HOMEOPATHY FOR INSOMNIA

Insomnia, a common sleep disorder, is also known as the Disorder of Initiation and/or Maintenance of Sleep (DIMS). Insomnia means one or more of the following.

·        Difficulty in initiating sleep ( going off to sleep).

·        Difficulty in maintaining sleep ( remaining asleep). This can include both:

a. Frequent awakening during the night, and

b. Early morning awakening.

·        Non-restorative sleep where despite an adequate duration of sleep, there is a feeling of not having rested fully (poor quality sleep).

Insomnia is very common, with nearly 15-30% of general population complaining of a period of insomnia per year requiring treatment. It is required for diagnosis that sleep disturbance occurs at least three times a week for at least one month, and that it causes either marked distress or interfers with social and occupational functioning.

Causes

The common causes of insomnia include:

a. Medical illness

·        Any painful or uncomfortable condition

·        Heart diseases

·        Respiratory diseases

·        Rheumatic and musculo- skeletal disease

·        Old age

·        Brain stem or hypothalamic lesions

·        Delirium

·        PMS (Periodic movements in sleep, e.g. Periodic Limb Movement Disorder, Restless legs syndrome)

b. Alcohol and drug use

·        Drug or alcohol withdrawal syndrome

·        Delirium tremens

·        Amphetamine or other stimulants, e.g. caffeine

·        Chronic alcoholism

c. Current medication

·        Current medication, e.g. fluoxetine, steroids, theophylline, propranolol

d. Psychiatric disorders

·        Mania ( may not complain of decrease in sleep, as there is often a decreased need for sleep)

·        Major depression ( difficulty in maintenance of sleep is more prominent, although difficulty in initiating sleep is also present)

·        Dysthymia ( difficulty in initiating sleep is characteristic )

·        Anxiety disorder ( difficulty in initiating sleep is common)

·        Stressful life situation ( may cause temporary insomnia )

e. Idiopathic insomnia

Management

·        A thorough medical and psychiatric assessment

·        Polysomnography may be needed in some patients to reacg a diagnosis

·        Treatment of the underlying physical and/or psychiatric disorder, if present

·        Withdrawal of current medications, if any

·        Relaxation techniques before sleep time and education regarding sleep hygiene. Sleep hygiene consists of general guidelines for promoting good sleep. In itself, it is not a treatment for insomnia.

·        Psychotherapy, if indicated

·        Drug treatment

Sleep hygiene

Some basic components of sleep hygiene are :

·        Regular, daily physical exercises ( preferably not in the evening )

·        Minimize day time napping

·        Avoid fluid intake and heavy meals just before bed time

·        Avoid caffeine intake ( e.g. tea, coffee, cola drinks) before sleeping hours

·        Avoid regular use of alcohol , especially avoid use of alcohol as a hypnotic for promoting sleep

·        Avoid reading or watching television while in bed

·        Sleep in a dark, quiet, and comfortable environment

·        Regular time for going to sleep and waking up

·        Try relaxation techniques  

HOMOEOPATHIC REMEDIES

Homoeopathy today is a rapidly growing system and is being practiced all over the world. It strength lies in its evident effectiveness as it takes a holistic approach towards the sick individual through promotion of inner balance at mental, emotional, spiritual and physical levels. When insomnia   is concerned there are many effective medicines available in Homoeopathy , but the selection depends upon the individuality of the patient , considering mental and physical symptoms

COFFEA CRUDA: Coffea cruda is one of the top remedies for insomnia of acute origin. Coffea cruda is prescribed when the mind is charged by an excessive inflow of thoughts and ideas at the time of sleep. Sometimes it is caused by joy, pleasurable excitement or sudden happy surprises as well as unexpected bad news. Such a state may also be found in those who drink too much wine or in those over- fatigued from long journeys . When the person lies down to attempt to sleep , the mind is simply awake with a flow of ideas.

NUX VOMICA: Nux vomica is prescribed when the insomnia is due to the abuse of stimulants e.g. Alcohol, wine, coffee, smoking or by over work or excess studying .. Nux vomica patient can often fall asleep early , but awakens at 3 or 4 am. with great mental activity or worries. When the time to rise rolls around the patient finally feels able to sleep but instead must get up in a tired , irritable state. Nux vomica is prescribed to irritable, easily angered and impatient people. They are often chilly , nervous and excitable.

ACONITUM NAPELLUS: Aconitum napellus is prescribed to those patients who are restless and excited with an anguished kind of fear. This sate of mind often comes in the early stages of a sudden acute illness, often after a chill. But this state may also be caused by a shock or fright, such as a serious accident ,natural disaster, or operation.

CHAMOMILLA: Chamomilla is another top remedy for insomnia. Chamomilla patients are irritable and uncivil. They are often frantic with pain or irritability and say they cannot stand it. Chamomilla patients are drowsy during the day , but unable to sleep in spite of sleeplessness. This type of irritability is seen in teething infants who insist on being carried , or in adults who will walk the floor.

ARNICA MONTANA: Arnica Montana is an effective remedy for sleeplessness due to physical or mental over exertion . The patient is overtired but cannot sleep and may feel bruised or the bed may feel too hard.

ALFALFA:  Alfalfa is effective for sleep better in morning. It induces quite, peaceful, and refreshing sleep .

COCCULUS INDICUS: Cocculus patients are sleepless from exhaustion. In Cocculus insomnia often comes from loss of sleep associated with night watching or nursing ill persons. Their sleep may be interrupted by waking and starting. Cocculus patients are emotionally sensitive , easily offended, and intolerant of contradiction or they may be extremely sad.

NATRUM MURIATICUM: Natrum mur is effective for insomnia due to grief and unpleasant events of the past.

AURUM METALLICUM: Aurum metallicum is effective for insomnia due to profound depression, melancholic mood and sleeplessness with negative thoughts occupying mind. The negative thoughts could include a feeling of worthlessness, hopelessness, a desire to end life and suicidal thoughts.

AVENA SATIVA: Avenasativa is prescribed for insomnia due to alcoholism or morphine habits.

IGNATIA AMAR:  Ignatiaamara is prescribed for insomnia due to grief and an event like death. There is continuous yawing and a fear that she can never sleep again.

KALI PHOSPHORICUM: Kali phos is prescribed for insomnia from anxiety and stress. Kali phos may also be prescribed for insomnia resulting from over exertion of mind and body.

BARYTA CARBONICUM: Baryta carb. is effective for insomnia of elderly people. It is prescribed  when a person feels sleepy but cannot sleep. Also there is great help for treatment of disturbed sleepand sleep with anxious dreams.

PASSIFLORA INCARNATA: Passiflora is considered to be a specific remedy for insomnia. It is the best remedy for sleeplessness among aged people that is accompanied by restlessness .Passiflora is also an effective remedy for insomnia of alcoholics.

ARSENIC ALBUM: Arsenic alb is an effective remedy for sleeplessness due to restlessness. There is inability to fall asleep or waking up at about 2 am due to anxiety. Great restlessness with a great need to get up and walk about in the room. Sleepy but unable to sleep . Child tosses in bed and kicks the cloths .

AMBRA GRISEA: Ambragrisea is effective for insomnia due to worries or business problems.

CANNABIS INDICA: Cannabis indica is effective for obstinate and severe forms of insomnia. The patient is sleepy , but cannot to do so.

PISCIDIA: Pisidia is effective for insomnia due to worry, nervous excitement , dysmenorrhoea, cough and pain.