Insomnia

Description

Insomnia, the most common sleep disorder, is the inability to sleep at all, or the inability to sleep satisfactorily during normal sleeping hours. This condition should only be considered a problem if it impairs daily functioning.

Basic forms of insomnia are: difficulty falling asleep (initial insomnia), difficulty staying asleep, or early morning waking. There may be restless or disturbed sleep, reduction of sleep time (regardless of when the person falls asleep or wakens), and complete wakefulness.

Requirements for sleep vary among individuals and with respect to one individual. For example, children need more sleep than adults. The exact role of sleep and the precise sleep-inducing mechanisms are unknown.

There are many ways to treat insomnia. Some treatments include: exercising during the day, going for a walk about an hour before bedtime, reading before bedtime, taking a warm bath, drinking warm milk which contains tryptophan before bed, sexual intercourse, muscle relaxation exercises, meditation, and/or in severe cases deliberately staying awake for one night to force the resumption of a normal sleep pattern.

Causes

The majority of insomnia cases are caused by psychological and emotional problems, such as:

Watching exciting television programs before bedtime
Depression (especially in the case of early morning waking)
Anxiety
Unexpressed anger
Arguing with family members
Fear of dying while sleeping

Other causes include:

Consuming caffeinated beverages, such as coffee before bedtime
Paradoxical insomnia, i.e., use of medications prescribed to reduce insomnia
Consuming large quantities of alcohol before bedtime
Need to urinate frequently and other urinary problems
Consuming a large meal before bedtime
Napping, especially late in the day
Bright lights
Noise
Sleeping in an over or underheated room
Lack of ventilation
Sleeping with too few or too many sheets
Restless legs syndrome
Hypoventilation syndrome
Sleep apnea
Hunger
Constipation
Pregnancy
Parkinson's disease
Arthritis
Cramps
Heart disorders
Hypertension
Infection
Hardening of the arteries
Irritable bowel syndrome
Any other painful or discomforting disorder

Signs & Symptoms

The primary symptom of insomnia is sleeping less than normal such that daily function is impaired or still being tired after sleeping.

Nutritional Supplements

Structure & Function:
        Single Nutrients &
        Multi Vitamin/Multi Mineral Formulas

---------------------------------
General Supplements
---------------------------------

	Adult	Child/Adolescent
Chlorella*
Choline	200 - 500 mg	100 - 300 mg
Inositol	200 - 500 mg	100 - 300 mg
Magnesium	400 - 800 mg	200 - 400 mg
Melatonin*
Vitamin B-6	25 - 100 mg	10 - 50 mg
Zinc	20 - 30 mg	10 - 20 mg

* Please refer to the respective topic for specific nutrient amounts.

Discussion:-

Chlorella has also been recommended for sleep disorders.

In the place of the now unavailable supplement: tryptophan, natural sources such as pumpkin seeds are used.

Note: All amounts are in addition to those supplements having a Recommended Dietary Allowance (RDA). Due to individual needs, one must always be aware of a possible undetermined effect when taking nutritional supplements. If any disturbances from the use of a particular supplement should occur, stop its use immediately and seek the care of a qualified health care professional.

Dietary Considerations

Tryptophan is a chemical in the brain which induces sleep. To maximize the amount of dietary tryptophan entering the brain, it should be consumed in a high carbohydrate, low protein bedtime snack, such as warm milk and cookies. Carbohydrate-rich foods, such as pasta, salad, fruit and rich desserts, are good sleep-inducers if eaten one hour before retiring. Intake of caffeinated beverages, such as coffee, should be restricted to promote sleep. A Carbohydrate Intolerance Diet is recommended.

Insomnia can be due to chronic manganese toxicity when doses are greater than one gram per day. A diet low in vitamin B-6 has been shown to produce insomnia in adults.

Homeopathic Remedy

1. Coffea cruda - 30C
2. Valeriana - 15X
3. Passiflora incarnata tinct. - mother tincture to 6C

Advanced, by symptom:

1. Restless mind - Coffea cruda

2. Apprehension - Arsenicum Album

3. Emotional stress, depressed, "sigh" - Ignatia amara.

Treatment Schedule

Doses cited are to be administered on a 3X daily schedule, unless otherwise indicated. Dose usually continued for 2 weeks. Liquid preparations usually use 8-10 drops per dose. Solid preps are usually 3 pellets per dose. Children use 1/2 dose.

Legend

X = 1 to 10 dilution - weak (triturition)
C = 1 to 100 dilution - weak (potency)
M = 1 to 1 million dilution (very strong)
X or C underlined means it is most useful potency

Asterisk (*) = Primary remedy. Means most necessary remedy. There may be more than one remedy - if so, use all of them.


References

Boericke, D.E., 1988. Homeopathic Materia Medica.

Coulter, C.R., 1986. Portraits of Homeopathic Medicines.

Kent, J.T., 1989. Repertory of the Homeopathic Materia Medica.

Koehler, G., 1989. Handbook of Homeopathy.

Shingale, J.N., 1992. Bedside Prescriber.

Smith, Trevor, 1989. Homeopathic Medicine.

Ullman, Dana, 1991. The One Minute (or so) Healer.

Tissue Salts

Kali Phos.

Herbal Approaches

----------
Herbs
-----------

Hops (Humulus lupulus)
Kava kava
Melissa
Oat straw
Passion Flower (Passiflora incarnata)
St. John's wort
Valerian Root (Valeriana officinalis)

"Sleep disturbances" (German Commission E)

Hops
Lavender
Lemon Balm
Valerian Root

Note: The misdirected use of an herb can produce severely adverse effects, especially in combination with prescription drugs. This Herbal information is for educational purposes and is not intended as a replacement for medical advice.

Discussion:

Each year some 10 million Americans receive prescriptions for sleeping pills. Care must be exercised in combining, or overlapping herbs and drugs e.g. Shepherd's Purse and Sweet Flag have been noted to potentiate barbiturate sleeping time.

Valerian (sometimes in combination with Melissa) has proven equal to benzodiazepine on some measures, superior in others, particularly with regard to concentration and daytime sedation.

Newall has compiled an extensive list of herbs with sedative action (the most popular are featured above):

Herb	Effect
Calamus (Sweet Flag)	Potentiates barbiturate sleeping time
Celery Seed	In vivo
Chamomile, German	Human
Couchgrass	In vivo
Elecampane	In vivo
Ginseng	CNS depressant and stimulant
Goldenseal	In vivo
Hops	In vivo
Hydrocotyle (Gotu Kola)	In vivo
Jamaica Dogwood	In vivo
Nettle	CNS depression, in vivo
Passion Flower	In vivo
Sage	In vivo
Skullcap	Reputed action
Shepherd's Purse	Potentiates barbiturate sleeping time
St. John's Wort	Traditional use, bioflavonoids
Valerian	Human, in vivo
Wild Carrot Seed	In vivo
Wild Lettuce	In vivo, related species

References:

Dressing, H et al., Are Valeriana/Melissa combinations of equal value to benzodiazepine? Therapiewoche. 1992, 42:726-736.

Hoffmann, D: The New Holistic Herbal. Element, 1983. Third edition 1990.

Leathwood, P et al., Aqueous extract of valerian root (Valeriana officinalis L.) improves sleep quality in man. Pharmacol. Biochem. Behav. 1982, 17:65-71.

Leathwood, PD & Chauffard, F: Aqueous extract of valerian reduces latency to fall asleep in man. Planta Med. 1985, 32(4):1,065-1,066.

Newall CA, Anderson LA, Phillipson JD. Herbal Medicines A Guide for Health-care Professionals. London: The Pharmaceutical Press, 1996.

Aromatherapy - Essential Oils

Basil Essence,	Chamomile Essence,
Lavender Essence,	Lemon Essence,
Mandarin Essence,	Marjoram Essence,
Melissa Essence,	Orange Essence,
Petitgrain Essence,	Rose Essence,
Sandalwood Essence,	Ylang-Ylang Essence.

In the old days people would keep sprigs of lavender in their drawers, where pillowcases (and other clothes) were stored, or directly crush lavender in the pillowcase.

Today, if you don't grow lavender in your garden, place some drops on your pillow, or even rub a little lavender oil under your nose and breathe deeply as you lie in bed.

Related Health Conditions

Anxiety	Arthritis
Arteriosclerosis	Breathing disorders
Constipation	Cramp
Depression	Heart disorders
Hypertension	Infection
Irritable bowel syndrome	Parkinson's disease
Pregnancy	Sleep apnea
Urinary disorders

Abstracts

References

Aldrich-MS & Shipley-JE: Alcohol use and periodic limb movements of sleep. Alcohol-Clin-Exp-Res; 1993 Feb; 17(1); P 192-6.

Bland, Jeffrey. Nutraerobics. San Francisco: Harper & Row, 1983.

Bland, Jeffrey. Medical Applications of Clinical Nutrition. New Canaan, Conn.: Keats, 1983.

Bonnet-MH & Arand-DL: Caffeine use as a model of acute and chronic insomnia. Sleep; 1992 Dec; 15(6); P 526-36.

Chang-HY et al: Effects of intravenously administered vitamin B12 on sleep in the rat. Physiology-&-Behavior, 1995, 57: 6, 1019-1024; 26 ref.

Chasroff, I.J. & J.W. Ellis. 1983. Family Medical Guide, William Morrow and Company Inc., Pub. 594 pp.

Curless-R et al: Is caffeine a factor in subjective insomnia of elderly people? Age-Ageing; 1993 Jan; 22(1); P 41-5.

Dickerson, J.W.T. 1978. Nutrition and disorders of the nervous system. Nutrition in The Clinical Management of Disease. J.W.T. Dickerson and H.A. Lee, eds. Edward Arnold, London.

Ehret, Charles F. & Lynn Waller Scanlon. 1983. Overcoming Jet Lag. Berkley Books Pub., New York. p. 160.

Fallon-MT & Hanks-GW: Control of common symptoms in advanced cancer. Ann-Acad-Med-Singapore; 1994 Mar; 23(2); P 171-7.

Folks DG & Fuller WC: Anxiety disorders and insomnia in geriatric patients. Psychiatr Clin North Am, 1997 Mar, 20:1, 137-64.

Hartmann. Effects of Tryptophan on Sleepiness. J Psych Rsrch,17. 1982.

Hartmann, E. & C. Spinweber. Chronic Insomnia: Effects of Tryptophan and Placebo. Psychopharmacology, 80. 1983.

Heinerman, John. 1982. Herbal Dynamics. Root of Life, Inc.: Publ.

Hirayama-T: Green-yellow vegetables for human health with special reference to cancer prevention. J.-of-the-Japanese-Society-for-Horticultural-Science, 1995, 63: SPECISSUE, 965-974.

Hui, Y.H. 1983. Human nutrition and diet therapy. WadsWorth, Inc; Belmont, California. 1039 pp.

Kendler BS: Melatonin: media hype or therapeutic breakthrough? Nurse Pract, 1997 Feb, 22:2, 66-7, 71-2, 77.

King AC et al., Moderate-intensity exercise and self-rated quality of sleep in older adults. A randomized controlled trial. [see comments] JAMA, 1997 Jan 1, 277:1, 32-7.

Kirschmann, J.D. 1990. Nutrition Almanac: Nutrition Search. McGrew-Hill: New York.

Klink-ME et al: The relation of sleep complaints to respiratory symptoms in a general population. Chest; 1994 Jan; 105(1); P 151-4.

Kolata, G. Vitamin C Prevents Periodontal Disease in an Animal Model. Science, 209. 1981.

Lindblom SS: Adults who snore. Postgrad Med, 1997 Jun, 101:6, 171-2, 174, 183-4 passim.

Lindsley, J.G. & W. Mitchell. Selectivity in Response to L-Tryptophan Among Insomniac Patients. Sleep, 6. 1983.

Luke, B. 1984. Principles of Nutrition and Diet Therapy. Little, Brown, and Co., Boston. 816 pp.

Morgan K & Clarke D: Longitudinal trends in late-life insomnia: implications for prescribing. Age Ageing, 1997 May, 26:3, 179-84.

Murray, M.T., & J.E. Pizzorno. 1991. Encyclopedia of Natural Medicine. Rocklin, Ca; Prima Publishing.

Nino-Murcia-G: Diagnosis and treatment of insomnia and risks associated with lack of treatment. J-Clin-Psychiatry; 1992 Dec; 53 Suppl; P 43-7; discussion 48.

Partinen M: Sleep disorder related to Parkinson's disease. J Neurol, 1997 Apr, 244:4 Suppl 1, S3-6.

Petersdorf, R.G. & R.D. Adams. 1983. Harrison's Principles Of Internal Medicine. 10th ed. McGraw Hill Pub Co., N Y. 2212 pp.

Pillitteri-JL et al: Over-the-counter sleep aids: widely used but rarely studied. J-Subst-Abuse; 1994; 6(3); P 315-23.

Scharf MB et al., Effects of estrogen replacement therapy on rates of cyclic alternating patterns and hot-flush events during sleep in postmenopausal women: a pilot study. Clin Ther, 1997 Mar-Apr, 19:2, 304-11.

Schrauzer-GN et al: Somatopsychological effects of chromium supplementation. Journal-of-Nutritional-Medicine, 1992, 3: 1, 43-48; 8 ref.

Smeyatsky-N et al: The treatment of sleep disorders. S-Afr-Med-J; 1992 May 2; Suppl; P 1-8.

Spaggiari-MC et al: Nocturnal eating syndrome in adults. Sleep; 1994 Jun; 17(4); P 339-44.

Subak-Sharpe, G.J. 1984. The Physician's Manual For Patients. Times Books Pub, New York. 607 pp.

Taylor-M.: Insomnia and nutrition [letter] Aust-Fam-Physician. 1994 Mar; 23(3): 498.

Van-Gils-C & Cox-PA: Ethnobotany of nutmeg in the Spice Islands. J-Ethnopharmacol; 1994 Apr; 42(2); P 117-24.

Weitzenblum E et al., Sleep-related hypoxaemia in chronic obstructive pulmonary disease: causes, consequences and treatment. Respiration, 1997, 64:3, 187-93.