Time to bid farewell to insomnia: 5 ways to help you sleep easy

Sleeplessness makes you tired, irritable, depressed and overweight, it also make you ill. Erratic sleep schedules because of work, travel or lifestyle can cause heart disease, insulin resistance that leads to diabetes, and frequent infections because of lowered immunity even if you are otherwise healthy.

If you struggle to nod off or get up frequently in the night for no apparent reason, here’s what you need to do to get the sleep that’s been eluding you.

No gadgets at bedtime

Smartphones, tablets, laptops, televisions and digital gadgets emit a blue-light wavelength that affects your body’s levels of melatonin, an essential hormone that kicks in the sleep cycle.

Melatonin, which controls your sleep-wake cycle, is regulated by light and is released when it gets dark to wind you down and prepare the body for rest. Light, including backlit screens, disrupts its release and keeps you alert. This will not only make it harder for you to nod off but also lower the quality of rest when you finally sleep.

Get some exercise

Regular exercise improves sleep quality as long as you don’t do adrenalin-pumping work-outs too close to bedtime. A post-workout burst of energy can keep you awake, so aim to finish vigorous exercises at least two hours before you head for bed.

Chronic sleeplessness adds to weight by making you eat more and choose foods that are higher in fat and sugar. Exercise also helps ward off junk food cravings triggered by short nights’ sleep and counters the effects of chronic lack of sleep, reported a recent study.

Go for comfort

Like Goldilocks, you will have a tough time sleeping in mattresses that are too soft or too hard, so get one that’s just right for you. Microscopic dust mites and other allergy triggers in bed linen, pillows, blankets, duvets and mattresses can make you sniffle and sneeze, which again affects sleep quality. Keep your bedroom free of dust, wash bed linen in warm water and air pillow and mattresses regularly.

Pillows that are too cushy or too flat can give you a stiff neck, so choose one that supports your neck in a neutral position. If you sleep on your side, you will breathe best when your nose is aligned with the centre of your body. Avoid sleeping on your stomach as it twists the neck.

Mild low back pain may not wake you but can disrupt deep, restorative sleep. Placing a pillow between the legs lowers stress on the low back. Those who sleep on their back can tuck a pillow under their knees to help ease the pain at night.

Get a schedule

Adopt a sleep pattern. Go to sleep and wake up at about the same time every day, including on weekends, to set your brain and body on a regular sleep-wake cycle. Over time, it’ll help you fall asleep quickly, sleep soundly through the night and get up at the same time. Going out in natural light within a few minutes of getting up further helps regulate the body’s biological clock.

Start winding down about an hour before bedtime by reading a book, listen to music, or taking a shower. Avoid activity other than sleep and sex in the bedroom so that your brain associates the space with rest and relaxation. It’s best to not use the phone, laptop or watch television in the bedroom, so step out if you can’t avoid use.

Most people sleep best at room temperature between 20 and 22 degrees Celcius.

Eat right

Big dinners and rich meals late in the evening stress the digestive system and make it hard to get high-quality sleep. Try to have your as early as possible, at least three hours before you go to bed.

Dinner should be your lightest meal, so opt for vegetables, complex carbohydrates like lentils or dairy foods instead of oily curries and meats. Do not snack in bed.

Alcohol makes you sleepy, but keeps you up after the initial effects wear off. People who drink a lot at bedtime get up frequently through the night and have less restful sleep.

Nicotine is a stimulant, like caffeine, and keeps you from falling asleep.

Winding down and other bedtime rituals help most people fall asleep faster and get better quality sleep. However, if your insomnia persists for more than four weeks, it may well be a symptom of an underlying physical or mental disorder, such as depression, diabetes, acid reflux, asthma or arthritis, so it’s best to get medical opinion to rule out the cause.



Best Herbs to Help With Insomnia

By Dr. Mercola

Nearly 60 million Americans struggle with insomnia. Doctors are still not sure how to treat this disorder that may have devastating effects on your daily routines.1
Chronic lack of quality sleep has been associated with reduced memory and learning, increased risk of dementia and type 2 diabetes and an increased risk of accidents. Losing just one night of sleep may impair your physical and mental status comparable to having a blood alcohol level of 0.10 percent.2

Best Herbs to Help With Insomnia

You may have experienced insomnia, or difficulty going to sleep or staying asleep each night. Some physicians believe this difficulty may arise from a physical cause and others from a mental or emotional issue.

In other cases insomnia may be the result of medical conditions, medications, poor sleep habits or other biological factors.

2 Types of Insomnia May Be Addressed Differently

There are two types of insomnia that affect people, but the resulting symptoms are the same. These symptoms include difficulty going to sleep, waking up often during the night or too early in the morning and feeling fatigued or tired when getting up in the morning.3

You may suffer from primary or secondary insomnia. Primary insomnia occurs when the sleep problems you’re having are not associated with another health condition.

Secondary insomnia occurs when you have another medical condition that results in poor sleep quality. Those conditions may include asthma, depression, arthritis, cancer or heartburn.4

How often you experience these symptoms define if you suffer an acute issue, happening for a short time, or a chronic issue, lasting for several months. The symptoms may also come and go throughout your life, making the treatment and diagnosis difficult for physicians.

Gayle Greene, author of “Insomnia,” describes her journey with insomnia on National Public Radio (NPR), saying:5

“Sleep is the fuel of life. It’s nourishing; it’s restorative. And when you are deprived of it, you are really deprived of a basic kind of sustenance. 

I don’t manage this beast, I live with it. I live around it. I bed down with it every night, gingerly, cautiously, careful not to provoke it. I do my best to placate it, domesticate it, dull its claws [and] avoid its fangs, knowing that at any moment it can pounce on me and tear me to bits.”

The causes are varied, and the triggers are not the same for every person. However, this might not stop your physician from addressing the issue the same way for each patient.

While a prescription for medication may help you sleep for a couple nights, there are significant side effects to these prescriptions and they typically cause more health problems than they help.

Problems With Prescription Sleeping Medication

The Centers for Disease Control and Prevention (CDC) announced in 2013 that at least 9 million people were using prescription sleep aids.6 The data was based on interviews with 17,000 adults, and found that 4 percent had taken a sleeping pill or sedative in the past 30 days.

They also found that use of sleeping medication increased with age. The lowest age group was between 20 and 39 years old, and the percentage of users continued to rise through senior years.

Although it may be easy to get sleeping pills from your doctor, they come with significant side effects and usually only help you to fall asleep and not to sleep through the night. Side effects of sleep medication may include:7,8

Burning or tingling
in your hands, feet,
arms or legs
Increased tolerance to the medication Difficulty weaning off the medication Uncontrollable shaking
Change in appetite Loss of balance Diarrhea Daytime drowsiness
Constipation Mental slowness Difficulty learning Unusual dreams
Erratic behavior Dizziness Dry mouth Headache
Gas Heartburn Stomach pain Weakness

Some people also suffer from other more complex symptoms, such as parasomnias. These are behaviors or actions over which you have no control, such as sleepwalking.

Parasomnia behaviors you may experience while taking sleeping pills may include driving, having sex, making phone calls and eating — all while being fast asleep.9

While these side effects are frightening, a study published in 2012 revealed people taking sleeping pills were four times more likely to die than people who don’t take the pills.10 The study also found those taking sleeping pills were 35 times more likely to have cancer. Other risks include:

•Increased insulin resistance, food cravings, weight gain and diabetes

•Complete amnesia, even from events that occurred during the day

•Depression, confusion, disorientation and hallucinations

Start With the Right Clothes

Sleeping may appear to be an inactive state, but it isn’t. Instead, it is a complex period of time during which your brain and body are busy detoxifying and resting. You can help the process by starting with clothing designed to improve your sleep quality.

Shawn Stevenson, author of “Sleep Smarter,” was quoted in Rodale Wellness, saying:11 “When it comes to your pajamas, think form and function over fashion.”

Your night clothes should be loose and not restrict your movement or your circulation. Small changes in your sleep clothes may not only improve your sleep quality, but also your health. Wear light, breathable, hypoallergenic and ideally organic materials. Organic cotton is a good choice.

The optimal temperature for a restful night’s sleep may be between 60 and 68 degrees F. Setting your thermostat higher than 75 degrees F or lower than 54 degrees F may interfere with your sleep cycle. One of the benefits of lightweight night clothes is that your body will stay cooler. As your core body temperature drops it induces sleepiness.12

This may be one reason you may flip the pillow during the night to lie on the cool side. Some research has demonstrated that people who struggle with insomnia naturally have a higher body temperature, making dropping off to sleep more difficult.13 If you have trouble sleeping, it’s important to drop your core body temperature. Wearing socks or using a hot water bottle near your feet helps to dilate your vessels, releasing more heat from your feet.

How the heat in your body is distributed also helps increase your sleepiness. This thermoregulation improves when you lie down and heat disperses from your core to your arms and legs. Wearing loose fitting shorts and t-shirts may help improve heat loss at night, helping you to fall asleep and stay asleep.

Cognitive Behavioral Therapy for Insomnia

In May, 2016, the American College of Physicians (ACP) recommended Cognitive Behavioral Therapy for Insomnia (CBT-I) as the initial treatment prescribed for chronic insomnia.14

The key element using CBT-I is to restructure and reframe your thinking patterns using a combination of education, behavioral interventions and cognitive therapy designed specifically for people suffering with insomnia.15 If you can’t find a trained therapist in your area, you may want to consider an online program.

Recent research is producing convincing data that internet-based programs are as effective as working with a therapist when followed appropriately.16 Whether you use a CBT-I program online or face-to-face with a therapist, the results appear to be the same.17

Online programs may be less expensive and don’t require additional time outside your home. On the other hand, if you aren’t likely to follow the program, having a therapist or engaging the help of an accountability partner may improve your results. Research has also found that the results from CBT-I last much longer than using sleep medication.18

Even those suffering from insomnia related to post-traumatic stress disorder (PTSD) experienced significant relief using CBT-I.19 In a press release, ACP president Dr. Wayne Riley said:20

“Cognitive behavioral therapy for insomnia is an effective treatment and can be initiated in a primary care setting. Although we have insufficient evidence to directly compare CBT-I and drug treatment, CBT-I is likely to have fewer harms. Sleep medications can be associated with serious adverse effects.”

Online programs may provide an answer for individuals who don’t have a certified therapist in their area. Greg Jacobs, Ph.D., sleep specialist and assistant professor of psychiatry at the University of Massachusetts Medical School, told The New York Times:21

“The number of clinicians nationally who know how to do CBT-I is a couple of thousand. We need 100,000. There are tens of millions of people out there who have insomnia.”

Herbal Teas May Help You Fall Asleep

People have been using herbal teas to help relax before bed for centuries. However, it’s important to remember that the effects of herbs can vary depending on the individual. Some herbs can cause sleep disturbances while others can either make you drowsy or contribute to sleeplessness.

You may want to experiment with several to find the one that works for you with the caveat that you need to remember that some herbs can interact with perscription medication you may be taking, or with another underlying medical condition. Also remember, not all herbs are appropriate for children.22 That said, the following herbs have a history of usefulness for helping people fall asleep:


This is probably one of the better known herbal teas used to relax and induce sleepiness, and which has shown in a clinical study that it could provide help for chronic insomnia.23 As a sleep aid, it’s fairly mild.24 It is also gentle and is helpful if you have an irritable digestive tract. Even sniffing the tea bags may be enough to trigger your brain to relax.25

An herbal infusion tea may be made by using 1 ounce of the dried herb steeped in 1 quart of water for four hours. Filter the dried herb out before drinking. This infusion is more concentrated than brewing a cup of tea. Chamomile tincture may also be used to help you sleep.

Passion Flower

This is a very mild herb, best used when you are overtired, anxious or overworked. Dr. Michael Traub, a naturopathic physician who has studied the passion flower, recommends making an infusion with 0.07 ounces (2 grams) of the herb in 5 ounces (150 milliliters) of water, or use 0.3 ounces (10ml) of tincture. Take three to four times daily.26

You can also steep 1 teaspoonful in 1 cup of boiling water for 10 minutes and drink it just before bedtime. But, according to the University of Maryland Medical Center (UMMC), consult your physician before taking it if you are already taking prescription drugs for insomnia, anxiety, depression or blood thinners.27

Kava kava

This herb is commonly used to reduce anxiety and depression. In an observational study with placebos, it was found to have some benefit as a sleep aid.28 It has been found safe in small dosages, but use caution, as kava supplements have been linked to liver damage.29 Germany, Switzerland and Canada have banned substances containing Kava because of the risk of liver damage. The safest way is to use a mild tea and not a supplement.

California Poppy

This is a favorite herb of many people seeking relaxation and drowsiness to sleep. Studies have demonstrated the herb’s ability to reduce the amount of time it takes you to fall asleep and improve sleep quality when used as directed.30 Taking 30 drops of the tincture two to three times daily may help you fall asleep easier.


This is possibly the most powerful herbal sedative, and not one to be used consistently. Using it before bed may help reduce the number of times you awaken during the night. However, this herb may trigger some wild dreams, as well as diarrhea and other gastrointestinal effects. If you’ve never used valerian, it’s best to start slowly to reduce the potential you may experience side effects. This herb also works well in combination with hops.31

Herbal Aromas May Increase Relaxation and Improve Sleep

Herbs are also aromatic. The scent they produce may sometimes have as much effect on your brain and body as drinking tea or tincture. These herbs are a wonderful addition to your night clothes or bedroom to help you relax and sleep.


As an aromatherapy, this plant from the mint family has been reported to help with sleep and relaxation issues.32 Mixing a little of the essential oil with olive oil makes a massage oil that promotes sleep. You might also add a drop or two to a warm bath before bed, or on a cotton ball inside your pillow case.33 Do not ingest lavender oil; also, do not use it topically on boys, as it may cause abnormal breast growth.34


The scent of hops, a component of beer, was a favorite of King George III and Abraham Lincoln as a means of inducing relaxation and sleep.35 This herb may be used to stuff a pillow for your nightly relaxation, or you may choose to drink a mild tea twice daily, once in the morning and another in the latter part of the evening. Studies with animals have shown that it also may be useful in the form of nonalcoholic beer.


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2 Ways to Treat Insomnia Caused by Chronic Pain

Man with insomnia.

Treat the chronic pain itself

The first step is to talk with your doctor about treatment options for the pain. Even if the cause of your chronic pain is vague or intractable, the pain itself can be treated with medications, physical therapy, and/or relaxation and meditation techniques. Ask your doctor if the professional help of a pain specialist could be beneficial for you too.When it comes to treating the sleep problems, there are two main solutions: cognitive behavioral therapy and medications.

Sleep solution 1: Cognitive behavioral therapy (CBT)

We all know what it’s like when you try to fall asleep, only to get more and more anxious about not being able to. This anxiety is bad enough, but then other thoughts creep in to make sleep more elusive—worries about pain, your condition, finances, work, relationships, etc.

Eventually these thoughts can develop into self-defeating thought patterns like, “I’ll never get to sleep no matter what I do,” or “I’m doomed to have a terrible day tomorrow if I don’t fall asleep in the next half hour.”

  • See Therapies for Treating Insomnia

Cognitive behavioral therapy teaches you identify these unhealthy thought patterns so you can learn to avoid them. CBT also teaches the practice of redirecting your mind away from anxiety-inducing thoughts.

All of this is the “cognitive” part of the CBT. The “behavioral” aspect comes in the form of learning and practicing healthy behaviors that can promote sleep. These are also referred to as sleep hygiene practices.

  • See 11 Unconventional Tips for Better Sleep

Good sleep hygiene practices include the following:

  • Go to bed and wake up at the same time every day.
  • Expose yourself to light during the day and make the bedroom dark at night, which can help regulate your body’s circadian rhythm.
  • Avoid large meals, caffeine, and exercise late in the day.
  • Remove all TVs, laptops, and other devices from the bedroom; use the bed only for sleep and sex.
  • Make the bedroom cool and quiet. Consider using a white noise machine or fan to mask outside noises.
  • If you can’t sleep, get out of bed and do something calming until sleepiness returns.

    Sleep solution 2: Medications

    As anyone who’s seen the TV ads during the evening news knows, there are a range of medications designed to treat sleep problems. Common options include alprazolam (Xanax), clonazepam (Klonopin), diazepam (Valium), lorazepam (Ativan), eszopiclone (Lunesta), zaleplon (Sonata), and zolpidem (Ambien, Stilnox, Stilnoct).

    • See Medications Used to Help Treat Insomnia

    These medications can be very effective, but they’re best used for shorter periods. That’s because they can cause side effects and dependency. They all require a prescription, so work with your doctor to determine if one of these medications is right for you.

    In addition, there are a few other medication types that can promote better sleep:

    • Melatonin receptor agonists. These medications, the most common of which is Rozerem, affect the melatonin receptors in the brain and are non-habit forming.
    • Antihistamines. These allergen fighters have long been known to cause drowsiness. Newer formulations are non-drowsy, but older versions such as Benadryl can still help with sleep.
    • Anti-depressants. These can help with sleep and chronic pain when taken in a much lower dose than needed to treat depression.

    Many doctors will recommend a combination of chronic pain remedies, CBT therapies, and medications for patients with chronic conditions who experience sleep problems. Work with your doctor to find the best formula of treatment(s) for you.



Can’t sleep? Try these foods to help avoid 3 a.m. wake-up call

It’s 2 a.m., 3 a.m., 4 a.m. and you can’t fall asleep. The night stretches on, and you’re staring at the clock, stressed, frustrated and miserable.

You’re not alone.

“At least 30 percent of the population has insomnia at some point in their lives,’ said Dr. Belen Esparis, medical director of the Sleep Disorders Center at Mount Sinai Medical Center in Miami Beach. ”At least 10 percent suffer from chronic insomnia.”

Insomnia can be caused by a lot of factors, including anxiety, depression, sleep apnea, restless leg syndrome and poor sleeping habits. In turn, lack of sleep has health repercussions, as well.

“Poor sleep quality worsens every chronic condition including depression, heart disease, high blood pressure and different types of cancer,” said Dr. Ashwin Mehta, medical director for Integrative Medicine, a holistic approach to supplement traditional treatment methods, at Memorial Healthcare System. “If you have a chronic health concern and you’re sleep deprived, you’re setting up a recipe for disaster.”

Experts also point to the link between lack of sleep and obesity.

“It has been shown that people who don’t get enough sleep are more likely to gain weight and be obese than people who get the amount of sleep they need,” Esparis said. “This is regardless of what you eat so sleeping enough is as important as your diet.”

And diet can be important in getting those much-needed Zzzs.

“Foods and nutrients contribute to every body process,” said Sheah Rarback, a registered dietitian on the faculty of the University of Miami Miller School of Medicine and a Miami Herald columnist. “There are certain foods that help us sleep by doing certain things in the body.”

Green, leafy vegetables, pumpkin seeds, edamame, bananas, avocados, beans, and nuts and seeds are all foods rich in magnesium, which helps muscles relax and induces a sleepy state, Mehta said. A lack of magnesium can cause restless leg syndrome and muscle spasms.

Certain foods contain an amino acid called tryptophan. We usually associate tryptophan with our post-turkey nap on Thanksgiving, but many meats and other proteins have it as well. Tryptophan is a sleep-enhancing amino acid that helps produce serotonin and melatonin, the “body clock” hormone that sets your sleep-wake cycles.

“A body that isn’t nourished during the day is not going to be in a restorative state at night,” Rarback said.

While a good diet has been known to promote better sleep, there’s “not significant evidence that the amount of food you’re eating can change sleep patterns,” said Gina Sweat, a registered dietitian and nutritionist at Cleveland Clinic of Florida in Weston.

“When you’re eating is just as important as what you’re eating,” Mehta added. “You want to wait at least two to three hours between your last meal and when you actually go to sleep.”

Sweat suggests eating dinner at least four hours before going to bed and perhaps having a snack no later than two hours before you go to bed.

How much you eat can be an issue, said Julie Rothenberg, a registered dietitian for Oncology Nutrition Services at Mount Sinai. Being too full can cause reflux symptoms, including heartburn, she said. “But if you eat too little, your body is craving nutrients and that also causes stress on your body and prevents you from having a deep sleep.”

What to avoid

Knowing what foods and drinks to avoid is part of the happy sleeping equation. Caffeine, alcohol, high-fat meals, sugary snacks and spicy foods may all be culprits ruining a good night’s sleep.

“Caffeine is hidden in so many of the foods and drink we have,” Mehta said. “One cup of coffee in the morning can potentially impact sleep quality. It depends on a person’s metabolism.”

It takes six hours to metabolize caffeine so consider your intake of coffee, tea, soda, chocolate and other foods that contain caffeine during the day, Rothenberg said. The notion of having a nightcap, a small cocktail, before going to bed isn’t necessarily going to lead to deep slumber either.

Image result for Can’t sleep? Try these foods to help avoid 3 a.m. wake-up call

“Alcohol is a central nervous system depressant,” Mehta said. “It may seem like having a drink helps people sleep, but it actually ends up being counterfeit sleep.”

Studies have shown that while alcohol may have helped people fall asleep more quickly, their sleep was more disrupted during the second half of the night. It’s recommended that you have no more than one 4.5-ounce pour of wine, one 11-ounce glass of beer or 1.5 ounces of hard liquor in an evening, Mehta said.

While one beverage — water — is always seen as beneficial, aim to drink up during the day and cut back on fluids a few hours before bedtime to help limit trips to the bathroom.

You also want to avoid certain foods before bedtime, like a greasy burger or big piece of cake.

“Fats create more stomach acid and increase the likelihood of reflux,” Rarback said. “Really spicy food can also cause some people to have stomach distress.”

You might as well forget about that grandmotherly snack of milk and cookies — or at least the cookies part. “Sugar and other high-glycemic foods can cause stress on the body,” Rothenberg said. “It raises the cortisol level, which makes it difficult to fall asleep and stay asleep.”

Milk’s a ‘soothing drink’

Milk can be helpful as long as you’re able to tolerate dairy products.

“Milk has different good things in it,” said Dr. Andres Lichtenberger, an internal medicine specialist with Baptist Health Primary Care. “It’s a soothing drink especially when it’s warm and can help you relax.” Calcium also helps the body’s process of producing melatonin.

Instead of a sweet snack, it’s better to have a handful of pumpkin seeds with Brazil nuts and a fig — no more than what fits in the palm of your hand, Mehta said. “Anything more than that is excessive.”

Proteins are the building blocks of tryptophan and carbohydrates make tryptophan more available to the brain, so try snacks that pair both, according to the National Sleep Foundation. Consider peanut butter or hummus on whole wheat toast or crackers, plain Greek yogurt with some nuts, apples and peanut butter, a banana and milk.

Exercising during the day can help your overall sleep patterns, but making a stop at the gym right before you go to bed can keep you awake, Lichtenberger said.

The idea is to ease into sleep with a consistent, relaxing pattern.

“Cue the body” for bedtime, Mehta said. “The body responds to a routine.”

Have a cup of chamomile tea. Turn off the TV. Remove your cellphones and computers from the bedroom. Try aromatherapy oils. Keep the room dark so you don’t interrupt your sleep cycle.

Foods to aid sleep

To help boost your chances of a good night’s sleep, here are some foods that could help you get that needed shut-eye:

Bananas: The fruit is a good source of potassium and magnesium, which help to relax muscles. They also contain Vitamin B6, which may improve sleep, and tryptophan.

Chamomile tea: “It helps calm the brain and helps put you to sleep sooner,” said Mount Sinai’s Rothenberg. Decaffeinated green tea, which contains the amino acid theanine, can also help reduce stress, UM’s Rarback said.

Cherry juice: Specifically, you want tart cherry juice, which has melatonin in it, nutritionists said. “Make sure it’s in its natural form without added sugar,” Rothenberg said.

Chickpeas: Legumes are a good source of magnesium. Eat them on their own or create a hummus dip. Edamame is another good source of magnesium.

Green leafy vegetables: Such vegetables, including kale, spinach, turnip greens and collard greens, are a top source of magnesium and calcium.

Lean proteins: Chicken, turkey, fish, eggs and other proteins, which contain tryptophan. But avoid high-fat cheeses and deep-fried chicken or fish.

Nuts and seeds: Brazil nuts are an excellent source of selenium, a mineral that helps you get a restful sleep. Almonds and pumpkin seeds are an excellent source of magnesium. “Nuts and seeds contain a good balance of proteins and fats that help you feel satiated,” Mehta said.

Whole grains: Barley, couscous, buckwheat and other complex carbohydrates help convert tryptophan into melatonin and serotonin. Avoid simple carbohydrates, including pasta, breads made with white flour and sweets like cookies, cake and other sugary foods.

Yogurt: It contains calcium, which helps produce tryptophan. Choose plain Greek yogurt without sugar. You can add a few nuts or dried fruit as a garnish



What Is Secondary Insomnia? Key Things To Know About Sleep Problems

For the estimated one-third of us who experience at least the occasional bout of insomnia, the nights of tossing and turning can be as perplexing as they are aggravating. “Why can’t I sleep?” we might ask in clenched frustration.

As it turns out, there are plenty of easily spotted reasons why, at least for most cases. That’s because insomnia typically comes in two flavors: primary and secondary insomnia. Let’s take a brief look at the differences between the two.

Alarm clock


As might be obvious given its name, primary insomnia is what doctors call a case of unwanted sleeplessness with no other apparent health problems coinciding with it. Secondary insomnia is the exact opposite.

The vast majority, upwards of 80 percent, suffer from secondary, their sleeping ability disturbed or worsened by something else, according to the American Sleep Association. In that sense, it’s more of a side-effect than an actual condition. A short, but not complete, list of causes includes:

  • Chronic pain
  • Asthma or other breathing problems like sleep apnea
  • Depression and other mental disorders
  • Certain medications or drugs, including caffeine and tobacco
  • An overactive thyroid
  • Dementia and Alzheimer’s Disease
  • Heartburn
  • Hypertension

The good news is that managing or treating these conditions can help treat the insomnia. The opposite is also true: Getting a better night’s sleep will inevitably help us better deal with whatever health issue we’ve facing.

For the unlikely few who develop a persistent insomnia that comes out of nowhere and doesn’t go away, though, there’s less help to offer. We don’t quite understand why these individuals become insomniacs, though there’s some evidence that they may be uniquely vulnerable. And major life changes, including radical shifts to our work or travel schedules or the death of a loved one, can trigger it.

Thankfully, there are some available treatments for even chronic cases of insomnia, ranging from specialized therapies that try to train your mind and sculpt your behaviors to better fall asleep, to newly developed drugs like suvorexant that induce sleepiness. Antidepressants and antihistamines have also been shown to be moderately effective.

Of course, no one drug or therapy is foolproof, especially since prescription drugs like Ambien can carry their own substantial health risks. So for those of you struggling to stay asleep, the best thing to do is work together with your doctors to figure out what can work best for you.



Benzodiazepines and Insomnia How They Work to Cure Sleeplessness

A few of the most popularly prescribed sleep aids fall into the family of pharmaceuticals called, benzodiazepines. These potent drugs produce a sedative effect that’s useful for treating insomnia. But the chemical mechanism makes them useful in many other medical applications including, treatment for anxiety and seizures (Valium and Ativan, for example), and as a sedative and anesthetic for some medical procedures.

Common benzodiazepine sleep medications include:

  • Halcion
  • Restoril

How Benzodiazepines Work

First, benzodiazepines have been on the open market since the late 1960s. Valium was one of the first and has continued to be popular as a tranquilizer and sedative. So how do they work in your brain?


The neurological processes in your brain are complex and your natural sleep-wake cycle is a part of them. When your sleep is disturbed not only is the loss of sleep a nuisance, but it can take a toll on your physiological state and even be a root cause for some medical problems further down the road. Essentially your biological clock that usually runs in sync with the natural world automatically creates rhythmic rises and falls in brain melatonin, a natural sleep chemical. When you experience insomnia this natural process is disrupted: you could be challenged with falling asleep, staying asleep, or going back to sleep early in the morning—all of which have to do with melatonin production, plus.

Benzodiazepines bind with the GABA receptor in your brain, a neurotransmitter, to increase a chemical that inspires drowsiness or sedation. Most benzos are very quick to act and have a brief half-life that makes them particularly useful for treating sleep onset insomnia or middle insomnia (trouble staying asleep, or waking in the middle of the night).

Treating Insomnia with Benzodiazepines

In the past physicians have been quick to treat insomnia pharmacologically, with prescribed sleep aids or hypnotics. Benzodiazepines have been useful particularly as anti-anxiety drugs and a growing number of non-benzodiazepines are widely prescribed for insomnia: Ambien, Lunesta, and Sonata. While structurally distinctive these non-benzo sleep aids work in much the same way, by stimulating your brain’s neurotransmitter responsible for production of a sedating chemical.

Most benzodiazepines however are useful short-term—your insomnia needs a short and quick jolt to get you back on track. Benzodiazepines work quickly to put you to sleep, so no more long and frustrating wakefulness before falling asleep (sleep latency), then keep you asleep, freeing you also from waking.

Side Effects and Risks Associated with Benzo Use

Benzodiazepine sleep medications are only to be used under the direction of a physician. They can be habit-forming and are typically only licensed for short-term treatment. There are risks for withdrawal if used for more than 2 weeks and your doctor should wean you from them gradually. Side effects can include headaches, nausea, confusion, dizziness and drowsiness, depression, and many more serious problems. Benzos are also commonly abused and easily overdosed.