Insufficient sleep, unsatisfactory quality of sleep, are becoming more and more acute problems of modern man - regardless of age. There are many young and middle-aged adults, as well as elderly people, who are confronted with sleep problems and suffer from insomnia.

What is insomnia?

Insomnia is defined as: difficulty falling asleep, difficulty in maintaining sleep or as sleeplessness. In general, people who suffer from insomnia sleep little or sleep tortuously, even if they have the opportunity to get adequate sleep. It is difficult to take into account the number of hours of sleep in the definition of insomnia, because it varies from person to person. It has been estimated that, on average, we need 7-9 hours of sleep a day to stay fit.

To understand insomnia we need to understand sleep. What neurological, chemical, humoral changes take place during sleep - that make it indispensable for health. In short: why we need to sleep and why it's so bad for us if we don't get enough.

Brain research still remains a challenge for specialists, although amazing progress has been made.

What sleep does:

Biochemically - more anabolic hormones such as growth hormone are secreted during sleep. During sleep metabolism decreases, body temperature drops, and energy is conserved. Anabolic processes such as: protein synthesis, glycogen stores replenishment, glucose in neurons consumed during the waking period are important in the non-REM phase of sleep. On the other hand, during sleep there is also cellular "sanitization" of metabolic products or oxygen free radicals resulting from cell metabolism.

Sleep also plays an important role in immunity - during sleep cytokine production increases.

Perhaps the most important role of sleep is in the development of neural networks. If neurogenesis seems to stop early in our lives, the development of new synapses and multiple cortical rearrangements may take place throughout our lifetime.

Thus, in order to learn a new behavior we need a new neural network that is linked to past experience, which is certainly helpful in the new task we have to accomplish. Sleep - during the REM period is the time when newly acquired information is integrated and processed in the already existing neural networks, and the responses to the new experience are correlated with the lived history and one's own potential. The new experience receives an emotional charge by activating the limbic system.

Sleep, throughout its duration, plays a particularly important role in memory consolidation. During sleep, of course, the acquisition of new information is limited, but consolidation and retention in memory is greatly enhanced by sleep. For example, learning from visual information is greatly enhanced by sleep the first night after acquisition. Poor sleep after we have acquired the information leads to its loss.

It is recommended for children preparing for tests or exams, students, etc. to sleep, after 3-4 hours of study, to facilitate memorization of information..

Dreams are a manifestation of brain activity during sleep and reflect the lax mental associations during the REM period that allow the formation of new neural networks, promoting creativity and improving problem-solving ability. REM creative activity supports its memory-enhancing function.

As an element of survival of the species, it has been proven in mammals that premature infants, newborns and young children have the longest REM period - precisely because this is the phase during which neuronal development is activated.

We all want to rejuvenate our brains, increase our creativity and problem-solving skills - all of which can be achieved through quality sleep (REM sleep).

There is a direct correlation between quality of sleep and productivity at work.

If in the past entrepreneurs used to strive to train their brains and bodies to function with a minimum of sleep, nowadays they have "woken up" and changed their minds, realizing that their chances of getting rich by working themselves to exhaustion are decreasing. An individual who works 18 hours a day below potential will be no more productive than his colleague who works half the time but is well rested.

In 2011, sleep deprived individuals were found to make riskier financial decisions (Journal of Neurosciences). 

Why insomnia occurs:

We need to distinguish the types of insomnia: difficulty falling asleep, frequent or sustained awakenings during the night, waking up very early in the morning.

Sleep disorders in classical medicine are given by the following situations: 

- Emotional stress, physical discomfort;

- Alcohol abuse;

- Circadian rhythm disturbance - occurs as a side effect in brain damage from various pathologic conditions;

- Brain disorders (tumor, epilepsy, neurosyphilis);

- Depression;

- Bipolar disorder; 

-         Menopause; 

- Medication use: corticosteroids, amphetamines;

- Using incentives: coffeenicotine; 

- Frame diseases such as: obstructive lung disease, hyperthyroidismhepatic encephalopathy, hepatic encephalopathy gastro-oesophageal reflux;

- Nocturia from diuretic use, heart failure, prostate hyperplasia, etc;

- Restless legs syndrome.  

Traditional Oriental medicine sees insomnia as a damage to the organelles (zang-fu) and a blockage of energy on the meridian and diagnoses insomnia in several ways. 

Illness in MTO is seen as a deficiency or excess of Yin or Yang, blood, fluid or energy - in diseases of internal origin (not caused by external agents - infectious, cold, heat or wind).

- Waking easily during the night: deficient yin of the heart; 

- Waking up at a certain time during the night - liver, lung or kidney meridian damage; 

- Restless dream sleep - affecting the heart meridian, shen (psychic energy), affecting the liver meridian; 

- Difficulty falling asleep - affecting the liver, stomach, gallbladder meridians.  

The treatment of insomnia is quite difficult and requires a good relationship between the doctor and the patient - considering that the psychological-emotional factors involved in lack of sleep are quite important.

There is, of course, drug therapy at hand - with multiple disadvantages - which we all know - (the sleep obtained is of poor quality, addictive, various side effects, failure to resolve the root cause) which I will not discuss here.

I remind you of other ways to combat insomnia:

I.  Sleep hygiene:

- get as much sleep as you need to feel rested and then get out of bed - don't laze around;

- Keep a regular sleep schedule; 

- don't force yourself to fall asleep - if you can't fall asleep, get out of bed and do something active and try to go to sleep later;

- Avoid caffeinated drinks after lunch;

- avoid alcohol in the evening;

- quit smoking - especially in the evening;

- don't go to bed hungry;

- create a sleep-friendly environment in the bedroom (light, sound, temperature);

- act on worries and anxieties before bedtime (you can make a list of the things you have to deal with the next day - so that sleep is a worry-free period anxiety);

- exercise regularly, preferably at least four hours before going to bed. 

II.  Relax 

You can use any relaxation known - massagemeditation, yoga. 

III. Stimulus control 

Stimulus control therapy is based on the idea that insomniacs have learned to associate sleep with wakefulness rather than sleep. Here's what you can do: 

- don't stay in bed for more than 20 minutes trying to sleep;

- if you don't fall asleep in 20 minutes, do a relaxing activity (reading a book/magazine - but on paper, not on screen; various household activities) until you feel drowsy;

- if you feel drowsy go back to bed, if you don't fall asleep in 20 minutes repeat the cycle;

- wake up at the same time every day - even at weekends;

- don't sleep during the day.

IV.  Cognitive behavioral therapy

Individuals who do not sleep at night are generally worried that they will perform poorly the next day if they do not get enough sleep. Such thoughts initiate a cycle where night-time alertness causes anxiety and decreases the chances of falling asleep. They may even begin to blame poor sleep for all the negative events in life.

The psychologist will help them cope anxiety and negative thinking, to understand that sleep is not the cause of all evils and to instill a proper thinking pattern.

V.  Acupuncture

Insomnia being a condition with deep emotional implications and with obvious energetic dysregulation, it responds very well to acupuncture - an essentially energetic therapy.

VI . Other therapies: 

-        phytotherapy (Passion flower incarnate, various sedative teas);

-         Melotherapy;

-         aromatherapy

Dr. Cristina Maria Hanganu- Medical practice offering integrated natural therapeutic options: acupuncture, homeopathy, gemmotherapy, dietotherapy
Address: Str Carol Davila nr 33, ap 2, sector 5, Bucuresti
email: perfectmedch@gmail.com

Website: www. perfectmed.wordpress.com