Insomnia is the most common sleep disorder, there are three different types and this condition affects one in four people.
Frequently Asked Questions
Insomnia is the most common sleep disorder, which affects one in four people.
1. Transient Insomnia
This version of insomnia can last anything from a few days to a week, can be triggered by various factors (such as excess environmental noise, medications, and extreme temperatures – either hot or cold). One type of transient insomnia experienced by avid travellers is jet lag, in which travelling through time zones causes a temporary disruption of the body's circadian rhythm.
2. Acute Insomnia
Acute insomnia has a sudden onset and may last for several weeks. Common triggers of acute insomnia include emotional stress or conflict, environmental changes such as moving house or job, or anxiety associated with going to bed. Acute insomnia can also be triggered by the same things that trigger transient insomnia (as stated above).
3. Chronic Insomnia
This type of insomnia can have detrimental effects on a person’s health, quality of life, productivity, and safety, and can last anything from months to years at a time.
In many cases, insomnia may be a consequence of another underlying medical problem, as discussed below:
1. Mental Health Issues
Insomnia is a symptom of many mental health problems, which includes anxiety, depression and bipolar disorder. Unstable mental health disorders can trigger insomnia, but the same is true in reverse that insomnia can be a major risk factor for mental health issues. Research findings suggest that patients with insomnia complaints have a major predictor for the onset of depressive disorder within 1-35 years. Insomnia is also linked to certain psychological personality traits, such as social introversion and repression of feelings.
Psychophysiological Insomnia (PPI). PPI is a type of chronic insomnia, which is associated with excessive worrying, specifically focused on not being able to sleep. It appears that this condition is linked to hyper-arousal when going to bed. The hypothesis behind it is that afflicted individuals have a hard time relaxing and settling down when they go to sleep, resulting in "racing thoughts" and the inability to “switch off”. These patients then focus on their difficulty falling asleep, which leads to anxiety that further disturbs sleep. Over time, poor sleep and worrying about sleeping can create a negative connotation with going to bed, which results in a pattern of chronically poor sleep that affects daytime activities. It is believed by some scientists that in addition to heightened arousal, individuals with PPI may have some dysfunctional neurological inhibitory mechanisms that would normally help the mind "disengage" from daytime thought patterns, which then prevents them from falling asleep.
2. Physical Health Issues
There are various physical health conditions that are associated with insomnia. These including musculoskeletal problems, cardiovascular disease, gastrointestinal and urinary problems, neurological problems, respiratory problems, immunological problems, and cancer.
3. Hormonal Imbalances
Levels of sex hormones in men & woman (i.e., oestrogen, progesterone, and testosterone) may have a significant impact on the person’s ability to sleep peacefully. This is especially true for women; the incidence of sleep disturbances in women rises to 40% three years after menopause. Studies have found that hormone replacement therapy to balance the declined hormone levels post in menopausal women can significantly improve sleep patterns.
The relationship between sleep and hormone levels is not limited to a woman, it occurs in men as well. Lower levels of testosterone correlate with increased severity of obstructive sleep apnoea (a particularly serious sleep disorder). People who have trouble sleeping should have their hormone levels tested to be able to rule out or treat this cause of sleep disorder. The belief was in the past that higher testosterone levels in men worsened sleep apnea, but more recent studies show it is low testosterone that is associated with sleep disturbances in ageing men.
Medication-induced insomnia can be caused by a wide variety of drugs. Some of these drugs include decongestants, monoamine oxidase inhibitors (MAOIs), selective serotonin reuptake inhibitors (SSRIs), corticosteroids, chemotherapeutic agents, calcium channel blockers, beta-agonists, and theophylline.
Stimulants (such as caffeine and nicotine) contribute to insomnia by making it harder for the brain to achieve the state of relaxation needed for sleep. The half-life (amount of time it takes the body to break down 50% of a dose) of caffeine is between three and seven hours (depending on each person’s ability to metabolise the substance). Larger amounts and/or repeated doses of caffeine lead to slower caffeine clearance, causing caffeine's effects to last even longer. As a result, caffeine consumption can impair sleep for many hours. Although, some studies have found that mild caffeine consumption in the morning does not impair sleep since the body has enough time to process the substance.
Nicotine use and nicotine withdrawal can contribute to insomnia. Even those undergoing nicotine replacement therapy (to quit smoking) experience the adverse effects of nicotine on sleep patterns.
While most people think of alcohol as a sedative, its consumption increases dopamine released levels within the brain, which has a stimulating effect. Chronic alcohol use is associated with insomnia, as is alcohol withdrawal.
Shift work will also contribute sleep disorder. Shift work sleep disorder is a type of insomnia which affects individuals that work non-standard work schedules (such as rotating shifts, on-call work, or permanent night shifts) trigger a disconnect between the body's circadian rhythm and actual time.
Insomnia has a dramatic toll on individuals and populations, but still, conventional treatment options remain far from ideal. Shocking statistics from a 2012 a well-controlled study revealed an association between popular hypnotic sleep aids, such as zolpidem (Stilnox), eszopiclone (Imovane) and temazepam (Normison), and a more than three-fold increased risk of death!
These alarming findings highlight the need for safe and effective strategies to improve sleep quality, especially since up to 10% of adults in the U.S. use hypnotic sleep aids for a proper night’s rest. It is important to note, however, that individuals who use hypnotic sleep aid drugs often have poor overall sleep quality, which could be the factor causing the sharply increased risk of death. Hypnotic sleep aids are by no means a cure for chronic insomnia, and purely a way to treat a symptom.
- Insomnia increases disease risk and exacerbates existing medical conditions in individuals.
- Insomnia can lead to elevated levels of cortisol, epinephrine and other "stress" hormones. These elevated levels of cortisol can cause symptoms such as weight gain, weakened immune system, and an increased risk of developing diabetes and osteoporosis.
- Insomnia triggers the release of chemicals (such as interleukin-6 [IL-6] and tumour necrosis factor-alpha [TNF–α]) that promote inflammation in the body. This is associated with arthritis, inflammatory bowel disease, heart disease, and other medical conditions.
- Insomnia can exacerbate chronic pain conditions by causing heightened sensitivity to pain and interfering with the body's ability to modulate central pain signals. As a result, poor sleep can increase the amount of pain perceived by people with chronic pain disorders (such as osteoarthritis and fibromyalgia). Therefore, treating insomnia may help reduce pain these individuals always aim for a good night’s rest!
1. Amino Acids and Hormones
Melatonin is a hormone produced in the small pineal gland and is highly correlated with the body's sleep-wake cycle. In humans, elevated melatonin levels coincide with the body's normal time for sleeping. Low melatonin levels have been linked to insomnia, particularly in the elderly. In a clinical review, serum melatonin levels were reported to be significantly lower (and the time of peak melatonin values delayed) in elderly subjects with insomnia compared to age-matched normal subjects.
Several studies have found that sleep is improved when subjects are treated with melatonin supplementation. One study found melatonin helped reduce the amount of time needed to fall asleep, whilst another study found it improves sleep quality and alertness after sleep. Lastly, results were the average amount of times a subject wakes up per night is substantially reduced when melatonin levels are correct. Despite these successful studies, melatonin is not always an effective solution for those with severe chronic insomnia and other routes of treatment need to be explored.
L-Tryptophan is an amino acid that serves as a precursor for serotonin and melatonin. L-tryptophan supplements may increase the amount of melatonin made by the pineal gland, thus facilitating sleep in those individuals. Early studies found 1 gramme of L-tryptophan could reduce the amount of time needed to fall asleep. Like melatonin, L-tryptophan levels decrease with age. Therefore, L-tryptophan supplementation may aid in the treatment of elderly insomnia.
Magnesium is a mineral that plays a role in cellular communication and regulation of day-night rhythms. As an individuals’ sleep restriction increases, intracellular magnesium concentrations declines. Magnesium supplementation used in a combination with melatonin and zinc has been shown to improve sleep in the elderly. Another trial found that magnesium supplementation helped relieve insomnia related to restless legs in subjects with an average age of 57 years. One form of magnesium specifically, known as magnesium threonate may be beneficial for improved sleep since it has been shown to penetrate the blood-brain barrier more efficiently than other forms of magnesium.
Zinc may also play a role in facilitating sleep. Researchers found that women with the highest levels of zinc in their bodies slept for longer periods of time than women with the lowest levels. As mentioned above, when combined with melatonin and magnesium, zinc also supported quality of sleep in the elderly. Among children with attention-deficit/hyperactivity disorder (ADD / ADHD), zinc (in combination with magnesium and omega-3 & omega-6 fatty acids) helped relieve problems with falling asleep.
3. Herbal Support
Valerian is a herb with sedative properties that has been used since the 18th century for the treatment of insomnia. The accepted mechanism of valerian root is interaction with the GABA system in the brain, thus helping reduce brain activity and allowing users of this herbal supplement to fall asleep more easily. Valerian affects the transport and liberation of GABA, modulating GABAergic signalling. Valerian also has the ability to improve an individuals’ quality of sleep; one study demonstrated that valerian increases the percentage of time participants spends in slow-wave sleep. This is significant because slow-wave sleep is considered the most refreshing sleep. The typical dose of valerian is about 300 to 600 mg, 30 to 120 minutes before going to bed sleep. It may take up to two weeks of daily usage for the full sedative effect of valerian to manifest.
Chamomile is a popular herb often used as a tea to promote sleep and relaxation. It was noted in a study on rats that chamomile had a mild hypnotic effect (much like benzodiazepines) and improved sleep onset latency.
Passionflower, Passiflora incarnate (P. incarnata), is a member of the passiflower genus Passiflora, and it is best known for its sedative and anxiety-reducing effects. The active compounds in P. incarnata appear to interact with the GABA and opioid systems.
Ashwagandha. Withania somnifera, also known as Ashwagandha, is an Indian herb that may be beneficial for treating insomnia. This herb has been best characterised for its effects on stress reduction, as several animal studies have found that this herb is able to improve the subjects’ ability to handle stress and can significantly reduce anxiety. Because emotional stress can be a significant contributor to insomnia, using ashwagandha to reduce stress may help improve sleep. This herb has also been found to directly improve sleep in animal models; it appears to do so by increasing GABAergic activity.
Lemon Balm is a herb traditionally used for its calming and anxiety-reducing effects. One double-blind, placebo-controlled, randomised study showed that 600 mg of lemon balm improved mood and significantly increased self-ratings of calmness in individuals. Lemon Balm has also been investigated in the treatment of sleep problems, such as insomnia. A study found that a combination of valerian and lemon balm was able to treat sleeping disorders even in children. About 81% of the children experienced improvement of their symptoms after taking the study preparation.
Lavender (as essential oil commonly used in aromatherapy). Aromatherapy is an alternative medicine practice that utilises plant oils to treat health problems. Lavender oils have been extensively studied for the treatment of insomnia. Studies have found that lavender oil improves sleep quality and reduces feelings of drowsiness after awakening.
Additional natural therapies:
Bioactive milk peptides. These selected peptides are made by breaking down milk proteins with enzymes, and they may relieve stress related, sleep disorders. A study found that these bioactive peptides were able to increase the amount of time spent sleeping and reduce the amount of sleep needed after just two weeks of treatment. Lactium, one of the trade names for this uniquely formulated product, is sometimes combined with melatonin to improve sleep by taking advantage of the sleep effects of both bioactive milk peptides and melatonin.
1. Improving sleep hygiene
One of the most widely used behavioural therapies is improving "sleep hygiene." There is a correlation between good sleep hygiene and reduced daytime sleepiness. Sleep hygiene includes a number of specific behaviours and environmental factors that contribute to good quality of sleep.
Consider implementing the following sleep hygiene measures for improved sleep quality
- Minimize the amount of light, noise and changes in temperature in the bedroom.
- Avoid eating large meals before bed, as indigestion can make falling asleep difficult.
- Limit the amount of stimulants (such as consuming caffeine, nicotine, and alcohol) consumed during the day, especially close to bedtime. Try to completely avoid these for minimum 4-6hours before bedtime.
- Avoid vigorous exercise during the two hours prior to sleep.
- Avoid bedtime activities that are not related to sleep (such as watching Television, reading, or listening to the radio).
- If worrying about falling asleep and the time, cover the alarm clock to avoid anxiety.
2. Sleep restriction to reset circadian rhythms
Sleep restriction therapy forces the individual to limit the amount of time spent in bed (including naps) to increase the biological need for sleep at night. A study comparing sleep hygiene therapy plus sleep restriction, to sleep hygiene therapy alone found that sleep restriction improved "sleep efficiency", a measure of the proportion of time spent in bed that resulted in sleep.
This process usually begins by restricting the time spent in bed to the amount of time estimated one should spend sleeping. For example, a person who stays in bed for nine hours but only sleeps six will initially restrict time in bed to six hours. These sleep restriction rules can cause mild sleep deprivation, in the beginning, however, the sleepiness it creates trains the body to fall asleep more quickly. As the body adjusts, people can extend the amount of time spent in bed by 15 to 20 minutes until they are able to get a full night sleep without spending extra time in bed.
3. Cognitive-behavioural therapy
Cognitive-behavioral therapy (CBT) is used for treatments of chronic insomnia and helps people develop behaviours that are more conducive to sleep. It has been shown to be an effective treatment for both “primary insomnia” (insomnia not due to other diseases) and insomnia caused by other medical problems. Notably, CBT for treatments of chronic primary insomnia may be more effective than the medication zopiclone in older adults.
General lifestyle considerations that may benefit people with insomnia include:
- Getting regular exercise,
- Developing a sleep ritual aimed at improving relaxation and resolving emotional dilemmas before going to bed.
- Resolving stress may help improve sleep quality.
People with insomnia should also review the Stress Management protocol.
A multi-gene DNA test can routinely be added to assessment, of:
- blood cholesterol and
- glucose levels,
- blood pressure and
- body mass index (BMI) as part of Wellness Programs offered by healthcare practitioners.
It includes analysis of variation in clinically useful genes that may contribute to:
- abnormal cholesterol levels,
- homocysteine accumulation,
- blood clotting,
- iron overload and
Some of these abnormalities contribute to the development of type II diabetes, obesity and hypertension. Oxidative stress, detoxification of carcinogens and oestrogen exposure are also important considerations in this context.
This pathology supported genetic test is performed in conjunction with assessment of any food allergy or intolerances known to be associated with many chronic disorders. The results of the genetic test are combined with clinical indicators and lifestyle factors to identify a combination of risk factors that may lead to disease development or progression if left untreated.
For all health conditions, the nutraceuticals are individually tailored by the Health Renewal Doctor. The doctor will decide- based on your history, physical examination and blood tests what would be the best for you and your specific needs and/or deficiencies. It cannot be over-emphasised that one must not self-medicate. Self-Medicating is done when a person takes prescription medication or nutraceuticals on their own without a doctor's supervision and/or consent. By not having a physical examination and blood testing done by a qualified and practising integrative medical practitioner, you could be not treating vital deficiencies or conditions such as elevated blood pressure, high sugar level, high stress levels (that can lead to adrenal burnout ) and high blood clotting factors that could lead to heart attacks and stroke. In addition, a program of dietary supplementation should not be launched without the supervision of a qualified physician. Several of the nutrients suggested in this protocol may have adverse effects. There is no single supplement prescribed to clients as there is no magic bullet that can support all the essential nutrients that one's body needs. Today's food is not functional and we need to supplement in order to maintain optimal bodily functions and nutrition.
Make an appointment to consult with your Health Renewal Doctor who is an integrative doctor and he / she will assist you in determining your risk factors and how best to prevent any problems or conditions that you may be susceptible to. The importance of early management of any condition cannot be overstated. Once certain conditions set in and damage to organs occurs, complete recovery may be difficult to attain. Best results for prevention and longevity is early detection of a possible problem combined with conventional treatments, nutritional supplements and a healthy diet and lifestyle.
The initial medical consultation at Health Renewal will be approximately 45 minutes. As this is a prolonged medical consultation, the initial consultation fee will be R 975 on arrival (for non-loyalty programme members) you will have to complete an in- depth questionnaire before the consultation so please arrive 20 minutes before the time. During the 45 minute consultation, your Health Renewal doctor will obtain a FULL medical history from you to determine your personal risk. A physical examination will be done after which the Doctor will decide which blood tests need to be requested from your local pathology laboratory. If you have a medical aid, these should be able to be claimed as well.
Once your blood results are received, they will then be analysed by your Health Renewal doctor who will begin working on a unique prescription plan for you with the compounding pharmacy. At your pre-scheduled second appointment 2 weeks later, the results and examination findings will be discussed with you. This will determine what abnormalities or deficiencies exist and you will be advised on your treatment options. These options may range from prescription medications, nutraceuticals, bio-identical hormonal creams or tablets or alternatively to having bio-identical implants or pellets inserted.
In office treatments such as Carboxytherapy may also be recommended for certain conditions such as hair loss, erectile dysfunction ED, menopause or PMS. If you need to lose weight our Renewal Institute Diet may be recommended. All these recommendations will be summarised on a sheet or print out which you can take home with you. The nutraceuticals offered at Health Renewal are of superior quality (Solgar) and are not rancid nor contain Hg (mercury ) or PCB'S (which is very important for Omega 3 Essential fatty acids EFA's). They are also free of gluten, preservatives, wheat, dairy, soy, yeast, sugar, artificial flavour, sweetener and colour. We have a great professional team made up of doctors, trained and registered nurses and therapists to support you at any time.
1. You are kindly requested to bring any supplements that you are currently taking, along to your consultation. The doctor can check the ingredients in take this into account when prescribing a treatment plan for you.
2. Also, if you have had any blood work done in the past 6 months, please bring the results along to the consultation. Should you not be in possession of the hard copies, please request these results from the lab you visited. Usually your ID number is sufficient.
Depending on the exact prescription given, you may be required to return to the doctor within 1-4 months’ time, in order to ensure optimum hormone levels are achieved. This will be determined by a repeat blood test and may be requested by your Health Renewal doctor.
You should ensure that you are current with your gynaecological visits/breast exams/mammograms (for female patients) and prostate exams (for male patients) as recommended by your GP/gynaecologist.
After the two week follow up, the initial blood results will be discussed and patient specific nutraceuticals may be initiated. A second follow up another evaluation and blood test at 8 weeks is recommended to measure serum improvements in your Lipogram, homocysteine and other essential blood results. Follow up appointments should be very 6 months.
The importance of early management of any condition cannot be overstated. Once certain conditions set in and damage to organs occurs, complete recovery may be difficult to attain. Best results for prevention and longevity is early detection of a possible problem combined with conventional treatments, nutritional supplements and a healthy diet and lifestyle.
Some days you need some help staying motivated to live a healthy lifestyle. Our compilation of health and wellness quotes and sayings provide the inspiration or the laugh you need to keep making positive choices for your overall wellbeing.
Here are ten quotes from great thinkers to challenge, motivate and inspire us to exercise, eat right and live healthier lives: Health and intellect are the two blessings of life.
- "We must turn to nature itself, to the observations of the body in health and in disease to learn the truth." – Hippocrates
- "In the book of life, the answers aren’t in the back." – Charlie Brown
- "The difference between the impossible and the possible lies in a person’s determination." – Tommy Lasorda
- "If you don’t have confidence, you’ll always find a way not to win." – Carl Lewis
- "The only way to keep your health is to eat what you don't want, drink what you don't like, and do what you'd rather not." - Mark Twain
- "The longer I live the less confidence I have in drugs and the greater is my confidence in the regulation and administration of diet and regimen." - John Redman Coxe
- "Poor health is not caused by something you don't have; it's caused by disturbing something that you already have. Health is not something you need to get, it's something you have already if you don't disturb it." - Dean Ornish
- "Those who think they have no time for bodily exercise will sooner or later have to find time for illness." - Edward Stanley
- "So many people spend their health gaining wealth, and then have to spend their wealth to regain their health." - A.J. Reb Mater
- "To avoid sickness eat less; to prolong life worry less." - Weng Chu Hui.