Insomnia
What is it?
Insomnia is a common sleep disorder suffered by up to 50 per cent of people in any one year. It can mean difficulty falling asleep, difficulty staying asleep, or waking too early in the morning.
Causes of insomnia
Insomnia is caused by many disorders, with psychological factors probably accounting for around half of all types. Depression, anxiety and stress are closely associated with insomnia, and other causes include chronic pain, disease, lack of physical exercise, nutrient deficiencies and stimulants such as caffeine, tobacco, chocolate and alcohol. Sensitive people should avoid these, particularly late at night. Some medications cause insomnia. Sleep requirements lessen with age and elderly people experiencing changes in sleep patterns may need reassurance that these changes are normal.
Treatment of insomnia
This depends on the underlying cause. There are several measures that may be useful. These include regular exercise (but not before bed), avoidance of stimulants, developing a regular bedtime routine, warm baths before bedtime; and avoidance of distractions that promote wakefulness. Drinking warm milk, or eating a high carbohydrate snack before bed also helps some people sleep. Medications such as sedatives and hypnotics are sometimes prescribed for people suffering from insomnia. These are potentially addictive and should only be taken for short periods.
Vitamins, minerals and insomnia
B vitamins
B vitamins are involved in the metabolism of neurotransmitters such as serotonin, which aids in the regulation of sleep. Deficiencies may lead to insomnia, and vitamin B6, niacin and folic acid are sometimes used to treat the disorder. Increasing intake of these vitamins is most likely to be effective in cases of deficiency.
Vitamin B12 injections have been used to treat insomnia and have had beneficial effects on the sleep-wake cycles in some patients. Some research suggests that vitamin B12 might affect sleep quality and performance. In a 1996 study, German researchers explored the effects of 3 mg of vitamin B12 on the quality of sleep and work performance of ten healthy, male staff members of an Austrian industrial plant. The results showed better sleep quality and shorter total sleep time in those taking supplements.1
Iron
Sleeping difficulties may be exacerbated by iron deficiency. Studies suggest that restless legs syndrome caused by iron deficiency, is relatively common in the elderly and causes significant discomfort and sleep disturbance. Iron supplements can help reduce the symptoms and lead to improvements in sleeping patterns.
Calcium and magnesium
Magnesium supplements have muscle relaxant effects and may be beneficial if taken at night.
Nutrients and insomnia
Melatonin
Melatonin is a hormone involved in the regulation of the sleep-wake cycle. Supplements have been used to treat insomnia. They may be useful in improving sleep duration and quality in those in whom the normal cycle is disrupted, such as people with jet lag and shift workers.
In a 1997 placebo-controlled, double-blind, cross-over study, researchers assessed the effects of melatonin in eight males. Following a 7-hour night-time sleep, the participants were given either a placebo or one of three doses of melatonin (1 mg, 10 mg, and 40 mg) at 10 am. All doses of melatonin significantly shortened the time taken to go to sleep. Melatonin also significantly increased total sleep time and decreased wake after sleep onset.2
In another placebo-controlled study, researchers studied the effects of single evening doses of melatonin on sleep in 15 healthy middle-aged volunteers. Compared to placebo, the 1.0 mg dose of melatonin significantly increased sleep time, sleep efficiency, non-REM Sleep and REM sleep latency.3
Jet lag
Melatonin use in jet lag appears to decrease jet lag symptoms and hasten the return to normal energy levels. In a double-blind placebo-controlled study published in 1993, New Zealand researchers investigated the efficacy of melatonin in alleviating jet lag in 52 flight crew members after a series of international flights. The optimal time for taking melatonin in this group was also investigated. The participants were randomly assigned to three groups; early melatonin (5 mg started three days prior to arrival until five days after return home); late melatonin (placebo for three days, then 5 mg melatonin for five days); and placebo. The results showed that the late melatonin group reported significantly less jet lag and sleep disturbance following the flight compared to placebo. The late melatonin group also showed a significantly faster recovery of energy and alertness than the early melatonin group, which reported a worse overall recovery than placebo.4
Herbal medicine and insomnia
Herbs, which act as relaxants and nervine tonics, are beneficial in the treatment of insomnia. These include valerian (Valeriana officinalis), passion flower (Passiflora incarnata), chamomile (Matricaria recutita), vervain (Verbena officinalis), hops (Humulus lupulus), kava (Piper methysticum) and oatstraw (Avena sativa). Other herbs that may be useful in helping the body adapt to stress include ginseng (Eleutherococcus senticosus and Panax ginseng).