Insomnia Classification and external resources
ICD-10	F51.0, G47.0
ICD-9	307.42, 307.41, 780.51, 780.52
eMedicine	med/2698
MeSH	D007319

Insomnia is a sleeping disorder characterized by persistent difficulty falling asleep or staying asleep despite the opportunity. The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The International Statistical Classification of Diseases and Related Health Problems 10th Revision ( ICD -10) is a coding of diseases and signs symptoms abnormal findings The 2007 version of the ICD is available online at http//wwwwho G00-G99 - Diseases of the Nervous system (G00-G09 Inflammatory diseases of the Central nervous system ( Bacterial meningitis The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. eMedicine is an online clinical medical knowledge base that was founded in 1996 by Scott Plantz and Richard Lavely two medical doctors Medical Subject Headings ( MeSH) is a huge Controlled vocabulary (or metadata system for the purpose of indexing journal articles and books A sleep disorder (somnipathy is a medical disorder of the Sleep patterns of a person or animal Sleep is a Natural state of bodily rest observed throughout the animal kingdom It is typically followed by functional impairment while awake. Insomniacs have been known to complain about being unable to close their eyes or "rest their mind" for more than a few minutes at a time. Both organic and non-organic insomnia constitute a sleep disorder. A sleep disorder (somnipathy is a medical disorder of the Sleep patterns of a person or animal ^[1][2]

According to the U. S. Department of Health and Human Services in year 2007, approximately 64 million Americans suffer from insomnia each year. The United States Department of Health and Human Services ( HHS) is a Cabinet department of the United States government with the goal of protecting ^[3] Insomnia occurs 1. 4 times more commonly in women than in men. ^[4]

Contents 1 Types of Insomnia 2 Patterns of Insomnia 3 Causes 4 Diagnosis 5 Insomnia Versus Poor Sleep Quality 6 Treatment for Insomnia 6.1 Medications 6.1.1 Benzodiazepines 6.1.2 Non-benzodiazepines 6.1.3 Antidepressants 6.1.4 Melatonin 6.1.5 Antihistamines 6.1.6 Atypical Antipsychotics 6.2 Other Substances 6.3 Cognitive behavior therapy 6.4 Complementary and Alternative medicine 7 See also 8 References

Types of Insomnia

Although there are several different degrees of insomnia, about three types of insomnia have been clearly identified: transient, acute, and chronic.

1. Transient insomnia lasts from days to weeks. It can be caused by another disorder, by changes in the sleep environment, by the timing of sleep, or by stress. Its consequences - sleepiness and impaired psychomotor performance - are similar to those of sleep deprivation. Sleep deprivation is a general lack of the necessary amount of Sleep. ^[5] If this form of insomnia continues to occur from time to time, the insomnia is classified as intermittent.
2. Acute insomnia is the inability to consistently sleep well for a period of between three weeks to six months. In Medicine, an acute disease is a disease with either or both of a rapid onset a short course (as opposed to a chronic course ^[6]
3. Chronic insomnia lasts from months to years. In Medicine, a chronic disease is a Disease that is long-lasting or recurrent It can be caused by another disorder, or it can be a primary disorder. Its effects can vary according to its causes. They might include sleepiness, muscular fatigue, and/or mental fatigue; but people with chronic insomnia often show increased alertness. ^[5]

Patterns of Insomnia

The pattern of insomnia often is related to the etiology. ^[7]

1. Onset insomnia - difficulty falling asleep at the beginning of the night, often associated with anxiety disorders. Anxiety disorder is a blanket term covering several different forms of abnormal pathological anxieties Fears and Phobias In clinical usage "fear"
2. Middle-of-the-Night Insomnia - Insomnia characterized by difficulty returning to sleep after awakening in the middle of the night or waking too early in the morning. Middle-of-the-night insomnia (MOTN is Insomnia characterized by difficulty returning to sleep after awakening in the middle of the night Also referred to as nocturnal awakenings. Encompasses middle and terminal insomnia.
3. Middle insomnia - waking during the middle of the night, difficulty maintaining sleep. Often associated with pain syndromes or medical illness.
4. Terminal (or late) insomnia - early morning waking. Characteristic of clinical depression. Major depressive disorder, also known as major depression, unipolar depression, unipolar disorder, clinical depression, or simply depression

Causes

Insomnia can be caused by:

• Psychoactive drugs or stimulants, including certain medications, herbs, caffeine, cocaine, ephedrine, amphetamines, methylphenidate, MDMA, methamphetamine and modafinil
• Hormone shifts such as those that precede menstruation and those during menopause
• Life problems like fear, stress, anxiety, emotional or mental tension, work problems, financial stress, unsatisfactory sex life
• Mental disorders such as clinical depression, schizophrenia, bipolar disorder, general anxiety disorder
• Disturbances of the circadian rhythm, such as shift work and jet lag, can cause an inability to sleep at some times of the day and excessive sleepiness at other times of the day. A psychoactive drug or psychotropic substance is a Chemical substance that acts primarily upon the Central nervous system where it alters Brain Stimulant drugs are Drugs that temporarily increase alertness and awareness Medication, also referred to as medicine, can be loosely defined as any substance intended for use in the diagnosis cure mitigation treatment or prevention of disease A(n herb (ˈhɝb or /ˈɝb/ see pronunciation differences) is a plant that is valued for qualities such as medicinal properties flavor scent or the like Caffeine is a bitter white crystalline Xanthine Alkaloid that acts as a Psychoactive Stimulant Drug and a mild Diuretic Cocaine ( benzoylmethyl ecgonine) is a Crystalline Tropane Alkaloid that is obtained from the leaves of the Coca plant Ephedrine (EPH is a Sympathomimetic Amine commonly used as a Stimulant, appetite suppressant concentration aid Decongestant, and to treat Amphetamine, and related drugs such as Methamphetamine are a group of drugs that act by increasing levels of Norepinephrine, Serotonin, and Dopamine MDMA ( 34-methylenedioxy- N -methylamphetamine) most commonly known today by the street name Ecstasy (often abbreviated E, X, Modafinil ( Provigil) is a stimulant-like drug manufactured by Cephalon, and is approved by the FDA for the treatment of Narcolepsy Hormones (from Greek ὁρμή - "impetus" are chemicals released by cells that affect cells in other parts of the body See also "Mensuration" a term sometimes used to describe Measurement, particularly in the context of Forestry. Menopause is the permanent shutting down of the female Reproductive system, a considerable length of time before the end of the lifespan Fear is an Emotional response to Threats and Danger. It is a basic survival mechanism occurring in response to a specific Stimulus, such as Anxiety is a physiological and psychological state characterized by Cognitive, Somatic, Emotional and Behavioral components Mental disorder or mental illness is a psychological or behavioral pattern that occurs in an individual and is thought to cause distress or disability that is not expected as Major depressive disorder, also known as major depression, unipolar depression, unipolar disorder, clinical depression, or simply depression Schizophrenia ( from the Greek roots schizein (σχίζειν "to split" and phrēn Generalized anxiety disorder ( GAD) is an Anxiety disorder that is characterized by excessive uncontrollable and often irrational worry about everyday things that Circadian rhythm sleep disorders are a family of Sleep disorders affecting among other things the timing of sleep Jet lag, also jetlag or jet-lag, is a physiological condition which is a consequence of alterations to Circadian rhythms it is classified Jet lag is seen in people who travel through multiple time zones, as the time relative to the rising and setting of the sun no longer coincides with the body's internal concept of it. The insomnia experienced by shift workers is also a circadian rhythm sleep disorder.
• Certain neurological disorders, brain lesions, or a history of traumatic brain injury
• Medical conditions such as hyperthyroidism and Wilson's syndrome
• Abuse of over-the counter or prescription sleep aids can produce rebound insomnia
• Poor sleep hygiene
• Parasomnia, which includes a number of disruptive sleep events including nightmares, sleepwalking, violent behavior while sleeping, and REM behavior disorder, in which a person moves his/her physical body in response to events within his/her dreams
• A rare genetic condition can cause a prion-based, permanent and eventually fatal form of insomnia called fatal familial insomnia

A common misperception is that the amount of sleep a person requires decreases as he or she ages. The brain is the center of the Nervous system in animals All Vertebrates and the majority of Invertebrates have a brain A lesion is any abnormal tissue found on or in an organism usually damaged by disease or trauma The medical history or Anamnesis of a Patient is information gained by a Physician or other healthcare professional by asking specific questions Traumatic brain injury (TBI also called intracranial injury, occurs when Physical trauma injures the Brain. A disease is an abnormal condition of an organism that impairs bodily functions and can be deadly Hyperthyroidism is the term for overactive tissue within the Thyroid gland resulting in overproduction and thus an excess of circulating free thyroid hormones Thyroxine Not to be confused with Wilson's disease, a rare condition caused by a defect in the body's ability to metabolize copper Rebound insomnia is Insomnia that occurs following discontinuation of Sedative substances taken to relieve primary insomnia Sleep hygiene can be defined as "all behavioural and environmental factors that precede sleep and may interfere with sleep Parasomnias are a wide variety of disorders that revolve around sleep Rapid eye movement sleep behaviour disorder ( RBD) is a Sleep disorder (more specifically a Parasomnia) that involves abnormal behavior during the Sleep A prion (ˈpriːɒn is thought to be an infectious agent that according to current scientific consensus is comprised entirely of a propagated, mis-folded Fatal familial insomnia (FFI is a very rare autosomal dominant inherited Prion Disease of the Brain. The ability to sleep for long periods, rather than the need for sleep, appears to be lost as people get older. Some elderly insomniacs toss and turn in bed and occasionally fall off the bed at night, diminishing the amount of sleep they receive. ^[8]

An overactive mind or physical pain may also be causes. Finding the underlying cause of insomnia is usually necessary to cure it. Insomnia can be common after the loss of a loved one, even years or decades after the death, if they have not gone through the grieving process. Overall, however, symptoms and the degree of severity affects different people differently, depending on their mental health, physical condition, and attitude or personality.

Diagnosis

Patients with delayed sleep phase syndrome are often mis-diagnosed with insomnia. Delayed sleep-phase syndrome (DSPS also known as delayed sleep-phase disorder (DSPD or delayed sleep-phase type (DSPT is a Circadian rhythm sleep disorder If the patient has trouble getting to sleep, but has normal sleep architecture once asleep, a circadian rhythm disorder is a more likely cause.

Insomnia Versus Poor Sleep Quality

Poor sleep quality can occur as a result of sleep apnea or clinical depression. Major depressive disorder, also known as major depression, unipolar depression, unipolar disorder, clinical depression, or simply depression Poor sleep quality is caused by the individual not reaching stage 4 or delta sleep which has restorative properties. There are, however, people who are unable to achieve stage 4 sleep due to brain damage who still lead perfectly normal lives.

• Sleep apnea is a condition that occurs when a sleeping person's breathing is interrupted, thus interrupting the normal sleep cycle. Sleep apnea is a sleep disorder characterized by pauses in Breathing during Sleep. With the obstructive form of the condition, some part of the sleeper's respiratory tract loses muscle tone and partially collapses. People with obstructive sleep apnea often do not remember awakening or having difficulty breathing, but they complain of excessive sleepiness during the day. Central sleep apnea interrupts the normal breathing stimulus of the central nervous system, and the individual must actually wake up to resume breathing. In Vertebrates the central nervous system ( CNS) is the part of the Nervous system which is enclosed in the Meninges. This form of apnea is often related to a cerebral vascular condition, congestive heart failure, and premature aging.

Major depression leads to alterations in the function of the hypothalamic-pituitary-adrenal axis, causing excessive release of cortisol which can lead to poor sleep quality. The hypothalamic-pituitary-adrenal axis ( HPA or HTPA axis) also known as the Limbic -hypothalamic-pituitary-adrenal axis (LHPA axis is a complex set of direct influences Cortisol is a Corticosteroid Hormone produced by the Adrenal gland (in the Zona fasciculata of the Adrenal cortex)

Nocturnal polyuria or excessive nighttime urination can be very disturbing to sleep. In Medicine, polyuria is a condition characterized by the passage of large volumes of urine (at least 2 ^[9] Nocturnal polyuria can be nephrogenic (related to kidney disease) or it may be due to prostate enlargement or hormonal influences. Deficiencies in vasopressin, which is either caused by a pituitary problem or by insensitivity of the kidney to the effects of vasopressin, can lead to nocturnal polyuria. Excessive thirst or the use of diuretics can also cause these symptoms.

Treatment for Insomnia

In many cases, insomnia is caused by another disease or psychological problem. In this case, medical or psychological help may be useful.

Medications

Many insomniacs rely on sleeping tablets and other sedatives to get rest. A sedative, or more specifically a sedative-hypnotic, is a substance that depresses the Central nervous system (CNS resulting in calmness relaxation sleepiness A sedative, or more specifically a sedative-hypnotic, is a substance that depresses the Central nervous system (CNS resulting in calmness relaxation sleepiness All sedative drugs have the potential of causing psychological dependence where the individual cannot psychologically accept that they can sleep without drugs. Certain classes of sedatives such as benzodiazepines and newer nonbenzodiazepine drugs can also cause physical dependence which manifests in withdrawal symptoms if the drug is not carefully titrated down. The benzodiazepines (pronounced, often abbreviated to "benzos") are a class of Psychoactive drugs with varying Hypnotic The nonbenzodiazepines are comparatively new drugs whose actions are somewhat similar to those of the Benzodiazepines but are structurally unrelated to the Benzodiazepines

In comparing the options, a systematic review found that benzodiazepines and nonbenzodiazepines have similar efficacy which was insignificantly more than for antidepressants. A systematic review is a Literature review focused on a single question which tries to identify appraise select and synthesize all high quality research evidence relevant to The benzodiazepines (pronounced, often abbreviated to "benzos") are a class of Psychoactive drugs with varying Hypnotic The nonbenzodiazepines are comparatively new drugs whose actions are somewhat similar to those of the Benzodiazepines but are structurally unrelated to the Benzodiazepines In Statistics, a result is called statistically significant if it is unlikely to have occurred by Chance. An antidepressant is a Psychiatric medication used for alleviating major depression or Dysthymia ('milder' depression ^[10] Benzodiazepines had an insignificant tendency for more adverse drug reactions. In Statistics, a result is called statistically significant if it is unlikely to have occurred by Chance. An adverse drug reaction (abbreviated ADR) or adverse drug event (abbreviated ADE) is an expression that describes the unwanted negative consequences ^[10]

Benzodiazepines

Main article: Benzodiazepine

The most commonly used class of hypnotics prescribed for insomnia are the benzodiazepines. The benzodiazepines (pronounced, often abbreviated to "benzos") are a class of Psychoactive drugs with varying Hypnotic The benzodiazepines (pronounced, often abbreviated to "benzos") are a class of Psychoactive drugs with varying Hypnotic Benzodiazepines bind unselectively to the GABA_A receptor. The benzodiazepines (pronounced, often abbreviated to "benzos") are a class of Psychoactive drugs with varying Hypnotic The GABAA receptor is one of two ligand-gated Ion channels responsible for mediating the effects of Gamma-aminobutyric acid (GABA the major ^[10] This includes drugs such as temazepam, flunitrazepam, triazolam, flurazepam, nitrazepam and midazolam. Temazepam (marketed under brand names Restoril, Euhypnos, Normison, Remestan, Tenox and Norkotral) is an intermediate-acting Flunitrazepam (ˌfluːnaɪˈtræzəpæm is a highly potent Hypnotic drug with powerful Sedative, Anxiolytic, Amnestic, and Skeletal Triazolam (marketed under brand names Halcion, Novodorm, Songar) is a Benzodiazepine derivative drug Flurazepam (marketed under the brand names Dalmane and Dalmadorm) is a drug which is a Benzodiazepine derivative Nitrazepam is a type of Benzodiazepine drug It is a hypnotic drug with Sedative and motor impairing properties Anxiolytic, Amnestic Midazolam (marketed under brand names Dormicum, Flormidal, Versed, Hypnovel and Dormonid, pronounced mɪˈdæzəlæm These medications can develop tolerance and dependence, especially after consistent usage over long periods of time.

Non-benzodiazepines

Main article: Nonbenzodiazepine

Nonbenzodiazepine prescription drugs, such as zolpidem and zopiclone, are more selective for the GABA_A receptor^[10] and may have a cleaner side effect profile than the older benzodiazepines; however, there are controversies over whether these non-benzodiazepine drugs are superior to benzodiazepines. The nonbenzodiazepines are comparatively new drugs whose actions are somewhat similar to those of the Benzodiazepines but are structurally unrelated to the Benzodiazepines The nonbenzodiazepines are comparatively new drugs whose actions are somewhat similar to those of the Benzodiazepines but are structurally unrelated to the Benzodiazepines Zolpidem is a prescription medication used for the short-term treatment of Insomnia, as well as some brain disorders Zopiclone (pronunciation perhaps ˈzɒpɪkloʊn sold as Imovane and Zimovane in Europe and Canada and as the Eszopiclone analogue Lunesta The GABAA receptor is one of two ligand-gated Ion channels responsible for mediating the effects of Gamma-aminobutyric acid (GABA the major These drugs appear to cause both psychological dependence and physical dependence, and can also cause the same memory and cognitive disturbances as the benzodiazepines along with morning sedation. The term " addiction " is used in many contexts to describe an obsession compulsion or excessive Physical dependence or psychological dependence such as Physical dependence (or drug dependence) refers to a state resulting from habitual use of a drug where negative physical Withdrawal symptoms result from abrupt discontinuation

Antidepressants

Main article: Antidepressants

Some antidepressants such as amitriptyline, doxepin, mirtazapine, and trazodone may have a sedative effect, and are prescribed off label to treat insomnia. An antidepressant is a Psychiatric medication used for alleviating major depression or Dysthymia ('milder' depression An antidepressant is a Psychiatric medication used for alleviating major depression or Dysthymia ('milder' depression Amitriptyline (or Amitryptyline) hydrochloride (sold as Elavil Tryptanol Endep Elatrol Tryptizol Trepiline Laroxyl Saroten is a Tricyclic antidepressant Doxepin is a psychotropic agent with Tricyclic antidepressant and Anxiolytic properties known under many brand-names such as Aponal Mirtazapine is an Antidepressant introduced by Organon International in 1994 used for the treatment of moderate to severe depression. Trazodone (trade names Desyrel, Molipaxin, Trittico, Thombran, Trialodine, Trazorel) is a Psychoactive compound Off-label use is the practice of prescribing drugs for a purpose outside the scope of the drug's approved label most often concerning the drug's indication. The major drawback of these drugs is that they have antihistaminergic, anticholinergic and antiadrenergic properties which can lead to many side effects. A histamine antagonist is an agent which serves to inhibit the release or action of Histamine. An anticholinergic agent is a substance that blocks the Neurotransmitter acetylcholine in the central and the Peripheral nervous system. A sympatholytic drug is a medication which inhibits the Postganglionic functioning of the Sympathetic nervous system (SNS Some also alter sleep architecture. As with many benzodiazepines, the use of antidepressants in the treatment of insomnia can lead to physical dependence; withdrawal may induce rebound insomnia and actually further complicate matters in the long-term. Physical dependence (or drug dependence) refers to a state resulting from habitual use of a drug where negative physical Withdrawal symptoms result from abrupt discontinuation Rebound insomnia is Insomnia that occurs following discontinuation of Sedative substances taken to relieve primary insomnia

Melatonin

Melatonin has proved effective for some insomniacs in regulating the sleep/waking cycle, but lacks definitive data regarding efficacy in the treatment of insomnia. Melatonin is a naturally occurring Hormone found in most animals including humans and some other living organisms including Algae. Melatonin agonists, including Ramelteon (Rozerem), seem to lack the potential for abuse and dependence. Ramelteon, marketed as Rozerem by Takeda Pharmaceuticals North America, is the first in a new class of sleep agents that selectively binds to the MT1 This class of drugs has a relatively mild side effect profile and lower likelihood of causing morning sedation. Natural substances such as 5-HTP and L-Tryptophan have been said to fortify the serotonin -> melatonin pathway and aid people with various sleep disorders including insomnia. 5-Hydroxytryptophan or 5-HTP is a naturally-occurring Amino acid, a precursor to the Neurotransmitter Serotonin and an intermediate Tryptophan (abbreviated as Trp or W) is one of the 20 standard amino acids, as well as an Essential amino acid in the Human diet Serotonin (ˌsɛrəˈtoʊnən ( 5-hydroxytryptamine, or 5-HT) is a Monoamine Neurotransmitter synthesized in serotonergic Neurons ^[11]

Antihistamines

The antihistamine diphenhydramine is widely used in nonprescription sleep aids, with a 50 mg recommended dose mandated by the FDA. A histamine antagonist is an agent which serves to inhibit the release or action of Histamine. Pharmacological action Diphenhydramine (dye fen hye' dra meen works by blocking the effect of histamine at H1 receptor sites In the United Kingdom, Australia, New Zealand, South Africa, and other countries, a 50 to 100 mg recommended dose is permitted. While it is available over the counter, the effectiveness of these agents may decrease over time and the incidence of next-day sedation is higher than for most of the newer prescription drugs. Dependence does not seem to be an issue with this class of drugs.

Cyproheptadine is an useful alternative to benzodiazepine hypnotics in the treatment of insomnia. Cyproheptadine (usually as cyproheptadine hydrochloride, trade name Periactin) is an antihistaminic and Antiserotonergic agent The benzodiazepines (pronounced, often abbreviated to "benzos") are a class of Psychoactive drugs with varying Hypnotic Cyproheptadine may be superior to benzodiazepines in the treatment of insomnia because cyproheptadine enhances sleep quality and quantity whereas benzodiazepines tend to decrease sleep quality. ^[12]

Atypical Antipsychotics

Low doses of certain atypical antipsychotics such as quetiapine (Seroquel) are also prescribed for their sedative effect but the danger of neurological and cognitive side effects make these drugs a poor choice to treat insomnia. The atypical antipsychotics (also known as second generation antipsychotics) are a group of Antipsychotic drugs used to treat psychiatric conditions Quetiapine ( kwe-TYE-a-peen marketed by AstraZeneca as Seroquel and by Orion Pharma as Ketipinor, is an Atypical antipsychotic Over time, Seroquel may lose it's ability to produce sedation.

Other Substances

Some insomniacs use herbs such as valerian, chamomile, lavender, hops, and passion-flower. A(n herb (ˈhɝb or /ˈɝb/ see pronunciation differences) is a plant that is valued for qualities such as medicinal properties flavor scent or the like Valerian ( Valeriana officinalis, Valerianaceae) is a hardy perennial flowering Plant, with heads of sweetly scented pink or white flowers The Lavenders Lavandula are a Genus of about 25–30 species of Flowering plants in the mint family Lamiaceae, native to the Mediterranean Hops are the female Flower cones of the hop plant ( Humulus lupulus) Passion flower ( Passiflora; syn Disemma Labill) is a Genus of about 500 Species of Flowering plants in Valerian has undergone multiple studies and appears to be modestly effective. ^[13][14][15] Cannabis has also been suggested as a very effective treatment for insomnia. Cannabis ( Cán-na-bis) is a Genus of Flowering plants that includes three putative species Cannabis sativa subsp ^[16]

Though alcohol may have sedative properties, the REM sleep suppressing effects of the drug prevent restful, quality sleep. In Chemistry, an alcohol is any Organic compound in which a Hydroxyl group ( - O[[hydrogen H]]) is bound to a Carbon Also, middle-of-the-night awakenings due to polyuria or other effects from alcohol consumption are common, and hangovers can also lead to morning grogginess. Middle-of-the-night insomnia (MOTN is Insomnia characterized by difficulty returning to sleep after awakening in the middle of the night In Medicine, polyuria is a condition characterized by the passage of large volumes of urine (at least 2 A hangover ( veisalgia) describes the sum of unpleasant physiological effects following heavy consumption of drugs particularly Alcoholic beverages The most commonly

Insomnia may be a symptom of magnesium deficiency, or lower magnesium levels. Magnesium deficiency refers to an absolute lack of Magnesium, the result of numerous conditions Magnesium (mægˈniːziəm is a Chemical element with the symbol Mg, Atomic number 12 Atomic weight 24 A healthy diet containing magnesium, can help to improve sleep in individuals without an adequate intake of magnesium. Magnesium (mægˈniːziəm is a Chemical element with the symbol Mg, Atomic number 12 Atomic weight 24 Magnesium (mægˈniːziəm is a Chemical element with the symbol Mg, Atomic number 12 Atomic weight 24 ^[17]

Other reports cite the use of an elixir of cider vinegar and honey but the evidence for this is only anecdotal. ^[18]

Cognitive behavior therapy

Recent research has shown that cognitive behavior therapy can be more effective than medication in controlling insomnia. Cognitive Therapy (CT is a type of Psychotherapy developed by American Psychiatrist Aaron T ^[19] In this therapy, patients are taught improved sleep habits and relieved of counter-productive assumptions about sleep. ^[19]

Complementary and Alternative medicine

Some traditional and anecdotal remedies for insomnia include: drinking warm milk before bedtime, taking a warm bath, exercising vigorously for half an hour in the afternoon, eating a large lunch and then having only a light evening meal at least three hours before bed, avoiding mentally stimulating activities in the evening hours, going to bed at a reasonable hour and getting up early, and avoiding exposing the eyes to too much light, especially blue light, a few hours before bedtime.

Using aromatherapy, including jasmine oil, lavender oil, Mahabhringaraj and other relaxing essential oils, may also help induce a state of restfulness. Aromatherapy is a form of Alternative medicine that uses volatile liquid plant materials known as Essential oils (EOs and other aromatic compounds from plants for Lavender oil is an Essential oil obtained by Distillation from the flower spikes of certain species of Lavender. Mahabhringaraj is a herbal hair oil It conforms to the Ayurveda system of Indian medicine An essential oil is a concentrated Hydrophobic Liquid containing volatile Aroma compounds from Plants They are also known as volatile Many believe that listening to slow paced music will help insomniacs fall asleep. ^[20]

The more relaxed a person is, the greater the likelihood of getting a good night's sleep. Relaxation techniques such as meditation have been shown to help people sleep. A Relaxation technique (also known as Relaxation training) is any method process procedure or activity that helps a person to relax to attain a state of increased calmness Meditation is a mental discipline by which one attempts to get beyond the conditioned "thinking" mind into a deeper state of relaxation or awareness Such techniques can lower stress levels from both the mind and body, which leads to a deeper, more restful sleep.

Traditional Chinese medicine has included treatment for insomnia. Traditional Chinese medicine (also known as TCM,) includes a range of traditional medical practices originating in China. A typical approach may utilize acupuncture, dietary and lifestyle analysis, herbology and other techniques, with the goal of resolving the problem at a subtle level. History Antiquity In China, the practice of acupuncture can perhaps be traced as far back as Herbalism is a traditional Medicinal or Folk medicine practice based on the use of Plants and Plant extracts Herbalism is also known as

In the Buddhist tradition, people suffering from insomnia or nightmares may be advised to meditate on "loving-kindness", or metta. Mettā meditation the practice of loving-kindness Mettā signifies Friendship and Non-violence as well as "a strong wish for the happiness of others" This practice of generating a feeling of love and goodwill is claimed to have a soothing and calming effect on the mind and body. ^[21] This is claimed to stem partly from the creation of relaxing positive thoughts and feelings, and partly from the pacification of negative ones. In the Mettā (Mettanisamsa) Sutta,^[22] Siddhartha Gautama, the Buddha, tells the gathered monks that easeful sleep is one benefit of this form of meditation.

Hypnotherapy, self hypnosis and guided imagery can be effective in not only falling asleep and staying asleep; they can also help to develop good sleeping habits over time. Hypnotherapy is therapy that is undertaken with a subject in Hypnosis. Visualizing can be effective in taking the mind away from present day anxieties and towards a more relaxing place.

See also

• Sleep
• Sleep disorder
• Fatal familial insomnia
• Sleep deprivation
• Delayed sleep phase disorder
• Actigraphy

References

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