Insomnia: What you need to know

Insomnia. This is a word that resonates like an inevitable bad night that announces itself, sometimes relentlessly, for the (too) many people who suffer from it. We all know someone who has problems with insomnia , and almost everyone can be confronted with it, at one time or another. Without going so far as to talk about the famous "illness of the century", we can still consider this sleep disorder as a major public health issue, so real is the impact of insomnia on our daily lives. Indeed, a bad night often means a bad day that follows!

Thus, combating sleep difficulties and reducing nighttime awakenings can sometimes be a difficult challenge. But then, how can you overcome chronic insomnia ? Are conventional treatments for sleep disorders really effective, or is there a reliable alternative through a natural treatment for insomnia , such as homeopathy for example? Here are some answers, as well as what you need to know about insomnia!

How can insomnia be defined?

Insomnia is the ultimate sleep disorder, so to speak. It is characterized by two factors: difficulty falling asleep at bedtime and frequent or prolonged nighttime awakenings . This reduction in the quality and quantity of sleep can manifest itself in occasional episodes, or over longer periods, or even regularly and lastingly.

We speak of transient insomnia when it is episodic and occasional, and we call it chronic insomnia when it manifests itself over the long term and becomes a recurring health problem that is difficult to treat. It is important to know that insomnia can be classified into three distinct types, but which can unfortunately be added together and "affect" each other:

• Insomnia when falling asleep : when you can't get to sleep
• Sleep maintenance insomnia : when you wake up during the night (several times or for a prolonged period)
• Early morning insomnia : when you wake up prematurely in the morning

Insomnia is therefore as much a problem of wakefulness as of sleep. According to the " Sleep Foundation ¹ ", it can be characterized by quantifying it as follows:

• Take more than 30 minutes to fall asleep
• Spending more than 30 minutes awake during the night
• Benefit from less than 6.5 hours of effective sleep

Insomnia is therefore defined according to different criteria, and it can take several forms, whether it be difficulty falling asleep , lack of sleep or even nighttime awakenings. This sleep disorder is, unfortunately, all too present in our society as the figures on its prevalence attest!

Some figures concerning insomnia

Unlike other sleep disorders, the prevalence of insomnia is relatively well quantified. In France, for example, INSERM ² ("National Institute of Health and Medical Research") estimates that insomnia affects 15 to 20% of the population in its transient (or "acute" form, i.e. occasional), this figure being reduced to 9% for chronic insomnia . These data are relatively corroborated by a 2007 study ³ published in the medical journal "Sleep Medicine", which grouped and cross-referenced figures from different countries in order to highlight a homogeneous trend, applying the same criteria (falling asleep, waking up at night, waking up early) to characterize insomnia. We thus note that 30% of the sample of people suffer from transient insomnia and that approximately 10% are victims of a more severe form of chronic insomnia.

Furthermore, if we push the criteria even further and exclude the presence of any other sleep disorder, physical pathology or mental disorder during episodes of insomnia, the prevalence drops to 6% of the general population for symptoms lasting at least one month.

What causes insomnia?

Just like the figures concerning it, insomnia has fairly clearly identified causes . In fact, there are 3 different types of origins to explain this sleep disorder, as reported by the specialized and referenced organization for sleep, " SleepFundation ⁴ ":

1. Causes of psychological origin :
   • Stress
   • Depression
   • Anxiety
2. Causes of physiological origin :
   • Lifestyle: consumption of alcohol, tobacco, stimulants (caffeine) or medication, overly large meals, screens and blue light in the evening, etc.
   • Unfavorable environment: noise, unsuitable room temperature, nearby electrical source, light, etc.
3. Causes of pathological origin :
   • Diseases: hyperthyroidism, asthma, gastroesophageal reflux, rhinitis, etc.
   • Painful pathologies: rheumatism, fever, cancer, etc.
   • Sleep disorders: sleep apnea, restless legs syndrome, etc.

Several studies ⁵ tend to affirm that the main cause of insomnia would be a form of "increased activity of the central nervous system, as well as of the "hypothalamic-pituitary-adrenal" axis, which is in charge of the response to stress." Behind this very specialized vocabulary, we can translate into more layman's language that the response of our brain to stress, anxiety or even depression is manifested by a "hyperarousal" syndrome due to an increase in the cerebral glucidic level (which "excites" the brain), as explained by INSERM ⁶ . The transition between sleep and wakefulness is then disturbed.

Thus, we see that chronic insomnia is essentially "psychophysiological" and caused by depression or anxiety ( in 40% of cases ⁷ ), sometimes creating a vicious circle resulting in fear of sleep or " anxiety about sleep performance ⁸ " Other factors such as age can come into play because yes, it's a fact, we sleep less as we get older!

Symptoms and Diagnosis of Insomnia

The symptoms of insomnia are visible and easily identifiable because they greatly affect our daily lives :

• Feeling tired during the day, drowsiness
• Attention or memory problems
• Headaches
• Irritability, nervousness
• Stress

Insomnia is a nocturnal phenomenon, but we notice that its consequences are felt in everyday life, during the day, whether on a mental, moral or physical level. The insomniac is tired, irritable, demotivated, he feels stressed , and the disruption of the circadian rhythm caused by insomnia could even have an impact on his health, creating hypertension or even weight gain!

Diagnosing insomnia primarily involves a clinical examination. During a consultation, the doctor will complete a questionnaire to collect the patient's medical history, as well as their impressions and feelings about the quality of their sleep. Symptoms such as stress , fatigue, or irritability can help diagnose insomnia fairly easily. In addition, in addition to a suitable questionnaire , keeping a sleep diary by the patient allows for precise monitoring that helps characterize this sleep disorder by recording the frequency and duration of insomnia episodes.

What treatments are there for insomnia?

Insomnia is not a trivial sleep disorder. Chronic insomnia and poor sleep quality have consequences that can be serious if left untreated. When the cause(s) of insomnia are established and it is a medical condition, the condition in question must be treated to reduce its influence on sleep time. For example, prescribing painkillers in the case of pathologies such as rheumatism, back pain, or any pain. Regarding physiological causes, you can sleep better and achieve better sleep quality by changing your diet (eating lightly in the evening, avoiding stimulants, etc.), your lifestyle (going to bed at a fixed time), and avoiding sleep-disrupting factors such as blue light from screens, tobacco, alcohol, or excessively high temperatures in the bedroom.

These small reflexes or daily habits to adopt can help you get a good night's sleep and regain restful sleep when the cause of sleep problems is physiological!

However, as we have seen previously, insomnia is very often psychological ( stress , depression, mental disorders, etc.). Therefore, the use of sleeping pill-based medication is often necessary to combat insomnia and facilitate falling asleep. However, the long-term adverse effects of these sedatives are recognized by numerous studies ⁹ . They therefore only allow the treatment of occasional transient insomnia over a short period. The question that then arises is how to overcome chronic insomnia ? In addition to powerful sedatives, which are dangerous for health in the medium and long term, natural and alternative treatments , such as hypnosis, are beginning to appear and bring encouraging results ¹⁰ .

Indeed, more and more studies are looking into the case of hypnosis, but also into " Cognitive-Behavioral Therapies ("CBT"), in order to verify their effectiveness in combating insomnia in a more psychological way. The results of the latter ¹¹ suggest that CBT could be a treatment for insomnia that would be interesting to exploit more. On the side of phytotherapy too, it appears that natural treatment based on certain plants such as valerian, passionflower or even lavender would produce satisfactory results ¹² to combat insomnia and regain quality sleep, in addition to an adapted lifestyle promoting sleep. In addition, the use of cannabis (the molecule cannabidiol to be more precise) is also studied by scientists ¹³ as a complement to a treatment against insomnia and anxiety, or even as the main treatment for these disorders. Encouraging results for improving sleep quality and reducing stress have been recorded but need to be confirmed by other studies.

Insomnia is a major sleep disorder that should not be overlooked given its direct and sometimes dangerous consequences on health, as well as its very harmful impact on daily life. We can still do justice to insomnia on one point: it has greatly inspired literature, particularly French literature, as evidenced by Victor Hugo who described his insomnia in a poem ¹⁴ aptly titled… “ Insomnia ”! Here is a passage from this poem taken from the collection “ Les Contemplations ” which illustrates the writer’s persistent insomnia:

"—Peace there! Go away, executioner! As for the verse, I'll let it go.—
I want to sleep all night like an old coward;
Come on, take care of your poor companion a little.
I'm tired, I'm dead, let me sleep! — No!
"Am I asleep?" said the implacable Idea.

While conventional treatments for transient and occasional insomnia show some effectiveness in the short term, traditional medications (sleeping pills, anxiolytics, etc.) are more dangerous in the long term when treating more severe chronic insomnia . Therefore, the use of a natural treatment to manage stress and thus improve the quality of sleep should be considered, for example meditation or any type of alternative natural treatment . There are effective alternative methods such as Hoomband or Dodow . The first, Hoomband , is a headband equipped with headphones, to be placed on your head at bedtime, which diffuses suitable sound content promoting relaxation and sleep. The second, Dodow , consists of a discreet little box that emits a halo of light from which you must synchronize your breathing in order to relax and fall asleep. Light games or listening to a story, choose your solution for better sleep! Finally, lifestyle is also important and should be taken into consideration to treat the physiological causes of insomnia.

Often, reading a good book, a poem by Victor Hugo, or listening to a story with Hoomband can help you fall asleep more easily. Unlike medication, it's not harmful to your health and doesn't require a prescription!

In addition to this article:

• Here is a link to a video from "Natural Medicine World" with Dr. Bredell discussing the benefits of homeopathy to help overcome stress and insomnia: Homeopathy: a solution to insomnia
• Here is another link to a simple and fun "Ted" video by Dan Kwartler to easily understand the causes of insomnia: What are the causes of insomnia?

Sources:

[1] Insomnia: definition, causes and consequences , Pr Charles M. Morin, “Fondation Sommeil” website, 2020 [2], [6] and Insomnia: a neurobiological and psychological disorder , “INSERM” website, September 2017 [3], [5] and [7] Insomnia: Definition, Prevalence, Etiology, and Consequences , T. Roth, PhD, “ Journal of Clinical Sleep Medicine ”, August 2007 [4] What causes Insomnia? , “SleepFundation” site, 2020 [8] The different types of insomnia , Pr Charles M. Morin, “Fondation Sommeil” site, 2020 [9] Residual Effects of Sleep Medications Are Commonly Reported and Associated with Impaired Patient-Reported Outcomes among Insomnia Patients in the United States , T. Fistzgerald, J. Vietri, “ Sleep Disorders ”, December 2015 [10] Hypnosis Intervention Effects on Sleep Outcomes: A Systematic Review , I. Chamine, R. Atchley et al, “ Journal of Clinical Sleep Medicine ”, February 2018 [11] Cognitive-behavioral therapy for primary insomnia , JD Edinger, MK Means, “ Clinical Psychology Review ”, July 2005 [12] Plant Extracts for Sleep Disturbances: A Systematic Review , S. Guadagna, DF Barattini et al, “ Evidence-Based Complementary and Alternative Medicine ”, April 2020 [13] Cannabidiol in Anxiety and Sleep: A Large Case Series , S. Shannon, N. Lewis et al, “ The Permanente Journal ”, January 2019 [14] Les Contemplations: Insomnie , Victor Hugo, “Wikisource” site, 2020