INSOMNIA

“King Sleep was father of a thousand sons –
…., the one he chose was Morpheus, who had such skill in miming any human form at will….voice,…gait,…words”
 Metamorphoses. Ovid

 Morpheus (“he who forms, shapes, molds”, from the Greek morphe) is the principal god of dreams and sleep. Morpheus sends images of humans in dreams or visions, and is responsible for shaping dreams, or giving shape to the beings which inhabit dreams. Described by Ovid he sleeps on an ebony bed in cave, surrounded by poppy flowers. The drug morphine (once “morphium”) derives its name from Morpheus based on its similar dream-inducing power

Morpheus was the god of dreams in Greek mythology. Due to some ancient sources he was the son of  Hypnosis ( in Roman mythology Somnus) the god of Sleep and the Grace known as Aglia or Brightness.

Ancient  Greeks believed  his dad was  spending most of his time in a cave by the river Oblivion with his brother Thanatos, the God of Death, lying on a black couch surrounded by black curtains and black bird plumbs he slept a lot.

This is perhaps a remarkable insight by the ancient Greeks, as it was not until recently that discoveries in brain research showed us that the deepest levels of dreamless sleep and death are closer than we would probably like to think.

Insomnia means difficulty in falling or staying asleep, the absence of restful sleep, or poor quality of sleep.  Insomnia in most cases is a symptom and not a disease. The most common causes of insomnia are medications, psychological conditions (e.g., depression, anxiety), environmental changes (e.g., travel, jet lag, or altitude changes),  and stressful events, can also be caused by faulty sleeping habits such as excessive daytime naps or caffeine consumption. 

It is estimated that 50 to 70 million Americans chronically suffer from a disorder of sleep and wakefulness, hindering daily functioning and adversely affecting health and longevity. The cumulative long-term effects of sleep loss and sleep disorders have been associated with a wide range of deleterious health consequences including an increased risk of hypertension, diabetes, obesity, depression, heart attack, and stroke.

Speaking about reasons of insomnia we can indicate here the most frequent:

  • Stress. Overwhelming concerns about work, school, health or family can keep somebody’s mind too active, making a person unable to relax. Excessive boredom, such as after retirement or during a long illness, may occur and also can create stress and keep you awake.
  • Anxiety. Everyday anxieties as well as severe anxiety disorders, including panic attacks, may keep mind too alert to fall asleep.
  • Depression. A depressed patient can have excessive sleep or have trouble sleeping. This may be due to chemical imbalances in the brain and should be evaluated by a specialist.
  • Medications. Prescription drugs, including some antidepressants, high blood pressure, and corticosteroid medications, can interfere with sleep. Many over-the-decongestants and weight-loss products contain caffeine and other stimulants. Antihistamines may initially make you groggy, but they can worsen urinary problems, causing you to get up more during the night.
  • Change in environment or work schedule. Travel or working a late or early shift, or jet lag  can disrupt  body’s circadian rhythms  The word “circadian” comes from two Latin words: “circa” for “about” and “dia” for “day.” Circadian rhythms act as internal clocks, guiding such things as your wake-sleep cycle, metabolism and body temperature.
  • Long-term use of sleep medications. Doctors generally recommend using sleeping pills for no more than four weeks, or until you notice benefits from self-help measures. If you need sleep medications for longer, take them no more than two to four times a week, try to reduce dosage, so they don’t become habit-forming. Sleeping pills often become less effective over time.
  • Medical conditions that cause pain. These include arthritis, fibromyalgia, and neuropathies, among other conditions. Making sure that your medical conditions are well treated may help with insomnia.
  • Behavioral insomnia. This may occur when you worry excessively about not being able to sleep well and try too hard to fall asleep. Most people with this condition sleep better when they’re away from their usual sleep environment or when they don’t try to sleep, such as when they’re watching TV or reading.
  • Eating too much too late in the evening. Having a light snack before bedtime is OK, but eating too much may cause you to feel physically uncomfortable while lying down, making it difficult to get to sleep. Many people also experience heartburn, a backflow of acid and food from the stomach to the esophagus after eating. This uncomfortable feeling may keep you awake.
  • Inherited condition. Some people have inherited poor sleep tendency. In any event avoidance of overexcitement in the evening time may help with insomnia.
  • Substances of abuse  – caffeine, tobacco,alcohol,cocaine,marijuana  etc.

Appropriate sleep habits are important in the management of insomnia. In some instances, changing sleep habits may correct the problem without the need for medications. Good sleep habits should include: 

  • Regular sleep times;
  • A comfortable bed and quiet room at a comfortable temperature;
  • Appropriate lighting;
  • Regular exercise but not close to bedtime or late in the evening;
  • A bedroom that is not used for work or other activities that are not related to sleep;
  • Avoidance of stimulants (e.g. caffeine, tobacco), alcohol, and large meals close to bedtime;
  • Relaxation techniques such as breathing exercises; and
  • Avoidance of naps during the day.

Medication treatment

Benadryl (Sominex, Nytol) and doxylamine (e.g., Unisom) are the two antihistamines that are currently marketed as OTC sleep aids. . Other uses for benadryl  include allergy, motion sickness, and cough suppression. Medication causes sedation by blocking the action of histamine in the brain, but the exact mechanism of action is not known. 

If insomnia is associated with pain, there are numerous products containing a combination of an antihistamine and pain reliever. These combination products should not be used if pain is not present because the added pain reliever is not necessary. 

Nonbenzodiazepine sedatives  include Lunesta, Sonata, and Ambien.

Rozerem is a prescription drug that stimulates melatonin receptors. Melatonin is a hormone produced by the pineal gland (located in the brain) during the dark hours of the day-night cycle. Melatonin levels in the body are low during daylight hours. The pineal gland responds to darkness by increasing melatonin levels in the body. This process is thought to be integral to maintaining circadian rhythm. Rozerem promotes the onset of sleep and helps normalize circadian rhythm disorders. Medication is approved by the Food and Drug Administration (FDA) for insomnia characterized by difficulty falling asleep.

Except above mentioned , very powerful tools to help with sleep problems, there are numerous alternative approaches to reduce stress and improve relaxation. Acupuncture, classical massage therapy, using botanical herbs (valerian root, chamomile etc.)  are among them. It is wise to consult with specialists to find out the reason of sufferings.