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Tuesday, December 17, 2013

Women and Insomnia - Treatments in Conventional Medicine

Posted by Chantel Martiromo,  Article By Kyle J. Norton 

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.
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.
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