2005-10-29 17:02:00
Julie Deardorff - Chicago Tribune

It's 3:37 a.m. and I'm up journaling at this ungodly hour because I have insomnia. Just recording the time makes me feel panicky. Why is everyone in the house asleep but me? How will I function tomorrow?

It's the same old thing: My mind is racing, an inane children's tune is looping endlessly in my head, and the more I think about how foggy I'll feel at work, the more anxious I get.

Maybe it's the full moon or the fact that The Baby might wake screaming at any moment. Maybe my afternoon chai tea wasn't really decaf. All I know is that once I glimpse the illuminated clock, I can't stop myself from calculating how much sleep I can still get. Then I'm wide awake.

At least I have some company. Some call insomnia our nation's silent health crisis, because more than half of Americans have trouble sleeping at least a few nights each week. About 60 percent suffer from a chronic sleep disorder.

Most of us reach for prescription drugs when we get to this point, and we're doing it more frequently. The use of sleep medication doubled from 2000 through 2004 among adults age 20 through 44, according to a new study conducted by Medco Health Solutions, a prescription management company. Spending on the medications jumped 190 percent.

Even more worrisome is that children, who shouldn't have this much stress or caffeine in their lives, are popping sleeping pills more often than ever. The Medco study found the use of sleep aids increased 85 percent for kids age 10 through 19.

But like any drugs, sleeping medications have side effects and some risk of physical or psychological dependency, which is why I don't take them. The most common problems are daytime drowsiness, dizziness, lightheadedness and issues with coordination. What I worry about, though, are things like memory loss (or "traveler's amnesia"), needing steadily higher doses, and dependency. Withdrawal symptoms can occur even if the medication has been used only a week or two.

Then there's the phenomenon of "rebound insomnia," which means people have more trouble sleeping the first few nights after they stop taking the drugs than they did before they started. "Do not get discouraged," says the warning on a magazine advertisement for Lunesta. "It usually goes away on its own after one or two nights."

But that's one or two nights of insomnia, enough time for the head games to start again. Then what do you do? Return to the sleep medication.

To steer clear of this cycle, I use some of the most common non-drug approaches. I drink chamomile tea before bed and pay attention to what I eat in the evening. Foods such as bananas, soy products, dates, figs, whole-grain crackers and yogurt are high in tryptophan, which promotes sleep. I cut back on some of my favorites - chocolate, sugar, cheese and wine - because they contain tyramine, which increases the release of the brain stimulant norepinephrine.

I'm caffeine-free after lunch, I don't rigorously exercise within three hours of bedtime, and sometimes I plug in a box fan for white noise. Once in bed, I wiggle my toes (a reflexology technique to relax the body) or try to visualize calm, peaceful scenes.

Sometimes this, or melatonin, is all I need. But when my head is still full of noise, I turn to the two most reliable techniques: yoga and deep breathing.

Although any style of yoga can help, the trick is figuring out which poses will relax the body and which ones will energize it. Kundalini yoga offers several specific sleep meditations while new books such as "YogaNaps" (Avalon Publishing Group, .95) and "Yoga in Bed: 20 Asanas to Do in Pajamas" (Running Press Book Publishers, .95) provide short sleep-inducing routines.

Meanwhile, deep breathing can be done while lying on your back or sitting cross-legged. Simply breathe into your lower belly, making sure it rises on the inhale. Then move your breath into your chest, top of your lungs and shoulders while counting to 10. At 10, hold your breath for a second, and exhale slowly to a 10 count.

On rare nights, like tonight, when none of this works, I'm tempted to try a drastic variation of the technique. This involves "accidentally" waking up my husband and tearfully telling him I can't sleep. I know that if I want to stay married, I can't use this too often. But the last time I tried it, he looked concerned, put his hand on my abdomen and told me to breathe. I was asleep within minutes.

The findings also shed some light on why people turn to complementary and alternative medicine to treat their sleep problems. Forty percent of those who tried alternative therapies said they had not found conventional treatments helpful. Thirty-five percent said their doctor had suggested the approach. One-quarter thought conventional medicine was too expensive, and two-thirds thought it would be "interesting to try."

The report, published last month in the Archives of Internal Medicine, was part of a larger look at U.S. sleep habits. Researchers also found a strong connection between reports of insomnia or sleep troubles and other health conditions, such as obesity, hypertension, congestive heart failure and anxiety or depression.

"This is giving us a nice snapshot of the characteristics of people who have insomnia in general, as well as those who use complementary and alternative medicine for insomnia and sleep problems," said Richard Nahin, senior adviser for scientific coordination and research at the National Center for Complementary and Alternative Medicine.

Although the report didn't rank the popularity of specific herbal or behavioral remedies, doctors who recommend complementary and alternative medicine said some alternative therapies - such as melatonin, kava kava and valerian - can be effective in treating sleep problems and are typically safer than sleep drugs.

Dr. Jay Udani, who runs the Integrative Medicine Program at the Northridge Hospital Medical Center, said he would recommend anyone with sleep problems start with mind-body techniques such as self-hypnosis, meditation or guided imagery. If that's not sufficient, he might recommend mind-body techniques combined with an herbal remedy - and melatonin would be his first choice.

But doctors cautioned against mixing sleep-inducing herbs or supplements with sleep drugs. Consumers should talk with their physicians first, they said.

http://www.azcentral.com/health/wellness/articles/1029insomnia-ON.html#