Insomnia requires treatment tailored to each situation. The first step is to observe his lifestyle and his immediate environment. These can be modified to promote sleep.
Changing the routine of bedtime
The behavior therapy called “stimulus control” is particularly effective. It is intended to accustom the body to a routine for sleep. It creates, however, sleep deprivation, which makes it difficult to apply. Once we found a deep sleep and regular, and cycles of wakefulness and sleep are in sync, you can gradually return to a less restrictive routine.
Here are some behavioral rules to be observed scrupulously:
1. To bed only when sleepy. There is nothing worse than trying to fall asleep at any price.
2. Do not stay in bed when you are awake for more than 20 to 30 minutes. When this happens, get up, get out of his room, take a relaxing activity and go to bed when you feel won by sleep. Repeat these movements as often as necessary. There is nothing worse than turning endlessly in his bed by being bad blood because sleep is slow in coming.
3. Getting up in the morning at a fixed time, whatever day of the week, including Saturdays and Sundays, even if we had not slept. It is true that reduced sleep time, but it helps to sleep with a stroke. At first, we must not delay his rise to make up the hours we could not close my eyes: long term this could exacerbate the problem. When finally a regular, uninterrupted sleep, we can slightly extend his nights (in increments of 15 minutes). Hiding their alarm clock allows some people to focus less hours of sleep (or arousal) they have left. After setting the tone, the dial away from the bed.
4. Do not go to bed less than five hours.
5. Make no other activities in bed (ideally in the bedroom) to share sleeping or having sex.
6. Regarding a nap during the day, opinions differ. Some prohibit the experts, because it would fill some needs sleep. At bedtime, we would have more trouble falling asleep. Others argue that a short nap, which has a maximum of 20 minutes and is done for 15 h, can be beneficial.
To experiment.
Several scientific studies show that this method has been proven. Improved sleep is observed at the end of the first month. Its disadvantage is that it requires discipline and motivation. You can try it yourself, but it can also be done in the context of psychotherapy like cognitive-behavioral.
Drugs
If insomnia persists despite everything, it is important to talk to her doctor in order to identify the causes.
If necessary, sleeping pills (also called hypnotics) may be prescribed: they can recover. They also help break the vicious circle of worry, anxiety, fatigue and insomnia that feeds some people.
Benzodiazepine sleeping pills are the most commonly prescribed. They act quickly on the central nervous system. They have a hypnotic effect, in addition to allay anxiety (anxiolytic) and stress. However, they should not be consumed more than two or three consecutive nights. If used regularly, they lose their effectiveness and may cause physical and psychological dependence (when one feels the intense need to resume). In addition, they may cause side effects (increased risk of falls and fractures, loss of concentration, etc), And withdrawal symptoms when stopped (anxiety, agitation, sleep disturbance, digestive disorders or other ailments). When treating insomnia, the goal is to return to sleep without creating dependency on drugs.
The benzodiazepine family of brands includes several medicines. They all have a sedative, anxiolytic and anticonvulsant at various intensities, and they are muscle relaxants. Benzodiazepines specifically indicated for treating insomnia are flurazepam (Dalmane ®), temazepam (Restoril ®) and nitrazepam (Mogadon ®). The oxazepam (Serax) and lorazepam (Ativan ®), whose primary indication is the relief of anxiety are also often used in cases of insomnia. Diazepam (Valium ®) is, for its part, hardly used, because its duration of action longer cause residual drowsiness the next morning.
Non-benzodiazepine sleeping pills (zopiclone which) are on the market in recent years. They have some advantages: they do not cause dependence and withdrawal easier. Their long-term effects remain, however, poorly documented.
It is important to consult your doctor when you want to stop taking sleeping pills or tranquilizers to avoid suffering a withdrawal syndrome. According to one study, cognitive-behavioral therapy facilitates the complete withdrawal of chronic insomniacs who have taken benzodiazepines and it also improves the quality of sommeil36. The results were visible after three months of treatment. The goal of cognitive-behavioral therapy is to correct certain beliefs amplifying insomnia and help them adopt practices to promote sleep.
Behavior Therapy
An accompanying cognitive-behavioral therapy can be useful and help to dispel erroneous associations or beliefs feeding distress related to insomnia (eg, “I must sleep at least eight hours per night, otherwise I will not fit the next day).
Other treatments
In cases of severe anxiety, depression or other psychological disorder, the doctor may prescribe antidepressants to relieve insomnia. It can also refer patients to a psychologist or a psychiatrist.
In cases of mild sleep apnea, we can try, initially, some “house stuff”:
- Lose weight (obesity);
- Do physical exercise;
- Maintain regular sleep habits;
- Sleep on a firm mattress without a pillow;
- Sleep on your side instead of on the back;
- Elevate the head of the bed;
- Avoid alcohol and tobacco.
If these measures prove ineffective, or if apnea is more serious, we can turn to other solutions, such as use of a ventilator airway pressure continuous positive (CPAP). This device keeps the throat open and prevents snoring and apnea. Wearing night of a dental prosthesis, which repositions the jaw, can also help. Finally, surgery to widen the airway is sometimes undertaken.
You can relieve leg syndrome restless, getting up and walking. Unfortunately, the calm is only temporary. When the problem effectively in night sleep quality, the doctor may prescribe a medication based on pramipexole (Mirapex ®).
In case of insomnia caused by grief, one can resort to painkillers. However, some of them can cause insomnia. If so, do not hesitate to ask his doctor to change the order.