medication
✓ Uncontrollable shaking
✓ Change in appetite
✓ Loss of balance
✓ Daytime drowsiness
✓ Mental slowness
✓ Difficulty learning
✓ Unusual dreams
✓ Erratic behavior
✓ Dry mouth
✓ Stomach pain
Some people also suffer from other more complex symptoms, such as parasomnias. These are behaviors or actions over which you have no control, such as sleepwalking.
Parasomnia behaviors you may experience while taking sleeping pills may include driving, having sex, making phone calls and eating — all while being fast asleep.9
While these side effects are frightening, a study published in 2012 revealed people taking sleeping pills were four times more likely to die than people who don't take the pills.10 The study also found those taking sleeping pills were 35 times more likely to have cancer. Other risks include:
• Increased insulin resistance, food cravings, weight gain and diabetes
• Complete amnesia, even from events that occurred during the day
• Depression, confusion, disorientation and hallucinations
Start With the Right Clothes
Sleeping may appear to be an inactive state, but it isn't. Instead, it is a complex period of time during which your brain and body are busy detoxifying and resting. You can help the process by starting with clothing designed to improve your sleep quality.
Shawn Stevenson, author of "Sleep Smarter," was quoted in Rodale Wellness, saying:11 "When it comes to your pajamas, think form and function over fashion."
Your night clothes should be loose and not restrict your movement or your circulation. Small changes in your sleep clothes may not only improve your sleep quality, but also your health. Wear light, breathable, hypoallergenic and ideally organic materials. Organic cotton is a good choice.
The optimal temperature for a restful night's sleep may be between 60 and 68 degrees F. Setting your thermostat higher than 75 degrees F or lower than 54 degrees F may interfere with your sleep cycle. One of the benefits of lightweight night clothes is that your body will stay cooler. As your core body temperature drops it induces sleepiness.12
This may be one reason you may flip the pillow during the night to lie on the cool side. Some research has demonstrated that people who struggle with insomnia naturally have a higher body temperature, making dropping off to sleep more difficult.13 If you have trouble sleeping, it's important to drop your core body temperature. Wearing socks or using a hot water bottle near your feet helps to dilate your vessels, releasing more heat from your feet.
How the heat in your body is distributed also helps increase your sleepiness. This thermoregulation improves when you lie down and heat disperses from your core to your arms and legs. Wearing loose fitting shorts and t-shirts may help improve heat loss at night, helping you to fall asleep and stay asleep.
Cognitive Behavioral Therapy for Insomnia
In May, 2016, the American College of Physicians (ACP) recommended Cognitive Behavioral Therapy for Insomnia (CBT-I) as the initial treatment prescribed for chronic insomnia.14
The key element using CBT-I is to restructure and reframe your thinking patterns using a combination of education, behavioral interventions and cognitive therapy designed specifically for people suffering with insomnia.15 If you can't find a trained therapist in your area, you may want to consider an online program.
Recent research is producing convincing data that internet-based programs are as effective as working with a therapist when followed appropriately.16 Whether you use a CBT-I program online or face-to-face with a therapist, the results appear to be the same.17
Online programs may be less expensive and don't require additional time outside your home. On the other hand, if you aren't likely to follow the program, having a therapist or engaging the help of an accountability partner may improve your results. Research has also found that the results from CBT-I last much longer than using sleep medication.18
Even those suffering from insomnia related to post-traumatic stress disorder (PTSD) experienced significant relief using CBT-I.19 In a press release, ACP president Dr. Wayne Riley said:20
"Cognitive behavioral therapy for insomnia is an effective treatment and can be initiated in a primary care setting. Although we have insufficient evidence to directly compare CBT-I and drug treatment, CBT-I is likely to have fewer harms. Sleep medications can be associated with serious adverse effects."
Online programs may provide an answer for individuals who don't have a certified therapist in their area. Greg Jacobs, Ph.D., sleep specialist and assistant professor of psychiatry at the University of Massachusetts Medical School, told The New York Times:21
"The number of clinicians nationally who know how to do CBT-I is a couple of thousand. We need 100,000. There are tens of millions of people out there who have insomnia."
Herbal Teas May Help You Fall Asleep
People have been using herbal teas to help relax before bed for centuries. However, it's important to remember that the effects of herbs can vary depending on the individual. Some herbs can cause sleep disturbances while others can either make you drowsy or contribute to sleeplessness.
You may want to experiment with several to find the one that works for you with the caveat that you need to remember that some herbs can interact with perscription medication you may be taking, or with another underlying medical condition. Also remember, not all herbs are appropriate for children.22 That said, the following herbs have a history of usefulness for helping people fall asleep:
This is probably one of the better known herbal teas used to relax and induce sleepiness, and which has shown in a clinical study that it could provide help for chronic insomnia.23 As a sleep aid, it's fairly mild.24 It is also gentle and is helpful if you have an irritable digestive tract. Even sniffing the tea bags may be enough to trigger your brain to relax.25
An herbal infusion tea may be made by using 1 ounce of the dried herb steeped in 1 quart of water for four hours. Filter the dried herb out before drinking. This infusion is more concentrated than brewing a cup of tea. Chamomile tincture may also be used to help you sleep.
• Passion Flower
This is a very mild herb, best used when you are overtired, anxious or overworked. Dr. Michael Traub, a naturopathic physician who has studied the passion flower, recommends making an infusion with 0.07 ounces (2 grams) of the herb in 5 ounces (150 milliliters) of water, or use 0.3 ounces (10ml) of tincture. Take three to four times daily.26
You can also steep 1 teaspoonful in 1 cup of boiling water for 10 minutes and drink it just before bedtime. But, according to the University of Maryland Medical Center (UMMC), consult your physician before taking it if you are already taking prescription drugs for insomnia, anxiety, depression or blood thinners.27
• Kava kava
This herb is commonly used to reduce anxiety and depression. In an observational study with placebos, it was found to have some benefit as a sleep aid.28 It has been found safe in small dosages, but use caution, as kava supplements have been linked to liver damage.29 Germany, Switzerland and Canada have banned substances containing Kava because of the risk of liver damage. The safest way is to use a mild tea and not a supplement.
• California Poppy
This is a favorite herb of many people seeking relaxation and drowsiness to sleep. Studies have demonstrated the herb's ability to reduce the amount of time it takes you to fall asleep and improve sleep quality when used as directed.30 Taking 30 drops of the tincture two to three times daily may help you fall asleep easier.
This is possibly the most powerful herbal sedative, and not one to be used consistently. Using it before bed may help reduce the number of times you awaken during the night. However, this herb may trigger some wild dreams, as well as diarrhea and other gastrointestinal effects. If you've never used valerian, it's best to start slowly to reduce the potential you may experience side effects. This herb also works well in combination with hops.31
Herbal Aromas May Increase Relaxation and Improve Sleep
Herbs are also aromatic. The scent they produce may sometimes have as much effect on your brain and body as drinking tea or tincture. These herbs are a wonderful addition to your night clothes or bedroom to help you relax and sleep.
As an aromatherapy, this plant from the mint family has been reported to help with sleep and relaxation issues.32 Mixing a little of the essential oil with olive oil makes a massage oil that promotes sleep. You might also add a drop or two to a warm bath before bed, or on a cotton ball inside your pillow case.33 Do not ingest lavender oil; also, do not use it topically on boys, as it may cause abnormal breast growth.34
The scent of hops, a component of beer, was a favorite of King George III and Abraham Lincoln as a means of inducing relaxation and sleep.35 This herb may be used to stuff a pillow for your nightly relaxation, or you may choose to drink a mild tea twice daily, once in the morning and another in the latter part of the evening. Studies with animals have shown that it also may be useful in the form of nonalcoholic beer.36
Occasional Use Only
In this short video, I go over several tips that may help you get to sleep easier and stay asleep through the night. Sleep-promoting herbs are only for occasional use. If you are pregnant, you should consult your physician before taking any medication or herb, as many can affect your growing baby.
Chronic issues with sleeplessness, insomnia or waking during the night may require you to evaluate your lifestyle and your habits, both during the day and at night. For a list of strategies you may consider using to improve the quality of your sleep and the number of hours you sleep, see my previous article titled, "Want a Good Night's Sleep? Then Never Do These Things Before Bed."