Insomnia Risk Factors and Current Treatments
Although we were able to find the risk factors for insomnia and current treatments for the disease, we were unable to provide data on the efficacy of these treatments even after thoroughly reviewing peer reviewed reports, health related websites, and government platforms. Our findings on the risk factors and treatments for insomnia have been outlined below.
Insomnia is the inability to fall asleep and/or stay asleep. This condition is reportedly one of the most common sleep problems that people around the world have. Globally, 1 in 3 people have insomnia while 1 in 4 Americans struggle with this condition. There are several factors that increase the likelihood of having insomnia. These risk factors are as follows:
Age: The older an individual is, the higher the chances of having insomnia. People above 60 years old have a higher chance of having insomnia when compared to young people. Older people are more likely to have insomnia because of bodily changes they go through related to aging. In addition, most of them have medical conditions which require them to take medications. This in turn leads to lack of sound sleep. Mayo Clinic reported that almost 50% of men and women over the age of 60 go through symptoms of insomnia. Gender: Studies report that women are more likely to have insomnia than men due to hormonal changes such as premenstrual syndrome (PMS) and pregnancy. These hormonal shifts not only affect the body, they also affect sleep patterns.
Medications & Stimulants: There are several medications (both prescriptions and over the counter) and stimulants that lead to insomnia. Some include diet pills, antidepressants, allergy medicine, drugs for high blood pressure, phenytoin (for seizure disorder), steroids, decongestants, selective serotonin reuptake inhibitors, and theophylline (for asthma). Coffee, tea, energy drinks, and most soft drinks contain caffeine which interferes with sleep. While alcohol helps people fall asleep at first, it inhibits deep stages of sleep which are important for one to get sufficient rest. Smoking also prevents adequate sleep due to the nicotine in it.
Psychological Factors: Experts have proven that being stressed is the main cause of mild insomnia. Stress can be triggered by job or family related issues, the death of a close friend, school, and several other personal problems. Insomnia is known to be one of the symptoms of depression, anxiety, and bipolar disorder.
Chronic Diseases: Chronic diseases can increase the risk of insomnia or disturb sleep. Some diseases linked to or associated with insomnia are diabetes, arthritis, heart disease, lung disease, Parkinson disease, restless leg syndrome, gastrointestinal reflux disease, Alzheimer disease, fibromyalgia, and sleep apnea.
Environmental Changes: A change in work shift, long-distance travel leading to jet lag, and a distracting sleep environment can negatively affect the body's circadian rhythm or internal clock. The circadian rhythm regulates body temperature, sleep cycles, and metabolism. Thus, a major change in environment can prevent adequate sleep.
Other Factors: Some other risk factors for insomnia include lifestyle behavior such as working out prior to sleeping and an irregular schedule.
In order to improve sleep quality and treat insomnia, several steps need to be taken. These steps vary based on the "underlying etiology." They are as follows:
PSYCHOLOGICAL AND BEHAVIORAL INTERVENTIONS
Psychological and behavioral interventions such as cognitive-behavioral therapy are recommended for treating chronic and primary insomnia. To treat primary insomnia, appropriate sleep measures need to be taken. Good sleeping habits like avoiding heavy meals in the night and having a comfortable environment to sleep are encouraged. Most patients with primary insomnia are advised to keep a sleep diary for 7 to 14 days in order to figure out the level of sleep disturbance that occurs. This is then used to tailor the appropriate treatment. Cognitive-behavioral therapy is said to be the most effective treatment for primary insomnia. According to a study done by the Research Institute of Child Development and Education at the University of Amsterdam, cognitive behavioral therapy is highly effective for "both short- and long-term outcomes" of insomnia. The study found that there were improvements after about "six sessions of cognitive behavioral group therapy for sleep disturbances."
Cognitive behavioral therapy for insomnia includes the following:
Biofeedback: This method involves sensors which are fixed to a machine and then placed on the body in order to measure body functions like heart rate and muscle tension. The machine shows pictures and produces sounds which enables a general practitioner or clinical psychologist to notice a patient's tensed state.
Stimulus-control therapy: The main aim of stimulus-control therapy is to help an insomnia patient form an adequate and consistent sleep pattern.
Paradoxical intention: This is used for people who have a hard time getting to sleep but it doesn't help stay asleep.
Sleep restriction therapy: This method involves putting a limit to the amount of time in bed which then leads to minor sleep deprivation. At this point, sleep time increases.
Hypnotics are sleeping medications that help people sleep. While it was used more often in the past, nowadays, it is not used by a lot of people. These medications are only considered for severe insomnia, as a temporary treatment for short-term insomnia, or if cognitive and behavioral treatments do not help with insomnia. Sleeping medications are not used by a lot of people because they could have dangerous side effects. They also reportedly cover up the symptoms of insomnia without actually treating it fully. The types of prescription drugs used for insomnia are melatonin receptor agonists and benzodiazepine/ non-benzodiazepine hypnotics. Specific examples include Ramelteon (Rozerem) and Zaleplon (Sonata).
Although not highly recommended, over the counter sleeping pills can be used for insomnia, however, most of them have side effects. Experts recommend speaking to a general practitioner in order to decide if OTC drugs can be used to treat insomnia.
Mild cases of insomnia can be managed by trying home remedies or by making simple lifestyle changes. Meditation is an easy and natural way of treating insomnia. It can help keep out intrusive thoughts that prevent adequate sleep which in turn makes it easier to stay asleep. Essential oils are aromatic liquids created with flowers and plants. Inhaling or rubbing essential oils like sandalwood, cedarwood, lavender, and neroli helps promote sleep. About 12 studies have revealed that these essential oils are beneficial for adequate sleep.
TREATMENTS THAT SHOULD NOT BE USED FOR INSOMNIA
In general, a general practitioner or clinical psychologist should be contacted in order to determine the best way to treat insomnia. That being said, medications such as antidepressants, barbiturates, clomethiazole, chloral hydrate, herbal remedies, and alternative treatments such as acupuncture are not recommended for the treatment of insomnia. This is because there are no studies revealing how effective these medications are for insomnia. In addition, their side effects may be too harsh on a patient with insomnia.
EFFICACY OF INSOMNIA TREATMENTS
In order to determine the efficacy of the above mentioned insomnia treatments, we first went through peer reviewed health related journals discussing insomnia. Reports were found in journals like Oxford Academic, BMJ Journals, and the US National Library of Medicine. However, these reports simply mentioned that insomnia treatments like cognitive-behavioral therapy are effective, they did not provide a specific efficacy figure to rate the effectiveness of these treatments. Our next approach involved scouring articles published by hospitals and healthcare organizations such as Mayo Clinic and Stanford Healthcare but these articles only cited the exact same information provided in the journals we initially relied on. We proceeded to examine insomnia associations and organizations including but not limited to National Sleep Foundation, American Sleep Association, and World Association of Sleep Medicine. Again, these platforms only stated that the insomnia treatments we found were effective, no further details were provided.
We found several studies on the efficacy of cognitive-behavioral therapy for insomnia but these studies were obstructed by paywalls. While summaries of their findings were provided, specific figures on the efficacy of insomnia treatments were not offered. We infer that the main reason there was no data on the efficacy of cognitive-behavioral therapy, home remedies, prescription drugs, and OTC pills for insomnia has to do with the fact that there are numerous drugs and methods in these categories and the efficacy of each one might be different.
The main risk factors for insomnia include age, gender, medications & stimulants, psychological factors such as stress, chronic diseases, and environmental changes. To treat insomnia, cognitive-behavioral therapy should be the first-line of action. Other recommended treatments include sleeping prescription drugs, over the counter pills, essential oils, and meditation. Unfortunately, we were unable to find the efficacy of these treatments.