- 1 Features of the treatment of insomnia
- 2 Cognitive behavioral therapy
- 3 OTC Medicines
- 4 Sleeping pills
- 5 Day tranquilizers
- 6 Antidepressants
- 7 Other drugs
- 8 Sleep hygiene
- 9 Conclusion
Features of the treatment of insomnia
Different doctors can deal with insomnia: a local therapist, a neurologist, a psychiatrist or a somnolog. To give the body a rest, recover, prescribe pills. They are recommended to take short courses, so as not to provoke addiction, the development of withdrawal syndrome.
Insomnia is often caused by stress factors. These can be destructive relationships, hard work, lack of time to rest, or mental disorder when the disturbance of night rest occurs against the background of depression or anxiety disorder. In such cases, only sedatives will not work, because the root cause of the disease will not be eliminated.
What exactly to take from insomnia, the doctor determines. The choice of the drug depends on the complaints, the clinical picture, and partly on the nature and emotional state of the patient. There are prescription and non-prescription drugs for insomnia.
Despite the fact that medications help you fall asleep, for a long-term effect you will need to find out the cause of the disorder, change your lifestyle. If the patient is taking medication, you need to inform your doctor. What medications can cause insomnia, and which are not, as indicated in the instructions. To avoid side effects, change the dose, and taking the drug is transferred to the morning time.
Overweight people need to consult with a gastroenterologist. Excess weight provokes sleep apnea, worsening rest. As soon as weight is normalized, the quality of sleep will improve.
Cognitive behavioral therapy
The best remedy for insomnia is a combination of medication with psychotherapy. The most effective is the cognitive-behavioral therapy (CPT). Psychotherapy helps to understand the cause of the violation, the methods of dealing with it. KPT helps to establish a regime of rest, to realize, learn to manage your fears.
Studies show that the quality of rest is improving already 6 weeks after the start of meetings with a psychotherapist.
The psychotherapist never gives “ready-made solutions”, but he encourages a person to draw his own conclusions, to find a solution to the problem. The task of the CPT course is to give an opportunity to see yourself from the outside, to adjust the regime, learn to manage your thoughts, be able to relax, despite the circumstances of life.
Non-addictive insomnia drugs can be freely purchased at any pharmacy.
One of the most used drugs for insomnia without a prescription. The effect of this group of drugs for sleep disorders was discovered by chance. Clinical trials show that taking antihistamines improves the quality of rest, reduces the symptoms of short-term insomnia.
Of the minuses – the effect is reduced already on the 3rd day. Donormil is commonly used.
It contains a light barbiturate – phenobarbital, which has a weak short-term hypnotic, sedative effect. Available in drops, tablets. Apply with short-term insomnia.
Nootropic drug to improve the quality of rest with insomnia with a mild anxiolytic effect. Promotes rapid sleep, reducing nighttime awakenings.
In addition, improves blood circulation in the brain, helps fight chronic fatigue.
This is a hormone that is produced by the brain during the night’s rest. Reaches a maximum between 10:00 pm and 2:00 am, gradually falling to dawn. Taking Melaxen against insomnia improves the quality of sleep, normalizes circadian rhythms.
In elderly people, it is especially indicated for disorders: melatonin synthesis slows down with age. Among the side effects note headache.
L-tryptophan and glycine
An essential amino acid involved in the synthesis of neurotransmitters, especially serotonin, melatonin. Helps to establish daily rhythms, improve the productivity of rest.
Glycine is another amino acid responsible for the functioning of the nervous system. Glycine improves cerebral circulation, calms, reduces anxiety.
Herbal preparations and vitamin complexes
The most popular herbal insomnia medicines contain valerian root extract, motherwort, lemon balm, primula, passiflora. They have a mild sedative effect, stop anxiety, improve the quality of rest.
You can use ready-sedative charges, brew herbal teas. The most popular herbal remedies are Persen, Novo-Passit, Sonilyuks, Sedistress.
Chronic stress, fatigue, consume the resources of the body. Vitamin A, C, group B vitamins are used for insomnia; folic acid is particularly useful (B9).
The main advantage of such drugs is minimal side effects. Over-the-counter insomnia pills are less effective than sleeping pills, but they are also safer. In joint therapy, the incidence of adverse symptoms is reduced. The action does not occur immediately, especially with herbal preparations. They are recommended to use in the evening, a few hours before the rest.
Some mistakenly believe that alcohol helps you fall asleep faster. Ethanol has a devastating effect on the work of the nervous system: the time of falling asleep decreases, but at the same time the quality of rest worsens, frequent awakenings are provoked. As a result, the body does not rest, it only gets worse.
For this reason, it is not recommended to use folk remedies for insomnia based on alcohol: the effectiveness will be reduced. In addition, alcohol is a strong depressant, aggravates the course of depression and other mental disorders.
People who are prone to allergies, should be used with caution funds based on herbal ingredients.
Insomnia pills are sold only by prescription, have a number of side effects that increase with prolonged use. Among them are hypotension, anxiety, nausea and vomiting. They are gradually forming addiction, and sleeping pills for insomnia stop working.
This is especially true for older people who are addictive occurs several times faster. They have sleeping pills can provoke mental disorders.
Classification of sleeping pills:
- non-benzodiazepines ((Z-drugs);
- melatonin receptor agonists;
- orexin receptor antagonists.
Earlier this group included barbiturates, but in recent years they have been used very rarely as a means of falling asleep. The exception is over-the-counter Phenobarbital.
What pills for insomnia will work better in a particular case, the doctor determines.
Most of the drugs from the benzodiazepine group are tranquilizers with pronounced sedative and anti-anxiety effects. With long-term use cause physical dependence, because of what are assigned short courses.
Benzodiazepine drugs are effective not only from insomnia, but also from stress. They soothe, help to fall asleep quickly, improve the duration and quality of rest. Side effects include daytime sleepiness, dizziness, problems with coordination, and, in high doses, impaired memory, sleep apnea.
Cause dependence at courses more than 2-4 weeks. As a rule, psychological dependence prevails over physical. Not recommended for patients with histories of drug addiction and alcoholism.
Non-benzodiazepine drugs are less addictive, but may affect the psyche. For example, on the reaction rate, concentration. Short courses improve the quality of sleep, long – its duration.
Most popular nonbenzodiazepines:
Non-benzodiazepine drugs are rarely used to treat short-term episodes of sleep disturbance.
New Generation Sleeping Pills
Among the melatonin receptor agonists, ramelteon is used to treat insomnia – effective tablets of the new generation. In clinical trials, they showed a lasting effect without addiction, the formation of dependence. Recommended for the treatment of chronic insomnia, especially with heavy sleep. Have a minimum of side effects, may be prescribed courses for more than 12 months in a row.
Among the side effects of daytime sleepiness, fatigue, dizziness, decreased libido, amenorrhea. The drug can provoke depression, aggravate the course of mental disorders.
Orexin receptor antagonists
Another cure for insomnia with minimal side effects is Suvorexant, an orexin receptor antagonist that is responsible for wakefulness. The drug reduces the time of falling asleep, promotes deep and productive sleep.
Side effects with prolonged use are not fully understood. It is reported cases of daytime sleepiness and inhibited reaction after waking up.
Clinical trials have shown that all types of sleeping pills are effective for treating short-term and primary episodes of insomnia. For the treatment of the chronic form of the disease, only those that can be taken by long courses are used: Zopiclone, Zolpidem and Ramelteon.
Day anxiolytics are called drugs that do not have a pronounced hypnotic effect, which allows them to be used during the day. These include Gidazepam, Buspirone, Tofizopam, Mebicar, Melazepam.
Despite the absence of a pronounced sedative effect, daily tranquilizers are also used as sedatives for insomnia. They reduce anxiety levels, helping to stabilize an emotional state. They help to fall asleep faster in cases of short-term insomnia caused by stress, and in the treatment of the chronic form they complement psychotherapy.
Daytime tranquilizers are also prescribed to patients who develop daytime sleepiness from other medications for insomnia.
Large studies on the effectiveness of antidepressants in the treatment of insomnia have not been conducted, and the opinions of doctors here differ.
- Trazodone It is less effective than prescription sleeping pills, but it helps speed up sleep with prolonged use. Because of adverse reactions, daytime weakness, drowsiness, and development of hypotension may occur.
- Tricyclic antidepressants: Amitriptyline, Doxepin, Imipramine, Clomipramine, etc. Have a pronounced sedative effect, improving sleep duration, its quality. Increase the phase of long sleep, but can provoke restless legs syndrome. They have many side effects, including cardiovascular (tachycardia, hypotension), weight gain, urination problems, dry mouth, daytime sleepiness. The most “mild” in terms of side effects is considered to be doxepin in a low dose and clomipramine.
- Mirtazapin. It has a sedative effect, it is an effective pill for falling asleep. It does not affect the phases of sleep, but suppresses nightly awakenings. Use is limited to side effects. Many Mirtazapin provokes a significant increase in weight.
Antidepressants may be preferable to sleeping pills in cases where insomnia is associated with depression, anxiety disorder, or fibromyalgia. Especially if the other drug therapy did not work. Often they are prescribed to people who are dangerous to use prescription tranquilizers because of their propensity to substance abuse.
Of the drugs for insomnia, in addition to sleeping pills and antidepressants, use some other psychotropic medications:
- Gabapentin. Widely used for the treatment of chronic pain and epilepsy. For the treatment of insomnia assigned to patients with fibromyalgia and restless legs syndrome. It has a sedative effect, significantly reducing the time of falling asleep. Affects the phases of sleep, making it deeper and reducing the number of nighttime awakenings.
- Tiagabin Anticonvulsant pills that are prescribed for sleep disorders. Have a dose-dependent effect. Increase the phase of slow sleep, reduce the time of falling asleep. Side effects include daytime sleepiness, dizziness, nausea.
- Olanzapine and Quetiapine. Atypical antipsychotics with moderate hypnotic effect. Increase sleep duration, reduce sleep time, night awakenings. Can provoke weight gain, hypotension.
The effect of these drugs was studied in healthy people. Major clinical studies have been conducted.
During and after treatment, in addition to drug support and psychotherapy, it is important to observe sleep patterns. You need to understand that some pills can not cure insomnia.
Basic rules for hygiene rest:
- Do not pour. Prolonged (more than 8–9 hours) sleep is very superficial and brings nothing but a feeling of fatigue. From daytime rest must be completely abandoned. No need to try to sleep off “for a few nights ahead.” If the dream is short, short, and after waking up it is not possible to fall asleep again, you need to get up and do something calm, relaxing.
- Follow the schedule. If you get up and go to bed at the same time, circadian rhythms stabilize, the body “learns” to fall asleep and wake up on its own. In the evening, you need to spend a lot of time relaxing. It is important to create a “sleep ritual” that must be observed every night in order to teach the brain to switch off. For example, take a walk down the street, take a warm shower, do meditation, read a book, listen to music, drink a cup of herbal tea.
- Provide comfort. At night in the bedroom should be quiet, dark, cool. Mattress and pillows are selected so that they were comfortable to sleep. It is recommended to remove the clock from visibility. Constant observation of them is distracting, it may increase anxiety, anxiety due to the inability to fall asleep. To improve the quality of rest, you can use a mask, ear plugs.
- Think positive. When a person tries to “force” himself to sleep, the level of anxiety automatically increases, the mechanisms of excitation in the brain are activated. If you can not fall asleep within 20 minutes, you need to get out of bed and do something soothing. Breathing exercises, sleep visualization, relaxing exercises, a cup of warm herbal tea or a book will help. Well helps listening to audio recordings with a detailed description of relaxation techniques. This will help not to suffer from thoughts and anxiety due to the inability to fall asleep. When arousal subsides, you can go back to bed.
It is extremely important to observe the sleep mode: go to bed no later than 23:00. This is due to the synthesis of melatonin, which peaks between 22:00 and 02:00. Melatonin is responsible for the quality of sleep, it is at this time that the brain rests as much as possible, sleep is the most productive.
1-2 hours before a night’s rest, they limit watching TV, using a computer or smartphone. They excite the mind, prevent sleep. Physical activity should be done either during the day or in the early evening. Morning exercises, though they help to cheer up, but in the long run, this will shorten the duration of a night’s sleep.
If there are problems with falling asleep, it is recommended to reduce the use of caffeine, nicotine and alcohol in the evening. Caffeine and nicotine are natural stimulants that interfere with sleep, but alcohol provokes frequent awakenings, completely disrupts the quality of sleep.
There are different methods of treating insomnia. They are selected individually, require an integrated approach. If insomnia becomes chronic, aggravated, you need to consult a doctor.