Sleep Disorders

Lack of sleep can affect your health, just like lack of exercise and unhealthy eating. The body rejuvenates, repairs cells, and produces natural killer cells in deep stages of sleep. The body produces antibodies during sleep, which enable us to fight off infections. Lack of sleep makes one prone to obesity, hypertension, heart attacks, and diabetes. Sleep derivation affects metabolism and hormone balance. As a result, the body ages more rapidly when it does not get the proper amount of sleep. Studies have shown that people over 60, who do not sleep well, have twice the risk of dying early when compared with those over 60 who sleep well. Unfortunately as we age, we tend to sleep less. It is not that less sleep is needed later in life, but sleep patterns are interrupted by anxiety, pain, heartburn, and needing to empty the bladder. Proper sleep not only improves alertness and concentration, but memory improves as well. Memory recall is significantly better after a good nights sleep.

Insomnia is much more common in women than in men. Approximately 20% of the population suffers from chronic insomnia. It is also much more common when hormone levels are changing in perimenopause and menopause. Insomnia is not only a frustrating condition, but results in irritability, fatigue, mental confusion, and headaches. Insomnia can either be transient or chronic. Transient insomnia lasts less than two weeks in duration, and can result from jet lag, acute life stresses, or grief. Insomnia can lead to depression. 90% of people who suffer from insomnia for at least six weeks are depressed. Chronic insomnia can usually be broken down into a psychological or biological diagnosis leading to sleeping problems. There are greater than sixty diagnoses that result in sleeping disorders. Common psychological causes of insomnia are depression, anxiety, and drug or medication abuse. The most common biological cause of sleeping disorders is sleep apnea. Sleep apnea accounts for 30% of all insomnia and effects 2-5% of fifty year old women. Sleep apnea usually affects people with larger neck sizes; during sleep they self obstruct their airway, resulting in hypoxia, causing them to awaken. People with apnea can wake up multiple times throughout the night, interrupting sleep. Other biological or medical causes for sleeping disorders consist of cardiovascular, pulmonary, neurologic, endocrine, or gastrointestinal conditions. Primary insomnia is often genetically linked; these people have a history of never sleeping well. Menopausal insomnia is one of the leading causes of sleeping problems in women. It can usually be cured by estrogen and progesterone supplementation.

There are multiple ways to eliminate insomnia. Appropriate diet and exercise is the first line of treatment. Eliminating caffeine from the diet is extremely important. Caffeine has a half-life of six hours, so the stimulant is in the body for hours after intake. It is also important to limit nicotine and alcohol in the evening. Many people end up abusing alcohol, using it as a sleep aid. Alcohol will help initiate sleep, but it causes poor sleep by suppressing rapid eye movement (REM) sleep. Research has shown that lack of REM sleep is equivalent to no sleep at all. For obvious reasons it is important to avoid sugar in the evening. The most important cure is to eradicate the underlying diagnosis causing insomnia. Most sleeping disorders are secondary to stress and anxiety. Cognitive behavior therapy (CBT) aims at eliminating anxiety and is usually more effective than traditional medicines. Maintaining a regular sleep schedule is an important component of CBT.

Valerian is an herb that has been used for insomnia for two thousand years. Studies have shown that it is more effective for long-term improvement in sleep instead of initiating sleep acutely. Kava is another herb used for insomnia, but it is not as effective as valerian, and there have been questions concerning it causing liver damage. The pineal gland naturally produces melatonin, controlling the sleep-wake cycle. The production of melatonin is stopped in response to sunlight, causing us to waken in the morning. Melatonin naturally peaks at three o’clock in the morning, and darkness is responsible for this peak. The invention of electricity has affected our melatonin production. We now rely on artificial light after the sun goes down, affecting our circadian rhythm. Supplemental melatonin is used for insomnia, but most studies have only evaluated its usefulness for eliminating jet lag. To learn more about melatonin, see the chapter on other supplements. Antihistamines, such as Benadryl, have been used with success but tolerance easily builds and hangovers from the medicine are common. Halcion, the antipsychotic, has been used for years but it is no longer recommended because studies have shown it causes holes in ones memory the following day. Antidepressants are also commonly used and can be helpful, mainly because depression is a common cause of insomnia. Trazadone, an antidepressant, is commonly used for insomnia but it can cause residual sedation secondary to a long half-life of the drug. Anxiolytics, such as Xanax and Valium are widely used, but they are terribly physically addictive medicines. Ambien is the most common prescription medicine used for insomnia because it is so effective. It is not addictive like the anxiolytics, and it usually does not cause a hang over because of its short half-life. The problem with Ambien is that rebound insomnia can result from long-term use. What this means is that it becomes very difficult to naturally sleep after withdrawing from Ambien. Studies are currently underway evaluating the safety of taking sleeping pills every night. Any remedy used for insomnia can have a psychological addictive effect.

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