Monday, April 28, 2008

Insomnia Treatments Without Side Effects: an Overview

On a daily basis, we are bombarded by commercials that tout the virtues of sleeping pills. We are constantly reassured that sleeping pills are getting better: Lunesta, Ambien and Sonata cause fewer side effects than their predecessors. But the fact remains that sleeping pills continue to have side effects. Just take a look at the prescribing information in any sleeping pill box. There is always the inadvertent portion on common side effects. Worse still, things like sleep-eating and sleep-driving are not listed there. Rosemary Eckley, a graphic artist in New London, Wis., said she thought she was sleeping well on Ambien but woke to find her wrist broken, apparently in a fall while sleepwalking, she wrote in an e-mail exchange.Also, they don’t greatly improve sleep for the average person. The National Institutes of Health found that viewed as a group, these sleeping pills reduced the average time to go to sleep 12.8 minutes, and increased total sleep time 11.4 minutes compared with fake pills. So what then are the existing insomnia treatments without side effects? Overall, they are called non-pharmacologic insomnia treatments. These include hypnotherapy, cognitive behavioral therapy, relaxation therapy and brainwave entrainment.1. HypnotherapyHypnotherapy has been well documented for its effective use with conditions such as depression and pain. As for insomnia, a meta-analysis showed that when combined with psychotherapy, 70% of patients have shown greater improvement compared with those on psychotherapy alone.The plus point with hypnotherapy is you can eventually be taught to self-treat and so gain a sense of control. This would give you the ability to stay insomnia free. However, just be mindful that not everyone can be hypnotized i.e. some people have persistently low hypnotizability as measured by the Hypnotic Induction Profile.2. Cognitive Behavioral Therapy (CBT)It is based on the idea that how you think affects the way you feel and behave. It involves techniques to change your negative thoughts about sleep (cognition) so you will stop sabotaging good shut-eye (behavior).A recent study conducted by Harvard Medical School's Gregg Jacobs found that CBT worked better than sleeping pills both in the short term and the long term. Volunteers only received four half-hour sessions of CBT, plus a follow-up phone call that led to sleep improvements that persisted even after treatment was stopped. As few as two sessions have been shown to produce results. Unfortunately, there are very few CBT practitioners specializing in sleep. However, nurses and psychology grad students can be easily trained to provide CBT. And there is a growing lay literature designed to help people try it for themselves.3. Relaxation TherapyThis includes muscle relaxation, biofeedback, imagery training through meditation and thought stopping. Professionals, who specialize in instructing these techniques, can be found in some healthcare centers, support communities and even cancer centers. The best part is you can accomplish some of these techniques on your own. You may find deep breathing, stretching, meditation or prayer to be relaxing. A warm bath, warm glass of milk or cup of chamomile tea at bedtime can help to induce a restful state. Avoid alcohol although it may cause initial tiredness, it usually leads to fragmented sleep.4. Brainwave EntrainmentMany professionals in psychology and neurology have used this technology to train, empower and treat people for a wide variety of issues including insomnia. Research has shown that brainwaves can be stimulated to actually change a person's current state. Hence, this is achieved through sound pulses that gently guide your brain to produce more of the brainwave frequencies associated with sleep.Your brain is re-trained to sleep deeply and naturally eventually foregoing the soundtracks. So, coupled with sleep hygiene or basic CBT, all you need to do is listen to some soundtracks. However, this isn’t for everyone as it involves brainwave stimulation. People who are epileptic, prone to seizures, pregnant or wearing a pacemaker would have to give this a pass. In summary, the good news is that studies have reported about 70 to 80% of the patients treated benefited from these insomnia treatments Just remember one thing: best results are obtained when you combine any of them. There is absolutely not one magic treatment for all.

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