Saturday, 28 December 2013

Women and Insomnia

Insomnia is a sign and symptom of sleep disorder and defined as a condition in which a person has a difficulty falling asleep and/or staying asleep or sleep of poor quality that can lead to substantial impairments in the quality of life and functional capacity of an individual. Most adults have experienced insomnia sometimes in their life. According to statistic, more than 30% of the population suffers from insomnia, one in three people suffer from some form of insomnia during their lifetime and women suffer from insomnia more often than men.

Types of insomnia
1. Transient insomnia
The symptom is last less than a week, as a result from sleep environment changes, timing of sleep or caused by depression, stress or other factors.
2. Acute insomnia
Acute insomnia, a more common type of insomnia, is defined as a condition of difficulty initiating or maintaining sleep for a period of less than three months, one is acute insomnia.
3. Chronic insomnia
The symptom is last more than 3 months and can be caused by another disorder, such as emotional or psychological basis.

Diagnosis and tests
The purpose of the insomnia diagnosis is to determine the causes ( psychology , medicine, etc) of the diseases to provide a best possible treatment to the patient. In general, after recording the family history and a physical and mental exams
obstructive sleep apnea
The test is to determine the periodic reduction in or a complete stop of breathing during sleep. It can be performed in the doctor office or at the hospital.
2. Epworth Sleepiness Scale
A validated questionnaire to be answered by the patient and can be helpful in
assessing insomnia.
3. Etc.

Causes and Ricks factors of insomnia in women
There are many factors that can cause insomnia
1. Hormone change
Hormones produced by glands or organs during menstrual cycle, pregnancy or in the stage of menopause can affect the pattern of sleep.
a. Menstrual cycle
According to an article posted at reader digest version, health- menstrual insomnia by
By Ellen Michaud with Julie Bain from Sleep to Be Sexy Smart and Slim showed that Premenstrual insomnia, as doctors call it, seems to be associated with a rapid drop in the hormone progesterone. “Progesterone is a soporific, a sedative-type drug that your body gives you every month when you ovulate,” says Dr. Lee.(researcher) “Then, just before your period, its production either slows to a trickle or falls dramatically.”

b. Menopause
According to the article of Menopause And Insomnia -- New Findings Link Estrogen Decline, Sleeplessness And Mineral Deficiency post on medical news today 15 May 2007 - 12:00 showed that women in the pre-menopause and menopause years are more and more finding themselves experiencing symptoms of chronic insomnia,.....Some of the above reactions occur nearly simultaneously whenever the level of estrogen falls. as a result of gradual drop in estrogen but severe drop in progesterone.

c. Pregnancy
The hormonal change during pregnancy may also affect the sleep pattern in some women, causing insomnia. According to a study of 189 women completed the surveys provided by the researchers at Northwestern studying insomnia and pregnancy, researchers found that pregnancy insomnia could also be caused by inadequate nutrient intake, particularly in the later stages as more nutrients are being directed to the developing fetus. For example, blood levels of the omega-3 fatty acid Docosahexaenoic acid (DHA) become much lower during the third trimester.
DHA is necessary for normal brain function. Low DHA levels have been associated with depression. That could be the connection between increased insomnia during pregnancy. The brain receptors responsible for regulating sleep are the same as those responsible for regulating mood. Both insomnia and pregnancy can affect the mood as a result of the effects of sleep deprivation and hormonal changes.

2. Disorder causes of insomnia
Women who has been affected by anxiety disorders or the delayed sleep phase disorder may experience the symptom of insomnia.

3. Frequent nighttime urination
Frequent nighttime urination can cause sleep disturbance, if the disorder persists for the prolonged period of time can lead to insomnia.

4. Depression and Anxiety
Women who have been affected by depression and anxiety are at high risk of developing insomnia.

5. Stimulants
Stimulants can cause nervous tension that can lead to insomnia.

6. Mental disorders
Increased risk insomnia for women with mental disorder.

7. Medical conditions
Certain sickness such as hyperthyroidism and rheumatoid arthritis[ can lead to insomnia.

8. Physical exercise
Exercise-induced insomnia ((EII)) is common in athletes. In a study of the epidemiological survey of exercise-induced insomnia in Chinese athletes by Youqi Shi, Zhihong Zhou, Ke Ning, Jianhong LIU, researchers concluded that EII symptoms are generally existed in Chinese athletes. The difficulty-initiating sleep(DIS)are most prevalent (79.5%) among EII. It frequently occurs after intensity exercise and before competition. 95% of EII symptoms belong to temporary psychological and physiological insomnia while 5% of them match the definition of insomnia described by the CCMD-2-R or are so-called obstinate psychological and physiological insomnia.

9. Excessive alcohol intake
Excessive intake of alcohol can interfere with the function of the nervous system in information transmitting information between brain cells and cells in the body, prolonged excessive drinking can cause insomnia.

10. Smoking
Smoking is a stimulant which can interfere with the body's ability to fall asleep.

11. Etc.

1. Difficulty falling and maintaining asleep
2. Poor quality sleep pattern
3. Difficult staying asleep
4. Poor concentration
5. Difficulty with memory
6. Impaired motor coordination
7. Irritability and impaired social interaction
8. Fatigue
9. Etc.

A. How to avoid
1. Maintain a health diet and lifestyle to prevent the hormonal causes of insomnia.
2. Reduce intake of alcohol
3. Stop smoking
4. Moderate exercise
5. Frequent nighttime urination can be treated
6. A glass of warm milk 15 minutes before going to bed may be helpful.
Taking a warm water bath an hour before bedtime can enhance sleep.
Reading, meditation can relieve nervous tension and induce sleep.
Do not eat a large meal within two hours of bedtime
10. Etc.

B. Diet
1. Tofu or bean curd
Tofu or bean curd is soft white blocks made by coagulating soy milk with substance such as salt or acid or enzyme, a stable emulsion of oil, water, and protein that can be made into tofu, originated from Chinese and part of East and Southeast Asian. Since it is proven to be one of many healthy foods, it become synonymous with vegetarianism and others.
Isoflavones is one of the most powerful phytoestrogen, which not only helps to reduce symptoms of peri-menopause and menopause due to decreasing of the reproduction of estrogen as aging, it also helps to reduce symptom of menstrual cramps and pain as well as enhancing normal menstrual cycle.

2. Tryptophan rich foods
Tryptophan is an essential amino acid, the precursor to serotonin, in turn, converted to melatonin, via N-acetyltransferase and 5-hydroxyindole-O-methyltransferase activities which are necessary neurotransmitter responsible for transmitting nerve impulses in the brain and induce relaxation and natural sleep, but high levels of tryptophan can increase the risk of drowsiness and cause harmful harmful effects of the age-related increase in brain serotonin. Intake food rich of tryptophan from the food below.
a. Chicken breast and Turkey
b. Tuna
c. Soybean
d. Beef
e. Lamb
f. Halibut
g. Shrimp
h. Salmon
i. Etc.

3. Carbohydrate
Eating foods with
high in carbohydrate stimulates the pancreas in production and releasing insulin in the blood stream as it also reduce others amino acids which would otherwise compete with tryptophan, leading to the production of serotonin, which in return enhances the production melatonin, the natural sleep induced hormone.
a. Bread and pasta
b. Whole gain cereal
c. Potatoes
d. Apple pie and
e. Ice cream
f. Oatmeal and raisin cookies
g. Etc.
High amount of simple carbohydrate over prolonged period of time can increase the risk of type II diabetes due to over work that diminishes the function of pancreas in production of insulin. It If you are any symptom of sleep disorder, eating turkey combined with complex carbohydrate rich foods would be a better choice for meat and glucose. What is your choice?

4. Chlorophyll

All green plants including algae contain at least one type of chlorophyll, the green pigment of plants which allows plants to absorb sun light and convert them into usable energy. Beside it is best known as oxygen uptaker to the blood, it is also important to calm the nervous system, to induce sleep due to rich amount of magnesium.
a. All dark green plants( Roman lettuce is the best choice)
b. Algae (Fresh water organic growth is the best choice)
c. Etc.

5. Magnesium
Magnesium is a natural sedative and stabilization of abnormal nerve excitation as it is used in conjunction with other medication to treat depressed elderly type 2 diabetics.. The mineral is important in manipulating of ATP, DNA, and RNA and many enzymes.
a. Leaf green vegetables (due to high amount of Chlorophyll)
b. Almonds
c. Sesame seed
d. Blackstrap molasses
e. Brewer's yeast
f. Whole grains
g. Etc.

For details of foods of above visit
100+ Healthy Foods Classification
or Super Food Health Effects

A. Conventional medicine
Generally, treatment of insomnia includes Non-pharmacological non-pharmacologic pharmacologic
A. 1.Non-pharmacological treatments
Non-pharmacological treatments have been used more effectively without worrying about the withdrawal effects after discontinued use of medication, including sleep hygiene, stimulus control, behavioral interventions, sleep-restriction therapy, paradoxical intention, patient education and relaxation therapy.
1. Sleep hygiene
Sleep hygiene is the method used to treat insomnia by including all behavioral and environmental factors that precede to sleep and may interfere with sleep. In a study of Sleep hygiene and actigraphically evaluated sleep characteristics in children with ADHD and chronic sleep onset insomnia KRISTIAAN B . VAN DER HEIJDE, researchers concluded that there were differences in sleep onset and sleep latency in ADHD children with chronic SOI and those without insomnia; however, sleep hygiene practices were similar and did not relate to sleep characteristics.

2. Stimulus control
The purpose of stimulus control is to The use of conditioning techniques to bring the target behavior of an individual under environmental control. If a person behaviors can respond differentially to the environment factors, he/or she are likely to fall to sleep under certain certain conditions. the characteristics of stimulus control is to helps the patient to behavior automatically when the conditioned stimulus is given but not to others.

3. Behavioral intervention
The purpose of behavioral intervention is to reinforce the positive behavior and avoid bad behavior regardless the environment influence.

4. Sleep-restriction therapy
Sleep restriction therapy base on the hypothesis that insomnia is caused spending too much time in bed cause of insomnia. By restriction the time in bed determine by the time a person normally asleep and schedule for others such as time to wake up, same bed time every night, etc.

5. Paradoxical intention
Paradoxical intention is a treatment of removing the psychological habit or thought cause of insomnia by helping the patient to understand the irrationality of the emotional reaction

6. Relaxation therapy
relaxation therapy is a form of treatment by enhancing the person into a relaxation stage quieting the mind to allow thoughts to flow in a smooth and induce the relaxation response.

7. Etc.

A..2. Pharmacologic treaments
1. Benzodiazepines
a. Benzodiazepines is used for patient with insomnia to initiate sleep and increase sleep time, but they also decrease deep sleep and increase light sleep.
b. Risk and side effects
b.1. Drowsiness and dizziness.
b.2. Stomach upset
b.3. Headache,
b.4. Confusion
b.5. Impaired coordination
b, 6. Fatigue
b.7. Memory loss
b.8. Trembling
b.9. Etc

2. Non-benzodiazepines
a. Non-benzodiazepine is a sedative-hypnotic drugs used to treat insomnia similar to those in the benzodiazepine class but with an advantage of reducing the time for the patient to fall asleep.
b. Risks and side effects
b.1. morning sedation
b.2. Drowsiness
b.3. Dizziness
b.5. Headache
b.6. Diarrhea
b.7. Etc.

3. Antidepressants
a. According the article of
Use of Low-Dose Sedating Antidepressants vs Benzodiazepine Receptor Agonist Hypnotics in Treating Insomnia by Thomas Roth, PhD, the author concluded that Because the use of low-dose sedating antidepressants in insomnia is a common practice, one can come to 2 conclusions. These were formalized in the National Institutes of Health State of the Science Conference on the Manifestations and Management of Chronic Insomnia in Adults. First, there is a need for dose-response data on the relationship with sleep, as well as long-term efficacy data. Second, "all antidepressants have potentially significant adverse effects raising concerns about the risk-benefit ratio."[11] In summary, there is a wealth of data supporting the efficacy and safety, with some concerns mentioned above, of the BZRAs for the management of insomnia. In contrast, while the use of low-dose sedating antidepressants for the management of insomnia is gaining in popularity, as pointed out by the National Institutes of Health, the wisdom of this use awaits further data on dose-related safety and efficacy.
b. Risk and side effects
b.1. Bladder problems
b.2. Loss of libido
b.3. Dizziness and drowsiness
b.4. Inability to achieve an orgasm
b.5. Headaches
b.6. Nervousness
b.7. Etc.

4. Melatonin supplement
a. Melatonin supplements has been used
treat insomnia without altering the sleep pattern by inducing sleep and regulating the sleep/waking cycle. In a study of Melatonin and zopiclone as facilitators of early circadian sleep in operational air transport crews. by Paul MA, Gray G, Sardana TM, Pigeau RA, researchers concluded that melatonin and zopiclone, in the dosages we used, are equipotent facilitators of early circadian sleep during transmeridian air transport operations.
b. Risks and side effects
b.1. Daytime sleepiness and drowsiness
b.2. Dizziness
b.3. Headaches
b.4. Abdominal discomfort
b.5. Confusion
b. 6. Nightmares
b.7. Etc.

5. Melatonin agonist
In a study of Melatonin agonist and insomnia by Ferguson SA, Rajaratnam SM, Dawson D., researchers concluded that all appear to be efficacious in the treatment of circadian rhythm sleep disorders and some types of insomnia. However, further studies are required to understand the mechanisms of action, particularly for insomnia. Clinical application of the agonists requires a good understanding of their phase-dependent properties. Long-term effects of melatonin should be evaluated in large-scale, independent randomized controlled trials.
b. Risks and side effects
b.1. Daytime sleepiness
b.2. Dizziness
b.3. Headaches
b.4. Abdominal discomfort
b.5. Confusion
b. 6. Nightmares
b.7. Etc.

6. Etc.
B. Herbs
1. Chamomile (Anthemis nobilis):
Chamomile, a time-honored sedative herb, is widely used in teas for its relaxing and calming effects, especialy in South America, and Mexico it is used as a herbal medicine to treat insomnia, restlessness and irritability, particularly in children.

2. Hops (Humulus lupulus):Hops are the female inflorescences of the plant Humulus lupulus L., and used used as an herbal medicine for mood disturbance and insomnia. In a study of Valerian-hops combination and diphenhydramine for treating insomnia: a randomized placebo-controlled clinical trial.
Morin CM, Koetter U, Bastien C, Ware JC, Wooten V., researchers found that Sleep improvements with a valerian-hops combination are associated with improved quality of life. Both treatments appear safe and did not produce rebound insomnia upon discontinuation during this study. Overall, these findings indicate that a Valerian-hops combination and diphenhydramine might be useful adjuncts in the treatment of mild insomnia.

3. Lavender (Lavandula officinalis):Lavender is a gentle strengthening tonic for the nervous system to treat moderate depression and for generalized anxiety disorder cause of insomnia.
4. Passion flower (Passiflora incarnata):Passion flower is an important herb to treat insomnia caused by anxiety, epilepsy, neuralgia, and withdrawal syndromes from opiates or benzodiazepines due to its sedative effect of centrally acting substances such as benzodiazepines, barbiturates, alcohol. in a study of Passionflower in the treatment of generalized anxiety: a pilot double-blind randomized controlled trial with oxazepam by Akhondzadeh S, Naghavi HR, Vazirian M, Shayeganpour A, Rashidi H, Khani M., researchers found that Passiflora extract is an effective drug for the management of generalized anxiety disorder, and the low incidence of impairment of job performance with Passiflora extract compared to oxazepam is an advantage. A large-scale trial is justified.

5. Valerian (Valeriana officinalis):Valerian has been used as a sedative agent to treat against insomnia, nervousness, and restlessness by many herbalists. Please read hops-valerian study above.

6. St. John's Wort (Hypericum perforatum):
St. John's Wort has been used as sedative agent as imipramine or selective serotonin reuptake inhibitors (SSRIs) to treat mild to moderate depression causes of insomnia. In a study of Equivalence of St John's wort extract (Ze 117) and fluoxetine: a randomized, controlled study in mild-moderate depression by Schrader E., researcher found that Although hypericum (St. John Wart extracted, Ze 117) may be superior in improving the responder rate, the main difference between the two treatments is safety. Hypericum was superior to fluoxetine in overall incidence of side-effects, number of patients with side-effects and the type of side-effect reported.

7. Etc.

C. Chinese Herbs
In traditional Chinese medicine, insomnia is most often results of imbalances of the Heart or Liver. Tian Wang Bu Xin Dan is one the most study and used to treat insomnia. Its ingredients
Radix Salviae Miltiorrhizae (Dang Shen)
Rhizoma Acori Tatarinowii (Shi Chang Pu)
Radix Rehmanniae Glutinosae (Di Huang)
Radix Angelica Sinensis (Dang Gui)
Fructus Schisandrae Chinensis (Wu Wei Zi)
Tuber Ophiopogonis Japonici (Mai Men Dong)
Semen Ziziphi Spinosae (Suan Zao Ren)
Semen Biotae Orientalis (Bo Zi Ren)
Radix Codonopsis Pilosulae (Dang Shen)
Sclerotium Poriae Cocos (Fu Ling)
Radix Scrophulariae Ningpoensis (Xuan Shen)
Radix Polygalae Tenuifoliae (Yuan Zhi)
Radix Platycodi Grandiflori (Jie Geng)
Radix Glycyrrhizae Uralensis (Gan Cao)
Caulis Polygoni Multiflori (Shou Wu Teng)
Asparagus Cochinchinensis Tuber (Tian Men Dong)

The International Chinese Medical Journal of Daytona notes in a 2003 review of insomnia posted from that this formula is especially helpful for those suffering from nervousness and vivid, disturbing dreams.

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