Introduction:
      Insomia refers to sleeplessness. A complaint of sleeplessness may be due to a mood disorder or depression. Sleep allows our brain to re-organize information. Unimportant information is "erased" and important information is locked into our permanent memory. Sleep restores the body. During sleep, the body goes to work actively repairing itself. Damaged cells are replaced with new ones, while organs and muscles are repaired and re-energized.  The immune system is also boosted during sleep. Inadequate sleep can disrupt the immune system, decreasing the ability to fight off diseases and illness.  Lack of sleep can cause problems with memory and concentration.

Classification:

            Classification of Sleep Disorders does not recognize a category of primary insomnia but discusses the following 3 free-standing insomnia subgroups such as Psycho physiological insomnia, Idiopathic insomnia and Sleep state misperception.

              Primary insomnia is sleeplessness that is not attributable to a medical, psychiatric, or environmental cause. The predominant symptom is difficulty initiating or maintaining sleep or nonrestrictive sleep for at least 1 month. The sleep disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.  Sleep disturbance varies from mild to severe.

Insomnia may manifest as difficulty falling asleep or as frequent nocturnal awakenings.

Patients often find that they can sleep well anywhere else but in their own bedroom).

Patients with this type of insomnia tend to be more tense and dissatisfied compared to people who sleep well. Emotionally, they typically are repressors, denying problems.

Idiopathic Insomnia:           

                                                          Insomnia is long-standing, typically beginning in early childhood. Patients often present with other hard-to-localize neurological signs and symptoms such as difficulties with attention or concentration, hyperactivity, and mild non focal electroencephalographic abnormalities. These individuals often show atypical reactions, such as hypersensitivity or insensitivity, to medications. Insomnia tends to persist over the entire life span and can be aggravated by stress or tension.

Sleep state misperception: Patients report insomnia subjectively, while sleep duration and quality are completely normal.

Causes:

                          There are many causes of insomnia including:

·      stress

·        environmental noise

·        extreme temperature changes in the surrounding environment

·        sleep/wake schedule problems such as those due to jet lag

·        medication side effects

·        depression

·        underlying health problems such as arthritis, kidney disease, heart failure, asthma, sleep apnea, narcolepsy, restless legs syndrome, Parkinson's disease and hyperthyroidism

Tips for good sleep:

Sleep on a comfortable mattress and pillow.

Try to go to sleep at the same time.

Avoid nicotine, alcohol and caffeine close to bedtime.

Exercise regularly.

Finish eating 2 to 3 hours before bedtime.

Follow a routine to help relax before sleep.
Make your surroundings conducive to sleep.

Treatment:

                    Drug therapy may be helpful for the short-term management of insomnia. Benzodiazepines are commonly used for the management of sleep disorders. Other drugs used in the short-term management of insomnia include a unique agent called Ambien(zolpidem), barbiturates, sedating antihistamines, and a new drug called Sonata Dromias contains a proprietary blend of natural ingredients that help you get to sleep faster and maintain a healthy sleep cycle.

Home Remedies:

  Cookies, nighttime snack of milk may help insomia. Sugary foods eaten about 30 minutes before bedtime can actually act as a sedative.

Epsom salts- Naturopathic practitioners recommend this remedy for sleepless nights. Add 1 to 2 cups Epsom salts to a hot bath and soak for about 15 to 20 minutes before hitting the hay.

Honey- Folk remedies often advise people with sleeping difficulty to eat a little honey. It has the same sedative effect as sugar and may get you to bed more quickly. Try adding 1 tablespoon honey to some decaffeinated herbal tea or even to your warm milk for a relaxing pre-sleep drink.

Toast- High carbohydrate, low-protein bedtime snacks can make sleeping easier. Carbohydrate-rich foods tend to be easy on the tummy and can ease the brain into blissful slumber.

Milk-Drinking a glass of milk, especially a glass of warm milk, before bedtime is an age-old treatment for sleeping troubles

  Herbal Remedies:             

  Dill seed, herb is often used as a folk cure for insomnia. Its essential oil has the most sedative-producing properties.

Fibromyalgia is an effective remedy for insomnia.

Valerian Root Extract is excellent remedy for anxiety, nervous tension, stress, insomnia and restlessness.

Chamomile and Jujube are widely used for the treatment of insomnia and anxiety.

Magnesium supplements may be helpful for relieving restless leg syndrome (RLS) and for treating insomnia.

Niacin can be used to stimulate a healthy nervous system, thus easing symptoms of depression, anxiety and insomnia. 

Passion Flower is the herb for treating intransigent insomnia. It is also used as a sedative in nervous disorders (including gastrointestinal complaints of nervous origin), difficulties in sleeping, and anxiety or restlessness.

Valerian is a common ingredient which is used as a mild sedative and sleep aid for nervous tension and insomnia.               

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