About insomnia treatment: sleep aids and stimulants
What is insomnia treatment: sleep aids and stimulants?
Insomnia is difficulty falling or staying asleep, the absence of restful sleep, or poor quality of sleep. Insomnia is a symptom and not a disease.
What are the causes for insomnia treatment: sleep aids and stimulants?
The most common causes of insomnia are:
- psychological conditions (for example, depression, anxiety),
- environmental changes (travel, jet lag, or altitude changes), and
- stressful events or a stressful lifestyle.
Insomnia can also be caused by poor sleeping habits such as excessive daytime naps or caffeine consumption and poor sleep hygiene.
What are the treatments for insomnia treatment: sleep aids and stimulants?
There are several ways insomnia may be treated without use of medication. These include behavioral modification and use of natural herbal remedies.
When a person consults a doctor about insomnia, they may be asked to keep a sleep log for several weeks to monitor sleep habits. The treatment options for short-term or chronic insomnia include not only medications, but often sleep habit and behavioral modifications for optimal long-term results.
Evaluating sleep habits is important in the management of insomnia. Treatment of underlying sleep disorders and in some instances, changing sleep habits may correct the problem without the need for medications. Good sleep habits (also referred to as good sleep hygiene) should include:
- Regular sleep times
- A comfortable bed and quiet room at a comfortable, temperature
- A darkened room
- Regular exercise, but not close to bedtime or late in the evening
- A bedroom that is not used for work, watching television, or other activities not related to sleep other than sex
- Avoid of stimulants (for example, caffeine, or tobacco), alcohol, and large meals close to bedtime (avoid 2-4 hours before bedtime if possible)
- Many people watch television before falling asleep. TV can be a very stimulating medium and needs to be closely evaluated if it adds to a person's insomnia.
- Relaxation techniques such as breathing exercises or yoga
- No naps during the day
- Try drinking warm milk before bed. It is high in the amino acid tryptophan, which helps induce sleep.
What are the risk factors for insomnia treatment: sleep aids and stimulants?
The American Academy of Sleep Medicine estimates 30% of adults have some symptoms of insomnia, 10% have insomnia symptoms so severe they cause consequences such as daytime sleepiness, and less than 10% have chronic insomnia.
Insomnia may be classified by how long the symptoms are present.
- Transient insomnia usually is due to situational changes such as travel, extreme climate changes, and stressful events. It lasts for less than a week or until the stressful event is resolved.
- Short-term insomnia usually is due to ongoing stressful lifestyle or events, medication side effects or medical conditions and lasts for one to three weeks.
- Chronic insomnia (long-term insomnia) often results from depression, digestive problems, sleep disorders, or substance abuse and continues for more than three weeks.
Transient insomnia may progress to short-term insomnia and without adequate treatment short-term insomnia may become chronic insomnia.
Some of the medications and substances that can contribute to insomnia are:
- caffeine and coffee,
- decongestants (for example, pseudoephedrine),
- diuretics (for example, furosemide [Lasix], hydrochlorothiazide [Dyazide]) especially if taken in the evening or at bedtime,
- antidepressants (for example, bupropion [Wellbutrin, Wellbutrin SR, Wellbutrin XL, Zyban], fluoxetine [Prozac]),
- appetite suppressants (for example, sibutramine [Meridia], phentermine [Fastin]), and
Insomnia also may be the result of withdrawal from:
- benzodiazepines (for example, diazepam [Valium], chlordiazepoxide [Librium], lorazepam [Ativan]),
- marijuana, and
- other addicting drugs.
Insomnia can also result from poor sleep-related habits (poor sleep hygiene).
Is there a cure/medications for insomnia treatment: sleep aids and stimulants?
There are numerous prescription medications options a doctor may prescribe if a person is suffering from short-term or chronic insomnia. Most are not recommended for long-term use.
Medication to treat insomnia includes several classes of drugs;
- Short-acting sedative-hypnotics (non-benzodiazepines) - these medications slow activity in the brain to allow sleep.
- zolpidem (Ambien, ZolpiMist)
- Intermezzo was approved by the FDA in 2011. It is a form of zolpidem, taken sublingually (dissolved under the tongue) and in smaller doses than Ambien.
- zaleplon (Sonata)
- eszopiclone (Lunesta)
- zolpidem (Ambien, ZolpiMist)
In 2007, the FDA issued a warning in regard to sedative-hypnotic drugs and their risks, which "...include severe allergic reactions and complex sleep-related behaviors, which may include sleep driving. Sleep driving is defined as driving while not fully awake after ingestion of a sedative-hypnotic product, with no memory of the event." The recommended dosing has recently changed ans is different based on gender and other factors. You should ask your doctor and pharmacist about appropriate levels and warnings.
- Orexin receptor antagonists – suvorexant (Belsomra) – this is a newer classification of insomnia medication working on orexin receptors in the lateral hypothalamus in the brain. The drug acts by decreasing activity in the wake centers of the brain and helping patients transition to sleep. This is in contrast to traditional insomnia medications which attempt to increase activity in the sleep centers of the brain. The medication is generally thought to be safe an well tolerated but some side weffects may occur.
- Melatonin receptor agonists - used to help patients who have difficulty falling asleep and it works similarly to melatonin
- ramelteon (Rozerem): Ramelteon is a medication taken by mouth 30 minutes prior to bedtime. Ramelteon should not be taken if the patient will not be able to sleep for at least 7-8 hours. Insomnia usually improves in 7-10 days.
- One of the advantages of ramelteon over other prescription sleep medications is the lack of dependence on the medication.
- Benzodiazepines (tranquilizers) - this class of medication is used to slow down the central nervous system, causing drowsiness. These medications have a high risk of dependence with chronic usage.
- flurazepam (Dalmane)
- temazepam (Restoril)
- estazolam (ProSom)
- Tricyclic antidepressants: Tricyclic antidepressants are medications work by increasing the amounts of certain natural substances in the brain that are needed for mental balance.
- doxepin (Silenor): in 2010, this sleep medicine was approved for the use in people who have trouble staying asleep. Silenor may help with sleep maintenance by blocking histamine receptors.
If your doctor recommends prescription sleep medications:
- Follow all prescribing instructions given by your physician.
- Tell your doctor any other medications or supplements you take as many can have adverse interactions with sleep medications.
- Tell your doctor about any pre-existing medical conditions.
- Note any possible negative side effects (changes in your body, and even your emotions)
- Do not use the medications nightly unless instructed to do so by a doctor - this can lead to dependence.
- Avoid drinking alcohol or taking other non-prescription drugs while using sleep medication.
- Never drive a car or operate machinery after taking a sleeping pill.