PATIENT EDUCATION INSOMNIA 8/09
SARAH SANDELL MD FACP Graduate Fellow, Integrative Medicine, University of Arizona
Assistant Clinical Professor of Medicine U.C.L.A., School of Medicine
Sleeping problems are very common especially in these “high stress” times. There are a number of very effective and safe things you can do to improve your sleep.
- Limit caffeine intake to the early part of the day.
- Exercise on a regular basis. Nice leisurely walks in the evening are fine but avoid any vigorous exercise before bedtime.
- Use your bed for sleep (not watching t.v. or prolonged reading). If you are unable to fall asleep within 30 minutes of getting into bed… get out of bed and do something relaxing until you feel tired again then try getting back to bed.
- Limit the amount of alcohol you consume. Drinking alcohol may make it easier to fall asleep but it does interfere with your ability to stay asleep.
- Make sure the bedroom is as dark and quiet as possible and at a comfortable temperature. If you are unable to keep the room dark use a comfortable eye mask
- Expose yourself to sunlight for at least 45 minutes in the morning and avoid bright lights in the evening
- Try this very effective ritual before bedtime; take a warm bath up to 90 minutes before you want to go to sleep. Light a candle and turn off the overhead lights. While in the bathtub or soon after drink a cup of chamomile tea.
- Mantram is the practice of repeating over and over in the mind certain syllables, words or phrases that help unify consciousness and counteract negative mental states. It is especially helpful for people with restless minds, whose turbulent thoughts keep them from relaxing, concentrating and falling asleep. The repetition of a verbal formula is a way of focusing the thinking mind and counteracting the damage done to both mind and body by thoughts that produce anxiety, agitation and unhappiness. You can practice mantram anywhere – it is a totally portable technique, requires no training or equipment, and can be used in any circumstance, so long as you don’t practice it while doing something that otherwise requires your undivided attention. Try experimenting with it – choose a word, sound or phrase that is pleasing to you, and repeat it. If your mind wanders, simply focus back on the word. You will be amazed at the results.
- Listening to guided imagery or other music specific for sleep can be helpful. You can put your head phones under your pillow and turn up the volume so you don’t have anything in your ears when you go to sleep. Go to www.healthjourney.com
- Learn relaxation breathing techniques. Go to www.healthjouney.com for Dr.Weil’s audio on breathing
- Keep a journal to write down thoughts and then forget them (most people start ruminating and then can’t fall back to sleep).
- Keep all electronics (phones, clocks etc at least 3 feet from your bed. If you need a clock next to your bed use a battery operated clock. Having electronic close to your brain while you sleep may reduce the release to melatonin which is a hormone that plays an important role in sleep
- Set aside time for problem solving and list making during the daytime
- Try an herbal tea at bedtime: Mix 1 teaspoon-tablespoon of the following herb in ac cup of boiled water x 20 mins then strain and drink: Valerian 30% Linden 20% Kava 20% Chamomile 20% Catnip 10%
- Try not avoid going to bed late: 1 hour of sleep before midnight is worth 2 after
- Consider homeopathic remedies (see next page). Choosing a homeopathic medicine for sleep is based on a person’s unique characteristics.
- Valerian 400-800mg at bedtime, available as the product Alluna in most pharmacies or 1-3 grams of dried herb equivalent
- Melatonin: the sublingual (under the tongue) is taken 15 minutes before bedtime and the swallowed pill is taken 30-60 minutes before bedtime. The effective dose varies but 1-3 mgs is a typical dosage for the oral form. This is especially effective for jet lag although you may need higher doses. Melatonin, taken close to the target bedtime at the destination (10 pm to midnight),f. Case reports suggest that people with epilepsy and patients taking warfarin may come to harm from melatonin.
- 5 pellets under tongue:
- Aconitum napellus 15C at bedtime: recent onset, anxiety agitation hyperesthesia. Wake up 12-1 am with anxiety, irritable heart sensation and heat (without sweating) throughout the body, often recalling a nightmare
- Hyoscyamus 15C twice a week: insomnia in nervous children who are agiated, cry out while asleep and wake with a start; wakeful after worry or joy overexcitement
- Stramonium 9C at bedtime repeat if wake up: insomnia with night terrors in children or due to paradoxical reaction to psychotropic medication; sleepy w/out real sleep with anxiety fear of solitude and dark nightmare night fright VIOLENT
- Belladonna: sleepy, yawns w/o fall asleep
- Coffea cruda 9C at bedtime repeat if wake up; due to overactive thoughts following strong emotion, with tremor, irritability, agitation and palpitations
- Gelsemium 9C at bedtime: insomnia due to apprehension/anticipation anxiety, fear or consequence of bad news, overemotional
- Arnica 9C at bedtime: bruises feeling bed is too hard
- Kali phos 15C twice a day: following intellect overwork; associated with physical or metal fatigue after overexertion; may have night terrors or sleepwalking
- Nux vomica15C at bedtime repeat if wake up: difficulty falling asleep and wake up at 3am when overworked, preoccupied by job stress, thinks a lot about inability to sleep and wake up tired; may occur due to overuse stimulants, alcohol
- Ignatia9-15C: triggered by upsets often in a social situation,after grief, spasms cramps, sighs
- Zincum 9-15C twice a day: continuous agitation hands and feet, asthenia, aggravation by wine, rest less legs,
- Chamomilla: excitement anger in young children
- Med of sensitive type 15C 5 pellets
- Pulsatilla: wants to stay up late, delayed bedtime
- Phosphorous: afraid of dusk, anxious at night
- Cal carb: afraid of dark, small and thin
- Causticum: impressionable, strong emotions, sensitive adult
- For travel time zone changes 6-9C 5 pellets Cocculus take am pm for home zone