One subtype of chronic insomnia is typified by the inability to remain asleep throughout the night despite falling asleep with little or no difficulty. Chronic drug or alcohol abuse is one cause; depression and anxiety disorders are other potential causes. Breathing disorders are also linked with chronic insomnia. Upper airway resistance syndrome may interfere with restful sleep, and obstructive sleep apnea syndrome, which frequently occurs in obese patients, may be characterized by loud snoring, choking, or gasping episodes during sleep. These frequent nocturnal breathing interruptions fragment sleep. As a result, both conditions are accompanied by excessive daytime drowsiness.
Breathing disorders may require diagnosis in a sleep laboratory and may warrant special treatment. For instance, continuous positive airway pressure treatment (using a type of breathing mask) may be prescribed to treat sleep apnea. Such treatments may greatly improve sleep (Guilleminault C et al 2001). Sleep apnea patients should avoid any medications, such as sedatives or hypnotics that may depress the respiratory system. These include barbiturates (e.g., Seconal® and Nembutol®) and benzodiazepines (e.g., Valium®) (Rajput V et al 1999).
If sleep is disrupted by another condition, such as restless legs syndrome, painful arthritis, or carpal tunnel syndrome, it may be helpful to seek treatment for that condition. In addition, the following herbs and supplements have been shown to help induce sleep:
- Valerian—300 to 600 milligrams (mg) valerian root 30 minutes to two hours before bedtime. If taking liquid valerian, take 30 to 40 drops of extract in a small amount of warm water within the hour before bedtime. Long-term valerian therapy is not recommended. Valerian is sometimes used with lemon balm.
- Melatonin—300 micrograms (mcg) to 10 mg about 30 minutes before bedtime. Sometimes lower doses work better than higher doses.
- GABA—350 to 700 mg before bedtime (taken sublingually)
- L-tryptophan—1500 to 2000 mg before bedtime
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