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How to beat insomnia
- Sonia Bains
- May 3
- 2 min read
NICE defines insomnia as
“a persistent difficulty with getting to sleep, maintaining sleep, or quality of sleep, which occurs despite adequate opportunity and circumstances for sleep, and results in impaired daytime functioning”.
Short term insomnia is considered as having symptoms less than three months and is common in times of stress. Chronic insomnia is more complex and can co-exist with other conditions for example anxiety, depression and musculoskeletal conditions.
For short term insomnia, z-drugs such as zopiclone or zolpidem can be offered. They work by boosting a chemical in the brain called gamma-aminobutyric acid (GABA.) GABA is a neurotransmitter that has a calming effect which helps us fall asleep. However the risk of dependence increases with the duration of the course. It is recommended that treatment does not exceed four weeks.
For longer term insomnia the z-drugs are not recommended unless there are severe symptoms or a severe acute episode.
For some, prolonged release melatonin is an option. Melatonin is a natural occurring hormone in the human body. It helps control your sleep cycle, it is produced just after it gets dark and reduces during daylight hours. It acts by signalling to your body that it is night time and encourages your body to sleep.
Another, less common, medication is called daridorexant. It works by inhibiting the action of orexin, which is a hormone that regulates wakefulness. This is only considered in severe insomnia when non-pharmacological methods, such as CBT, have been unsuccessful or are unavailable.
For both short term and long term insomnia, good sleep hygiene is essential. This involves making changes to sleep habits, diet, exercise and environment.
It is recommended to have a set bedtime and wake up at the same time everyday. Bright lights from phones and TV’s should be avoided before bedtime as the blue light can suppress melatonin production.
Caffeine should be avoided after midday and nicotine and alcohol should be avoided at least two hours before sleep.
Exercise during the day is recommended but should not be performed within 90 minutes of going to bed.
Keeping the room at the right temperature makes it easier to fall asleep as does keeping the room quiet and dark. Ear plugs and good blinds can help with this, as can reducing light from clocks and phones. Some people find white noise or gentle sounds can be relaxing.
Sometimes those with insomnia will be referred to a sleep specialist who can perform a “sleep study.’ This can involve monitoring oxygen levels and breathing overnight. A tailored programme can be created to improve sleep function and quality of life.
Sources
https://guysandstthomasspecialistcare.co.uk/investigations/sleep-disorder-clinic/ Assessed and Endorsed by the MedReport Medical Review Board
