insomnia

Gamma Oryzanol & formulations with Gamma Oryzanol as the active ingredient on stress/ anxiety/ insomnia/ sleep issues

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Title Of The Study: Rice bran extract supplement improves sleep efficiency and sleep onset in adults with sleep disturbance: A randomized, double-blind, placebo-controlled, polysomnographic study

We previously reported that rice bran extract supplement (RBS) administration to mice decreased sleep latency and induced non-rapid eye movement (NREM) sleep via inhibition of the histamine H1 receptor. Based on this, we performed the first clinical trial to investigate whether RBS would be beneficial to subjects with disturbed sleep. We performed a randomized, double-blinded, placebo-controlled, 2-week study. Fifty subjects with sleep disturbance were enrolled and received either RBS (1,000 mg/day) or placebo. Polysomnography was performed, and Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale (ESS), and Fatigue Severity Scale were administered at the initiation and termination of the study. Compared with the placebo, RBS led to significant polysomnographic changes, including decreased sleep latency (adjusted, P = 0.047), increased total sleep time (P = 0.019), and improved sleep efficiency (P = 0.010). Additionally, the amount of stage 2 sleep significantly increased in the RBS group. When adjusted for caffeine intake, wakefulness after sleep onset, total wake time, and delta activity tended to decrease in the RBS group. RBS administration decreased ESS scores. There were no reported serious adverse events in both groups. RBS improved sleep in adults with sleep disturbance. Trial registration: WHO ICTRP, KCT0001893.

Title Of The Study: g-Oryzanol produces an antidepressant-like effect in a chronic unpredictable mild stress model of depression in Drosophila melanogaster

Chronic unpredictable mild stress (CUMS) is a valid model for inducing depression-like symptoms in animal models, causing predictive behavioral, neurochemical, and physiological responses to this condi- tion. This work aims to evaluate the possible antidepressant effect of c-oryzanol (ORY) in the CUMS- induced depressive model in male Drosophila melanogaster. We will use the CUMS protocol to continue the study previously conducted by our research group, mimicking a depressive state in these insects. Male flies were subjected to various stressors according to a 10-day randomized schedule and con- comitantly treated with ORY or fluoxetine (FLX). After the experimental period, in vivo behavioral tests were performed (open field, forced swimming, aggressiveness test, mating test, male virility, sucrose preference index and light/dark test) and ex vivo analyses measuring serotonin (5HT), dopamine (DA), octopamine (OCT) levels and body weight. We report here that ORY-treated flies and concomitant exposure to CUMS did not exhibit obvious behaviors such as prolonged immobility or increased aggressive behavior, reduced male mating and virility behavior, and anxiolytic behavior, in contrast to ORY, not altering sucrose preference and body weight flies exposed to CUMS. ORY effectively pre- vented 5HT and OCT reduction and partially protected against DA reduction. The data presented here are consistent and provide evidence for the use of ORY as a potential antidepressant compound.

Title Of The Study: Control Study of Quetiapine Combined with Oryzanol Vitamin B1 And Vitamin B6 Tablets in Senile Schizophrenia

Objective To investigate the efficacy and safety of quetiapine combined with oryzanol and double vitamin B in the treatment of elderly schizophrenia. Methods Seventy-four elderly patients with schizophrenia who were admitted to the Second Affiliated Hospital of Xinxiang Medical College from October 2012 to October 2013 were randomly divided into two groups. Control group and observation group, 37 cases in each group. The control group was treated with oral quetiapine, and the observation group was treated with quetiapine + oryzanol double-dimensional B treatment. (CGI) and Adverse Reaction Scale (TESS) to evaluate the efficacy and adverse reactions. Results The marked and effective rates of the control group were 64.86% and 86.47%, respectively, and the observation group was 75.68% and 94.59%, respectively. There were significant differences in the efficiency and effective rate (P＜0.05). From the 4th week of treatment, the PANSS total score and CGI total score of the observation group were significantly lower than those of the control group, and the differences were statistically significant (P＜0.05 or P＜0.01). The TESS score in the first 4 weeks of the observation group was significantly lower than that of the control group (P＜0.05 or P＜0.01). Conclusion Quetiapine combined with oryzanol and double-dimensional B is effective in treating senile schizophrenia , good security.

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Title Of The Study: Deanxit Combined with Large Dose of Oryzanol in Treatment of Post Stroke Depression and Anxiety in
Elderly Male

Objective To investigate the therapy effect of deanxit combined with large dose of oryzanol in the treatment of post stroke depression(PSD) and anxiety in elderly male.Methods Sixty cases of PSD and anxiety patients were divided into three groups by random number table method with 20 cases in each,deanxit group treated with deanxit,oryzanol group treated with oryzanol,and combination group treated with deanxit and large dose of oryzanol,a total of 4 weeks.Before and after 4 weeks treatment respectively using Hamilton depression scale (HAMD) and Hamilton anxiety scale (HAMA) scores.Results The HAMD and HAMA scores before treatment in three groups had no statistical significance (P ＞ 0.05).Compared with before treatment,HAMD and HAMA scores in three groups after treatment were significantly lower (P＜ 0.01).HAMD scores in combination group were improved better than those in deanxit group and oryzanol group [(12.85 ± 3.69) scores vs.(15.30 ± 3.28),(18.65 ± 3.13) scores](P＜ 0.01),and deanxit group were better than oryzanol group(P＜ 0.01).HAMA scores in deanxit group and combination group were lower than those in oryzanol group [(8.65 ± 3.33),(7.25 ± 3.34) scores vs.(10.65 ± 3.18) scores] (P ＜0.01).Conclusion Deanxit combined with oryzanol is effective in the treatment of PSD and anxiety in elderly male.

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Title Of The Study: Effect of Deanxit Combined with Oryzanol Injection on Life Quality, Anxiety and Depression In Elderly Cerebral Patients

Objective To study the effect of deanxit combined with oryzanol injection on life quality,anxiety and depression in elderly cerebral infarction patients.Methods 90 elderly cerebral infarction patients were divided into deanxit group (27 cases)(Group A),oryzanol injection group (28 cases) (Group B) and deanxit joint oryzanol injection combined treatment group (35 cases) (Group C) according random number method during August 2012 to March 2015.Aher four weeks of treatment,life quality,anxiety and depression were compared in each group before and after treatment.Results After treatment,the score of physiological function,bodily pain,general health,vitality,social functioning,mental health,physical function,emotional function in Group A,Group B and Group C were significantly higher than before treatment (P ＜ 0.05).After treatment,the score of physiological function,body pain,general health,vitality,social functioning,mental health,physical function,emotional function in Group C were significant higher than Group A and Group B (P ＜ 0.05).The score of HAMD and HAMA after treatment in the Group C was the lowest among the three groups (P ＜ 0.05).Conclusion Deanxit combined with oryzanol injection can significantly improve the life quality and reduce patient anxiety and depression in patients wiith first elderly cerebral infarction.

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Title Of The Study: Effect of Oryzanol on Anxiety and Depression in Patients with Cerebral Infarction

Objective: To investigate the effect of oryzanol on anxiety and depression in patients with cerebral infarction. Methods: 62 cases of patients with cerebral infarction complicated with anxiety and depression admitted to our hospital from January 2016 to January 2017 were selected as subjects and divided into control group and treatment group according to different treatment methods, 31 cases in each group. The patients in the control group were given conventional therapy. The patients in the treatment group was treated with oryzanol tablet(20 mg, tid) on the basis of the control group. The changes of anxiety and depression and the clinical effects in the two groups were observed before and after treatment. Results: Before treatment, there was no significant difference in Hamilton anxiety scale(HAMA) and Hamilton depression scale(HAMD) scores between the two groups(P>0.05). After treatment, the scores of HAMA and HAMD in the treatment group were significantly lower than those in the control group(P<0.05). The total effective rate in the treatment group was 96.77%, which was significantly higher than 80.66% in the control group(P<0.05). Conclusion: Oryzanol can effectively improve anxiety and depression after cerebral infarction and play an important role in promoting disease rehabilitation and improving the quality of life, which is worthy of clinical application.

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Title Of The Study: Effectiveness of Oryzanol in Alleviating Exam-tension and Improving Students\’ Examination-adapted Ability

The medicinal effect of oryzanol in relieving exam stress was investigated, and it can provide an effective method for students to improve their ability to take exams. The subjects of the survey were randomly selected 283 second-year college students from Qufu Normal University. The quality of sleep the night before; and then let the students who are nervous about the exam take oryzanol for 3-7 days before the college English test, and the effect of oryzanol on the nervousness of the exam and the sleep disorder before the exam is calculated. At the time, 88.3% of the students felt nervous, and 59.4% of the students had varying degrees of loss on the eve of the exam…

Title Of The Study: Suanzaoren Decoction Combined with Vitamin E and Oryzanol in the Treatment of Climacteric Syndrome with Insomnia 20 Cases

Objective To analyze the effect of Suanzaoren decoction combined with vitamin E and oryzanol in the treatment of climacteric syndromewith Insomnia.Methods 40 cases of patients with climacteric syndrome in our hospital were randomly selected as the research objects.The study period was from October 2015 to October 2016.The subjects were divided into control group and observation group, and each group included 20 patients.The control group used oryzanol and vitamin E treatment, and the observation group was also given Suanzaoren decoction on the basis of the control group.The therapeutic effect of two groups was summarized.Results Comparing with the control group, the effective rate of study group was ideal.The clinical symptom score, PSQI score and therapeutic satisfaction of the study group were significantly higher than those of the control group, and there was statistical significance (P<0.05).Conclusion Suanzaoren decoction combined with vitamin E and oryzanol in the treatment of climacteric syndrome can improve the clinical symptoms, the quality of sleep and quality of life, has less adverse reaction, is conducive to the prognosis of patients, and has higher application value.

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Title Of The Study: Suanzaoren Decoction(酸枣仁汤) Combined With Flupentixol And Melitracen Tablets And Oryzanol In The Treatment Of Perimenopausal Depression Randomized Controlled Study

[Objective] To observe the Suanzaoren Decoction Combined with Flupentixol and melitracen tablets and oryzanol in the treatment of perimenopausal depression effect. [Methods] 60 outpatients were randomly divided into two groups according to the method of random parallel control. The control group of 30 cases of Flupentixol and melitracen tablets, 0.5 mg/times, 2 times/d, oral; oryzanol, 10 mg/times, 3 times/d, oral. Treatment group, 30 cases of Suanzaoren Decoction(Suanzaoren 30 g, Szechuan lovage rhizome, Poria, Anemarrhena 12 g, licorice 6 g; liver depression of the fire add gardenia, cortex moutan; phlegm heat disturbance and Rhizoma Coptidis, Trichosanthes, gardenia; Yin deficiency and fire wangka dry lotus seed, Ligustrum lucidum, Lily and Rehmannia glutinosa; due to deficiency of Qi and blood, blood Yangxin sunburn and licorice), daily 1 agent, water to cook 400 ml, 2 times daily; western medicine in the treatment of with the control group. Continuous treatment for 1 courses of 15 d. Observation of clinical symptoms, HAMD score, adverse reaction. Treatment of 1 courses of treatment(15 d), determine the efficacy. [Results] The treatment group, 8 cases recovered, 10 cases were markedly effective, 11 cases were effective, 1 case ineffective, effective rate is 96.67%; control group, 4 cases were cured, 8 cases were markedly effective, 9 cases were effective, 9 cases ineffective, efficient 70.00%. The treatment group curative effect surpasses the control group(P<0.05). HAMD score of two groups were improved(P<0.01), the treatment group improved better than the control group(P<0.01). [Conclusion] Suanzaoren Decoction Combined with droperidol thiadiazole tons and deanxit and oryzanol treatment of perimenopausal depressive disorder, and the results were satisfactory. No serious adverse reactions, worthy of promotion.

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Title Of The Study: The Efficacy Analysis of Oryzanol Combined with Anshenbunao Liquid in Neurasthenia

Objective To investigate the clinical efficacy of oryzanol combined with Anshenbunao liquid in neurasthenia.Methods 198 cases patients with neurasthenia were randomly divided into observation group and control group,each of 99 cases.Control group were treated with oryzanol treatment;Observation group were taken Anshenbunao liquid therapy on the basis of oryzanol treatment.Compared the depression score,total efficiency and adverse reactions,before and after a course of treatment for the two groups.Results After the treatment,the total effective rate of observation group(91.92%) was higher than that of control group(73.74%),the difference was statistically significant(P<0.05).The depression scale of the two groups were better than than those before treatment,there was significant difference(P<0.05).The improvement of the observation group was significantly better than control group patients,and there was statistically significant(P<0.05).Two groups during the treatment had no significant adverse reactions. Conclusion : Oryzanol combined with Anshenbunao liquid has a safe and effective advantage in the treatment of neurasthenia.It is worthy of clinical application.

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Title Of The Study: Clinical Study of Combined Therapy of ATP Etc on 36 Cases with Somatization of Pre-test Syndrome

Objective To investigate the effect of oral administration of adenosine triphosphate (ATP), oryzanol (Oryzanol) and vitamin B1 (vitamin B1) in the treatment of somatic symptoms in patients with preexisting stress syndrome. Methods A retrospective analysis was conducted to investigate the efficacy of oral administration of adenosine triphosphate (ATP), oryzanol (oryzanol) and vitaminB1 (vitamin B1). The clinical data of 36 patients treated with combined therapy were used to evaluate their clinical efficacy and adverse reactions. Results Before and after treatment, the patients were compared with anxiety scale HAMA assessment (P<0.01), sleep quality score (P<0.01), autonomic nerve function test (recumbent). (P<0.01), headache severity (P <0.01),systolic blood pressure (P<0.01), heart rate (P<0.01), there were significant differences, and the control before and after diastolic blood pressure treatment (P>0.05) There was no significant difference; no obvious adverse reactions were found. Conclusion The combination of ATP, oryzanol and vitamin B1 in the treatment of somatic symptoms caused by physiological arousal inpatients with pre-exam stress syndrome has obvious effect, and no obvious adverse reactions occurred.

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Title Of The Study: Clinical Observation on Liver and Kidney Maintenance Acupuncture Combined with Oryzanol in Treatment of
Insomnia after Ischemic Stroke

Objective To study the effect of liver and kidney conservation acupuncture combined with oryzanol on ischemic stroke insomnia. Methods 81 patients with ischemic stroke insomnia who were admitted to the Department of Neurology, Jinqiu Hospital, Liaoning Province from January 2019 to December 2020 were selected were randomly divided into the observation group and the control group by drawing lots. Forty-one patients in the control group took oryzanol tablets 30 mg orally before going to bed, and 40 patients in the observation group took oryzanol on the basis of combined use of liver and kidney conservation acupuncture. Comparison 2 The Pittsburgh Sleep fatal iM tho on sensation group m as 5 ishinzantiy higher irah that of the so hitro lto Up a P200s, Tantae the PSQI scores of the observation group were significantly lower than those of the control group(P<0.05); after treatment, SL, ASA, AT, A/TSA of the two groups were significantly decreased(P<0.05), TSA and SE were significantly increased (P<0.05). <0.05), and the sleep EEG-related indexes of the observation group were significantly better than those of the control group (P<0.05). Conclusion : Liver and kidney conservation acupuncture combined with oryzanol has a definite curative effect on ischemic stroke insomnia, not only can improve the It also helps to improve sleep EEG-related indicators, which is worthy of application and promotion.

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Title Of The Study: Clinical Effect of Oryzanol Combined with Sports Therapy in the Treatment in Patients with Neurasthenia

Objective To investigate the clinical effect of oryzanol combined with exercise therapy in the treatment of patients with neurasthenia. Methods 78 patients with neurasthenia treated in our hospital from March 2014 to March 2015 were selected and randomly divided into the control group and the observation group, 39 cases in each group, the control group The control group was given simple psychological counseling, and the observation group was given oryzanol combined with exercise therapy on the basis of the control group. After 30 days of treatment, the total effective rate, Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD)scores were compared between the two groups . Results The total effective rate (93.5%) of the observation group was higher than that of the control group (75.4%), and the difference was statistically significant (P<0.05). Before treatment, there was no statistically significant difference between the two groups of HAMA and HAMD scores (P>0.05), after treatment, the HAMA(18.21‡5.36) and HAMD (20.46+5.62) scores of the observation group were lower than those of the control group (23.68+4.36) and HAMD (24.41‡6.24), and the difference was statistically significant ( P < 0.05). Conclusion Oryzanol combined with exercise therapy is better than simple psychotherapy in the treatment of neurasthenia, and the clinical effect is significant.

Insomnia and Neurologic Disorders: Exploring the Bidirectional Relationship

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A-rear-view-of-a- woman-sitting-alone -on-a-bed-in-room- and-looking-through-the -window-at-night.

Disordered sleep is known to increase the risk for neurologic disorders, such as Alzheimer disease (AD) and Parkinson disease (PD). Similarly, patients with neurologic disorders commonly report sleep disorders, including excessive daytime sleepiness and insomnia, suggesting a bidirectional relationship between sleep and brain health.1

Although researchers have identified a strong association between sleep disorders, specifically insomnia, and neurologic disorders, little is known about their underlying causes, etiology, pathophysiology, and effective treatments.2

Diagnostic Criteria for Insomnia

Recent changes in classification criteria have resulted in the recognition of insomnia as a disorder,3 which is differentiated as transient (persistent symptoms for at least 4 weeks) or chronic (disease duration of at least 3 months). The Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Sleep Disorders (ICSD) have been used to define insomnia in clinical practice; however, patients with insomnia may not meet all the criteria.4 Overall, insomnia has been described by the cardinal symptom of the inability to initiate and maintain sleep or having “poor” sleep, but the presentation of this disorder is much more complex.4

Nonorganic insomnia, which lacks an underlying medical cause, affects 6% of the population in countries including the United States and the United Kingdom. Among individuals with progression to chronic insomnia, 70% still fulfill the diagnostic criteria at 1 year.3,4

Prevalence of Insomnia in Neurologic Disorders

Compared with the general population, patients with neurologic disorders have a higher prevalence of insomnia.5 Based on multinational meta-analyses and reviews, the prevalence of insomnia in neurologic disorders can only be estimated (Table), as the exact prevalence is unknown.2,5 The worldwide prevalence of insomnia symptoms is 30% to 35%.3

More than 50% of secondary insomnias have been indicated to co-occur with psychiatric illnesses, including addiction, alcohol dependence, anxiety, and depression, followed by diseases of the central and peripheral nervous system, restless leg syndrome (RLS), and sleep-related breathing disorders, including obstructive sleep apnea (OSA).4

Research has revealed sex differences in patients with insomnia, with women having a significantly higher prevalence than men do. The increased prevalence of chronic insomnia among women has been attributed to biological factors, including hormonal changes and comorbid medical conditions, and psychosocial factors, including stress and anxiety with regard to burden of family responsibilities.6 Notably, the increased prevalence of sleep disorders in women with neurologic disorders has been underappreciated and -treated because of overlapping symptoms.7

In older adults, insomnia is typically comorbid to other neurologic and psychiatric illnesses and sleep disorders, including OSA and RLS.Approximately 50% of these patients report sleeping difficulties.8

Table: Estimated prevalence of insomnia in neurologic disorders

Neurodegenerative disorders (including PD, AD, and dementia)11%-74.2%
MigraineApproximately 70%
Epilepsy28.9%-74.4%
Multiple sclerosis (MS)40%-50%
Traumatic brain injuryApproximately 30%
After stroke26.9%-50%

Screening and Clinical Evaluation of Insomnia

Due to the wide range of sleep-related disorders, health care professionals across various specialties, including psychiatry, pulmonology, neurology, and otorhinolaryngology, may do insomnia screenings for patients with neurologic disorders.4

The presence of insomnia in neurologic disorders is known to cause a worsening of symptoms and quality of life, heightened depression symptoms, and increased mortality rates.5 Therefore, it is recommended that neurologic evaluations address insomnia while taking patient history, as insomnia may be a distinct entity or the cause of an underlying problem.4

Given the higher prevalence of sleep disorders in neurologic disorders, the importance of understanding assessment tools, both subjective and objective, has been emphasized. Nurse practitioners and treating clinicians have been advised to determine the method of assessment for sleep disorders on a case-by-case basis.8 In a 2019 update on the assessment and management of insomnia, the researchers discussed choosing the appropriate assessment tool for insomnia, such as the use of a sleep diary, actigraphy, personal monitoring devices, polysomnography, and questionnaires.9

Treatment and Management of Insomnia in Neurologic Disorders

Researchers have recommended that insomnia in patients with neurologic disease be treated according to the updated clinical practice guidelines.10,11 General practitioners, specialists, and certified sleep specialists may collaborate in the treatment of patients with insomnia with neurologic disorders, based on the complexity of the cause.4

Based on guideline recommendations, cognitive behavioral therapy for insomnia (CBT-I) is the initial treatment for chronic insomnia disorder because of its significantly favorable benefit:risk ratio.10

The US Food and Drug Administration (FDA) has approved drugs, including benzodiazepines, nonbenzodiazepine hypnotics, suvorexant, and ramelteon, for insomnia treatment.11 Off-label treatments, such as for major depressive disorder, have also been used to treat insomnia; some of them include trazodone, amitriptyline, mirtazapine, and doxepin. In addition, research has shown that melatonin may be beneficial for patients with comorbid insomnia and neurocognitive disorders. Another second-line treatment option is morning bright light therapy.3

However, for the treatment of secondary insomnia in patients with neurologic disorders, pharmacologic interventions may be more targeted to the symptoms and underlying cause.4 Treating physicians have been recommended to continue to counsel patients with neurologic disorders on sleep hygiene.3

Overall, combined therapy of psychologic and pharmacologic treatments may be more beneficial than any single treatment for insomnia.

19 Ayurvedic Tips for Insomnia

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If you’re tossing and turning or just can’t get a restful night’s sleep, Ayurveda may have just the wisdom you need.

Insomnia is unfortunately very common. A report published by the American Academy of Sleep Medicine (AASM) featured more than 2,000 Americans and discovered that almost 3 in 10 people are negatively impacted by insomnia on a daily basis. Chronic insomnia, which is when sleep difficulties occur at least three times a week for three months or longer, affects at least 10 percent of Americans.

What Are the Different Types of Insomnia?

Insomnia that lasts from a single night to a few weeks is called transient insomnia. But chronic insomnia, as mentioned before, occurs at least three nights a week over three months or more. Chronic insomnia is either primary or secondary: primary insomnia is not related to any other health problem, while secondary insomnia can be caused by a medical condition (such as cancer, asthma, or arthritis), drugs, stress, mental health concerns (such as depression), or a poor sleep environment (such as too much light or noise, or a bed partner who snores).

How Does Ayurveda Define Insomnia?

According to Ayurveda, insomnia (known as nidranasha or anidra) is a disease of the channels of the mind (or manovaha srotas). The manovaha srotas are the channels that carry thoughts, feelings, sensations, emotions, and the components of other mental processes.

Insomnia is the condition of insufficient sleep, interrupted sleep, or poor-quality sleep. This might look like having trouble falling asleep or waking up frequently during the night. Some people find it difficult to return to sleep once they are up at odd hours.

According to Ayurveda, waking up early in the morning and then staying awake is also considered insomnia. Experiencing a compromised quality of sleep where you wake up feeling unrefreshed and unrested despite sleeping seven to eight hours would be identified as insomnia, as well.

Ayurveda teaches us that insomnia is not just an illness, but a symptom of an underlying doshic imbalance and a sign of many other chronic physical, behavioral, cognitive, and mental issues that may appear in the future if not addressed.

What Causes Insomnia?

Ayurveda has a great deal to say about how to support balanced sleep in general. According to Ayurveda, there are two main models that explain the mechanism of insomnia: cognitive and physiological. According to the cognitive model, what prevents a person from falling asleep is rumination and hyperarousal—for example, overthinking, mind chatter, and stress.

Physiological conditions that can contribute to insomnia include sleep apnea, hormonal fluctuations, chronic pain, congestive heart failure, hyperthyroidism, GERD or heartburn, restless leg syndrome, menopause, certain medications, and substances such as caffeine, nicotine, and alcohol.

How the Doshas Influence Insomnia

A person with Vata imbalance has difficulty falling asleep at first. This is particularly common during Vata time of the night, which occurs between 2-6 a.m. Vata’s light and mobile qualities make it difficult for the mind to rest and the chatter to stop.

Imbalanced Pitta individuals experience broken sleep during the night. Their obsessive-compulsive thoughts keep them stimulated between the hours of 12-4 a.m.

For those dealing with Kapha dosha aggravation, sleep terminates at a very early hour in the morning. They can’t go back to sleep once awake.

Ayurvedic Remedies for Insomnia

It’s always best to work with an Ayurvedic doctor or practitioner to figure out which dosha is causing the insomnia and to receive customized treatments. We know that sleep is crucial to optimal health: it aids the body in repairing, regenerating, and recovering. Sleep flushes out toxins, boosts our memory, increases our focus, and much more. Simple adjustments to our routine, exercise, diet, and lifestyle habits can have a profound impact on our sleep.

Here are tips to use Ayurveda to manage insomnia:

1. Stick to a consistent sleep routine.
2. Eat nutritious meals appropriate for your dosha.
3. Have an early, light dinner, preferably three hours before you go to bed.
4. Don’t drink caffeinated beverages after 2 p.m.
5. Turn off your phone and tablets at least an hour before bed.
6. Avoid consuming news and conversations that lead to sensory overload.
7. Go for nature walks.
8. Exercise regularly but refrain from movement that is too stimulating in the evening.
9. Take a warm bath with dosha-specific essential oils, like lavender, chamomile, or ylang ylang.
10. Apply warm sesame oil to the feet to sedate the nervous system. It will help ease stress, calm the mind, and soothe the body.
11. Cultivate a daily meditation practice to lower stress and promote sleep.
12. Try self-reflection and gratitude journaling.
13. Minimize any contentious conversations in the evening.
14. Practice alternate nostril breathing and Bhramari pranayama to calm the mind.
15. Make sure your bedroom is dark and quiet, with the head of your bed facing any direction but north (as energy from that direction can be stimulating).
16. Wind down your evening with yoga asanas like Big Toe Pose, Bridge Pose, Cat Pose, Corpse Pose, Cow Pose, Dolphin Pose, Downward-Facing Dog, and Easy Pose.
17. Herbs helpful for Vata and Kapha types of insomnia include Ashwagandha, Tulsi, Indian valerian root, Bola (Indian myrrh), Shallaki (frankincense) and Brahmi. Drinking warm milk with nutmeg before bed also works.
18. Pitta-based insomnia, which shows up as body heat and mental agitation, can be treated with cooling nervines, such as chamomile, Mandukaparni (gotu kola), Chandan (sandalwood), and Hypericum (St. John’s wort).
19. Shirodhara and Picchu treatments (herbal oil applied to the crown of the head) are extremely useful in the treatment of insomnia.

Promising Therapeutic Target Uncovered to Treat Stress-Related Sleep Disorders

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New research from the Perelman School of Medicine at the University of Pennsylvania reveals neurons in the preoptic hypothalamus—the region of the brain that regulates sleep and body temperature—are rhythmically activated during non-rapid eye movement sleep (NREM). Stress activates these brain cells out of turn, causing “microarousals,” that interrupt sleep cycles and decrease the duration of sleep episodes.

young beautiful hispanic woman at home bedroom lying in bed late at night trying to sleep suffering insomnia sleeping disorder or scared on nightmares looking sad worried and stressed

The findings are published in Current Biology in an article titled, “Regulation of stress-induced sleep fragmentation by preoptic glutamatergic neurons.”

“When you have a bad night of sleep, you notice that your memory isn’t as good as it normally is, or your emotions are all over the place—but a bad night of sleep interrupts so many other processes throughout your body. This is even more heightened in individuals with stress-related sleep disorders,” said senior author, Shinjae Chung, PhD, an assistant professor of neuroscience. “It’s crucial to understand the biology driving the brain activity in these crucial stages of sleep, and how stimuli like stress can disrupt it, so that we might someday develop therapies to help individuals have more restful sleep that allows their brain to complete these important processes.”

The researchers monitored the activity in the preoptic area (POA) of the hypothalamus of mice during their natural sleep and found that glutamatergic neurons (VGLUT2) are rhythmically activated during NREM sleep. They also found that VGLUT2 neurons were most active during wakefulness, and less active during NREM and REM sleep.

During microarousals in NREM sleep, VGLUT2 neurons were the only active neurons within the POA, and their signals started to increase in the time before a microarousal. To confirm that active VGLUT2 neurons were indeed the cause of microarousal, the researchers stimulated the VGLUT2 neurons in sleeping subjects, which immediately increased the amount of microarousals and wakefulness.

To illustrate the connection between stress and increased VGLUT2 neuron activation, researchers exposed subjects to a stressor, which increased awake time and microarousals, and decreased overall time spent in REM and NREM sleep. Researchers also noted increased VGLUT2 neuron activity during NREM sleep in the stressed subjects. What’s more, when researchers inhibited VGLUT 2 neurons, microarousals during NREM sleep decreased, and NREM sleep episodes were longer.

“The glutamatergic neurons in the hypothalamus give us a promising target for developing treatments for stress-related sleep disorders,” said first author, Jennifer Smith, a graduate researcher in Chung’s lab. “Being able to reduce interruptions during the important stages of non-REM sleep by suppressing VGLUT2 activity would be groundbreaking for individuals struggling with disrupted sleep from disorders like insomnia or PTSD.”

Why You Get Sleepy After Eating

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  • Feeling sleepy after eating is common and can be attributed to factors like size and timing of the meal.
  • High-fat and high-carbohydrate foods have been found to increase perceived drowsiness after eating.
  • Overall health and sleep patterns can also contribute to feelings of fatigue after meals.
  • Eat mindfully and make nutritional choices to avoid post-meal tiredness.

Most people have felt their eyelids get heavy shortly after a large meal. Whether it be a holiday feast or a weekend brunch, you may wonder what exactly causes sleepiness after eating. Fortunately, post-meal tiredness, also called postprandial somnolence, may not be a cause for concern if it does not interfere with a person’s work, school, or social life.

However, in some cases, a post-lunch dip in energy can have consequences for workplace productivity and raise the risk of accidents Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source , including car crashes. In addition, excessive sleepiness is sometimes caused by an underlying health problem or sleep disorder.Whether drowsiness sets in after a meal can depend on multiple factors including when, how much, and what a person eats Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source . Learning more about postprandial sleepiness can make it easier to understand why people get tired after a meal, foods that may cause drowsiness, and ways to reduce sleepiness after eating.

What is Postprandial Somnolence?

Postprandial somnolence refers to a feeling of sleepiness after consuming food Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source . It is sometimes known as the post-lunch dip or referred to more informally as a “food coma.”

Researchers are not exactly sure why it is common for people to get sleepy after eating. Studies suggest that multiple factors Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source may influence energy levels after a meal, including fluctuations in certain cellular proteins Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source , hormones, blood flow, brain chemicals, inflammation, and the body’s internal clock.

A larger meal may be more likely to cause sleepiness, and the composition of a meal can have an impact as well. Research has found that meals that are high in fat, carbohydrates, or calories may increase sleepiness.

It can be challenging to identify any single cause of postprandial sleepiness. Instead, there are many potential reasons why drowsiness sets in after eating, and those reasons can change based on the person and their meal.

Which Foods Can Make You Sleepy?

More research is necessary to understand how different nutrients and foods affect instances of daytime sleepiness. Additionally, many studies about diet and sleep focus on nighttime sleep, which is distinct from a daytime energy dip. Nevertheless, some types of foods may be more likely to trigger sleepiness.

  • High-fat foods may be rich and heavy: Fat-laden foods can be difficult to digest, leading to increased likelihood of post-meal tiredness.  
  • High-carbohydrate meals can increase drowsiness: In addition to fat, some research has found that meals with large amounts of carbohydrates increase the perceived amount of postprandial fatigue.
  • Tryptophan triggers the brain’s sleep process: Tryptophan is an amino acid known to promote sleep Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source within the brain. Turkey contains high levels of tryptophan, so it is famously blamed for sleepiness after Thanksgiving dinner. Other foods with tryptophan include milk, bananas, oats, and chocolate. While tryptophan alone may not always cause sleepiness, its effects are enhanced when eaten with carbohydrates.
  • Tart cherries promote sleep: Small studies have found tart cherries Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source to be associated with improved nighttime sleep. Certain kinds of sour cherries contain tryptophan and melatonin, a hormone that helps regulate sleep, as well as other active ingredients that may promote sleep.
  • Nuts are rich in melatonin: Walnuts, pistachios, and other nuts have some of the highest melatonin levels Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source of plant foods. Given the effects of melatonin on sleep, eating a significant amount of nuts may induce a feeling of drowsiness.

While these foods may promote postprandial sleepiness, not everyone will experience fatigue after eating them since various factors influence how the body reacts to a meal.

What Else Causes Sleepiness?

Aside from the nutritional makeup of meals, other factors that may play a role in feeling sleepy after eating include a person’s meal timing, work schedule, overall health, exposure to daylight, and body composition. Post-meal drowsiness may also be a symptom of excessive daytime sleepiness, which can occur as a result of poor sleep at night from insomnia or another sleep issue.

Circadian Rhythm

Many aspects of sleep and wakefulness are regulated by circadian rhythms, internal processes dictated by the body’s internal clock. One of the body’s circadian rhythms, known as the sleep-wake cycle, can affect energy levels over the course of the day, which often involves a post-lunch dip that can cause sleepiness.

In addition, the propensity to fall asleep changes throughout the day. Most people experience the greatest sleepiness before bed but also have an increased desire to sleep near midday. This often occurs in the early afternoon, which is after many people eat lunch. Several factors can influence when and how much this dip in energy occurs, including whether someone tends to be a morning or evening person.

Disrupted Sleep at Night

Drowsiness after lunch may be exacerbated by generalized instances of excessive sleepiness throughout the day. This tendency to feel extremely tired or doze off at inappropriate times can have many causes, including a failure to get enough quality sleep at night.

Excessive daytime sleepiness can also be caused by sleep disorders like obstructive sleep apnea as well as medical conditions that interfere with nightly sleep.

Alcohol Consumption

Alcohol has a sleep-inducing effect Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source . As a result, consuming alcohol with a meal may make post-meal sluggishness more likely. Some research suggests that people who do not get enough sleep at night are more susceptible to drowsiness if they drink alcohol during the day.

Even though alcohol can make it easier to fall asleep, it worsens sleep quality and can make it less likely for sleep to be restorative.

Underlying Health Conditions

Feeling sleepy after a meal can be linked to certain health conditions that may cause fatigue after eating or throughout the day.

  • Unbalanced blood sugar levels can cause sleepiness: Diabetes is a condition marked by elevated blood sugar, referred to as hyperglycemia. Blood sugar rises after a meal, triggering hyperglycemia and fatigue. Postprandial hypoglycemia Trusted Source UpToDate More than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights. View Source , which is caused by low blood sugar levels, can trigger a range of symptoms, including weakness and drowsiness Trusted Source UpToDate More than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights. View Source .
  • Anemia exacerbates fatigue: Anemia is a condition where red blood cells fail to carry the necessary amount of oxygen through the body. Individuals with anemia frequently experience tiredness which may occur at various times, including after a meal.
  • Tiredness is a symptom of hypothyroidism: People with an underactive thyroid gland Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source are prone to have fatigue that can affect them at various points during the day.
  • Low blood pressure decreases energy levels: Postprandial hypotension Trusted Source UpToDate More than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights. View Source , or low blood pressure after a meal, affects people with certain health conditions and is more common in older adults. Fatigue is one potential symptom of this drop in blood pressure.
  • Certain medications can make you tired: Drowsiness is a side effect of some medications. Depending on when a person takes their medications, they may experience sleepiness after a meal.

Is It Normal To Be Sleepy After Eating?

Post-meal drowsiness is common and may be influenced by a person’s internal clock and physiological response to food. Extreme sleepiness that occurs several times a day or interferes with daily life could be an indication of sleep problems or another health condition. Anyone concerned about their post-meal sleepiness or general daytime alertness should speak with a medical professional for individualized guidance.

What Are Ways To Prevent Sleepiness After Eating?

Although there is no guaranteed way to prevent postprandial sleepiness, there are some practical steps that may help people stay awake and alert after meals.

Eat Mindfully

Being aware of both the quantity and nutritional composition of a meal may help avoid postprandial sleepiness. While dietary needs and responses to food can vary from person to person, it may help to avoid large and heavy meals that can increase the urge to doze off after eating.

Individuals can take note of any foods or types of meals, such as high-fat or high-carb meals, that seem to have the biggest effect on their postprandial sleepiness. Identifying these patterns and choosing foods accordingly can be effective in preventing postprandial somnolence. Being mindful about alcohol consumption may also help prevent dips in alertness after meals.

Take a Quick Nap

Another strategy for managing the post-lunch dip is to take a quick nap. Several studies have found that people who take naps of 15 to 45 minutes shortly after a meal feel less sleepy and more alert after waking. However, it is important not to nap for too long because longer naps are linked to greater sleepiness.

Seek Out Bright Light

Taking a nap after a meal may not always be an option, especially for students and people at work. In that case, seeking out bright light may be a good alternative. Exposure to bright light may have a similar effect as a nap on postprandial sleepiness with the ability to improve alertness.

Improve Nightly Sleep

Getting sufficient sleep at night can reduce excessive daytime sleepiness, which may translate to less drowsiness after a meal.

Improving sleep often starts by developing better sleep hygiene, which refers to habits that affect nightly rest. Having a steady sleep schedule, making the bedroom dark, quiet, and comfortable, and limiting caffeine intake late in the day are examples of steps to enhance sleep hygiene.

Avoid Eating Too Late at Night

While sleepiness after a meal is often associated with lunch, it can also occur after dinner, especially when it is eaten late in the evening.

Some people may be inclined to have a late dinner, but research suggests that eating shortly before bed Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source can disrupt healthy sleep patterns. A late dinner has also been associated with a higher risk of health problems like obesity and metabolic syndrome Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source .

Get Active

Post-meal sleepiness may be related to general daytime fatigue. Some research has found that regular exercise can reduce fatigue. It is always wise to consult with a health care provider before beginning a new exercise plan, but finding a way to get regular physical activity may improve energy levels.

Stay Hydrated

Water intake is another factor that affects energy and fatigue. Both dehydration and hyperhydration can result in feelings of fatigue and tiredness Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source . Taking steps to stay properly hydrated may help the body maintain a more consistent level of alertness and energy, including after meals.

When You Should Talk to A Doctor

Postprandial sleepiness is common, but there are circumstances in which it may be linked to a more serious condition. People should talk with a doctor if they show signs of excessive or problematic sleepiness, such as:

  • Postprandial sleepiness that interferes with work, school, or social obligations
  • Drowsiness that occurs when driving or operating heavy machinery
  • Excessive tiredness or falling asleep at multiple points during the day
  • Postprandial sleepiness accompanied by other symptoms or health changes

Does Warm Milk Help You Sleep?

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If you struggle to obtain the recommended seven or more hours of sleep each night, you are not alone. One-third Trusted Source Centers for Disease Control and Prevention (CDC) As the nation’s health protection agency, CDC saves lives and protects people from health threats. View Source of American adults report not receiving the recommended amount of sleep. Sleep is essential to good health and development, so it is imperative that we get enough each night.

There are a multitude of home remedies people may try to help themselves fall asleep more easily and sleep more soundly. Drinking warm milk at night to feel tired is one such strategy that has been shared for years. Learn what the research says about this habit, and if it helps promote sleep.

Does Warm Milk Help You Sleep?

Scientific evidence suggests that warm milk before bed may help you sleep. In a study of people staying in a hospital’s heart unit, those who drank warm milk and honey for three days noticed improvements in sleep Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source . A study of adults over age 60 found that drinking fermented milk over the course of three weeks reduced nighttime wakings Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source .

If you struggle with initiating sleep, milk might be able to help. In a study of people over 65, those who drank more milk and engaged in physical activity reported falling asleep more easily Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source than those who did not.

Why Does Warm Milk Make You Sleepy?

Milk’s sleep-promoting properties might be due to the amino acid tryptophan Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source . Tryptophan-enriched foods have been shown to improve sleep and mood Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source in the elderly.

Tryptophan plays an important role in the production of serotonin and melatonin Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source . Serotonin is a neurotransmitter that impacts mood, cognitive reasoning, and memory Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source . Melatonin is a hormone released by your body in response to darkness, in order to help you feel like sleeping Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source at night.

Milk collected from cows milked at night Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source contains ample amounts of melatonin in addition to tryptophan. Although only animal studies have been conducted with this night milk so far, it could make humans sleepier than regular milk does.

Is it Bad to Drink Milk Before Bed?

Drinking milk before bed does not appear to have documented negative side effects in most people. Some people, however, might want to avoid milk. For example, people who have a dairy allergy, are lactose intolerant Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source , or have irritable bowel syndrome with symptoms that are worsened by dairy Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source   probably should not use milk to promote sleep. If you are avoiding milk, you may want to opt for non-dairy sleep-inducing foods instead.

Some may worry that drinking milk before bed could promote weight gain. However, research suggests a glass of milk at night could help promote fitness. One study found that drinking milk after a workout and before bed Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source helps with muscle recovery. Another study found that drinking milk before bed increases a person’s resting metabolic rate Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source , or how quickly they burn calories, the next morning.

Some sleepers may be concerned that drinking milk before bed could lead to snoring. However, contrary to popular belief, growing evidence suggests that drinking milk does not produce more mucus Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source .

Tips for Better Sleep

For better sleep, it may help to try other foods high in tryptophan Trusted Source Medline Plus MedlinePlus is an online health information resource for patients and their families and friends. View Source , such as:

  • Cheese
  • Chicken
  • Turkey
  • Fish
  • Sunflower seeds
  • Peanuts
  • Pumpkin seeds
  • Soy beans

If you have tried drinking milk or consuming other tryptophan-rich foods before bed and still struggle to fall asleep, you may want to take measures to improve your sleep hygiene Trusted Source Centers for Disease Control and Prevention (CDC) As the nation’s health protection agency, CDC saves lives and protects people from health threats. View Source .

  • Set a Comfortable Temperature: While everyone’s ideal temperature is different, keep your room cool but not frigid. If you sleep with a partner, talk to them about a temperature you both agree on.
  • Establish a Routine: Create and maintain a , so you wind down at the same time each night, including weekends.
  • Avoid Certain Foods and Drinks: Avoid heavy meals, alcohol, and caffeine before bed.
  • Keep Your Bedroom Dark: Try light-blocking curtains or a sleep mask to ensure you aren’t being exposed to light during the night.
  • Minimize Blue Light Exposure: Avoid watching TV or looking at a smartphone in the hours before bed.
  • Exercise: Exercise regularly, preferably earlier in the day.

Consider talking to your doctor if you still are not getting enough sleep after improving your sleep hygiene. It may be due to an underlying sleep disorder, such as insomnia. Your doctor can help you reach a diagnosis, schedule a sleep study or prescribe medications.

10 Tips to Beat Insomnia

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If you are suffering from insomnia, there are many steps you can take to change behaviors and lifestyle to help you get to sleep. Here are some tips for beating insomnia.

  1. Wake up at the same time each day. It is tempting to sleep late on weekends, especially if you have had poor sleep during the week. However, if you suffer from insomnia you should get up at the same time every day in order to train your body to wake at a consistent time.
  2. Eliminate alcohol and stimulants like nicotine and caffeine. The effects of caffeine can last for several hours, perhaps up to 24 hours, so the chances of it affecting sleep are significant. Caffeine may not only cause difficulty initiating sleep, but may also cause frequent awakenings. Alcohol may have a sedative effect for the first few hours following consumption, but it can then lead to frequent arousals and a non-restful night’s sleep. If you are on medications that act as stimulants, such as decongestants or asthma inhalers, ask your doctor when they should best be taken to help minimize any effect on sleep.
  3. Limit naps. While napping seems like a proper way to catch up on missed sleep, it is not always so. It is important to establish and maintain a regular sleep pattern and train oneself to associate sleep with cues like darkness and a consistent bedtime. Napping can affect the quality of nighttime sleep.
  4. Exercise regularly. Regular exercise can improve sleep quality and duration. However, exercising immediately before bedtime can have a stimulant effect on the body and should be avoided. Try to finish exercising at least three hours before you plan to retire for the night.
  5. Limit activities in bed. The bed is for sleeping and having sex and that’s it. If you suffer from insomnia, do not balance the checkbook, study, or make phone calls, for example, while in bed or even in the bedroom, and avoid watching television or listening to the radio. All these activities can increase alertness and make it difficult to fall asleep.
  6. Do not eat or drink right before going to bed. Eating a late dinner or snacking before going to bed can activate the digestive system and keep you up. If you suffer from gastroesophageal reflux (GERD) or heartburn, it is even more important to avoid eating and drinking right before bed since this can make your symptoms worse. In addition, drinking a lot of fluids prior to bed can overwhelm the bladder, requiring frequent visits to the bathroom that disturb your sleep.
  7. Make your sleeping environment comfortable. Temperature, lighting, and noise should be controlled to make the bedroom conducive to falling (and staying) asleep. Your bed should feel comfortable and if you have a pet that sleeps in the room with you, consider having the pet sleep somewhere else if it tends to make noise in the night.
  8. Get all your worrying over with before you go to bed. If you find you lay in bed thinking about tomorrow, consider setting aside a period of time — perhaps after dinner — to review the day and to make plans for the next day. The goal is to avoid doing these things while trying to fall asleep. It is also useful to make a list of, say, work-related tasks for the next day before leaving work. That, at least, eliminates one set of concerns.
  9. Reduce stress. There are a number of relaxation therapies and stress reduction methods you may want to try to relax the mind and the body before going to bed. Examples include progressive muscle relaxation (perhaps with audio tapes), deep breathing techniques, imagery, meditation, and biofeedback.
  10. Consider participating in cognitive therapy. Cognitive therapy helps some people with insomnia identify and correct inappropriate thoughts and beliefs that may contribute to insomnia. In addition, cognitive therapy can give you the proper information about sleep norms, age-related sleep changes, and help set reasonable sleep goals, among other things.

The Unexpected Impact of Caffeine and Alcohol on Sleep

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Sleep experts have long known that consuming caffeine or alcohol on their own can harm sleep. Now, new research suggests that these effects may cancel each other out when caffeine and alcohol are both consumed on the same day. Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source

This is the first study to look at how caffeine and alcohol together impact sleep in the real world rather than in a lab. Researchers from the Center for the Study of Health and Risk Behaviors at the University of Washington in Seattle and the Center for Human Sleep Science at the University of California in Berkeley ran the study. 

For 42 days, the study followed 17 finance traders in New York City, a group known for consuming large amounts of caffeine and alcohol. Each morning of the study, participants took an online survey with questions about their prior day’s caffeine and alcohol use and their previous night’s sleep.

Caffeine and alcohol consumed on the same day appeared to offset each substance’s expected negative impact on sleep. Lead researcher Frank Song called these results “intriguing,” as the researchers didn’t expect them.  

Since caffeine consumption tends to shorten sleep and alcohol tends to result in poor sleep quality, the researchers expected that combining the two would make sleep worse than either on its own. Instead, they found that alcohol consumption may counteract the reduced sleep time usually caused by caffeine. And caffeine may help a person feel more awake after a night of reduced sleep quality caused by alcohol.

This isn’t to say that using caffeine to wake up in the morning and alcohol to fall asleep at night is a healthy choice. While it may help in the short term, the researchers refer to this practice as “self-medication” and caution against using it as a long-term strategy. 

Self-medicating in this way may lead to a cycle in which a person needs more caffeine each morning in order to feel alert after poor sleep, then needs more alcohol each evening to balance the day’s caffeine. All the while, a person’s sleep deteriorates due to the effects of both substances, and this poor sleep can harm their overall health.

Insomnia, Short Sleep Linked to GreaterRisk for MI

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Insomnia — difficulty falling or staying asleep — was associated with a 69% greater risk of having a myocardial infarction (MI) than among adults without insomnia, according to new research.

Those who slept 5 or fewer hours per night had the highest risk for MI, and those with both diabetes and insomnia had double the risk for MI compared with patients without these comorbidities.

The findings are from a meta-analysis of studies studies in more than 1 million patients, almost all without prior MI who were, on average, in their early 50s and followed for 9 years.

Yomna E. Dean, a medical student at Alexandria University, Egypt, reported these results in a press briefing February 25, and the study was simultaneously published in Clinical Cardiology. It will be presented at the upcoming American College of Cardiology (ACC) Scientific Session/World Congress of Cardiology (WCC) 2023.

“Insomnia and ≤ 5 hours of sleep are highly associated with increased incidence of MI, an association comparable to that of other MI risk factors and as such, it should be considered as a risk factor for MI and to be incorporated into MI prevention guidelines,” the researchers conclude.

“We believe that [insomnia] should be screened and patients should be educated about the importance of sleep because nowadays insomnia is no longer a disease — sleep deprivation could also be a life choice,” Dean told a press conference prior to the meeting later this week.

“Clinicians must educate the patients about the importance of sleep in maintaining a healthy heart and encourage proper sleep hygiene,” Dean reiterated in an email to theheart.org | Medscape Cardiology.

“And if a patient still has insomnia, other methods should be considered such as cognitive behavior therapy for insomnia (CBT-I).”

Adds to Growing Evidence

This study does not allow any conclusion about whether treating insomnia will reduce heart attack risk, Jennifer L. Martin, PhD, president of the American Academy of Sleep Medicine (AASM), noted in an email to theheart.org | Medscape Cardiology. Nor does it report the diversity of study participants, since insomnia is also a health equity issue, she noted, and insomnia symptoms and comorbidities were self-reported.

However, this analysis “adds to the growing evidence that poor quality or insufficient sleep is associated with poor health,” said Martin, professor of medicine at UCLA’s David Geffen School of Medicine, Los Angeles, who was not involved with this research.

The study reinforces the recommendation from the American Heart Association, which includes “Get Healthy Sleep” as one of “Life’s Essential 8” for heart health, Martin noted.

“Particularly in primary care where disease prevention and health promotion are important, clinicians should be asking all patients about their sleep — just like they ask about diet and exercise — as a key aspect of maintaining heart health,” she said.

Advice about basic sleep hygiene advice is a first step, she noted.

When improved sleep hygiene is not enough to address chronic insomnia, the American Academy of Sleep Medicine’s clinical practice guidelines and the guidelines of the VA/Department of Defense, recommend first-line treatment with CBT-I, typically offered by a sleep specialist or mental health clinician.

Similarly, the American College of Physicians suggests that sleeping pills should be reserved for short-term use in patients who may not benefit sufficiently from CBT-I.

Sleeping Too Little, Too Much, Equally Harmful

“Studies have found that insomnia and subsequent sleep deprivation puts the body under stress,” Dean said. “This triggers cortisol release which could accelerate atherosclerosis,” and increase risk of MI.

For this analysis, the researchers identified nine observational studies, published from 1998 to 2019, with data on incident MI in adults who had insomnia.

The diagnosis of insomnia was based on ICD diagnostic codes or on the DSM‐5, which defines insomnia as the presence of any of the following three symptoms: difficulty initiating sleep, difficulty maintaining sleep, or early morning awakening with inability to return to sleep.

Patients with sleep apnea were excluded.

The studies were in populations in China, Germany, Norway, Taiwan, United Kingdom, and United States, in 1.1 million adults aged 18 and older.

The patients had a mean age of 52 years and 13% had insomnia.

During follow-up, 2406 of 153,881 patients with insomnia, and 12,398 of 1,030,375 patients without insomnia had an MI.

In the pooled analysis, patients with insomnia had a significantly increased risk of MI (relative risk [RR] 1.69, P < .00001), after adjusting for age, gender, diabetes, hypertension, high cholesterol, and smoking.

Sleeping 5 hours or less was associated with a greater risk for MI than sleeping 6 hours, or 7-8 hours, but sleeping 9 hours or more was just as harmful.

Table. Risk for MI with Different Sleep Durations

Sleep Durations (hours/night)Relative Risk for MIP value
≤ 5 vs 61.38< .00001
≤ 5 vs 7-81.56< .00001
≤ 5 vs ≥ 91.04.57
6 vs 7-81.14.0002
6 vs ≥ 90.75< .00001
7-8 vs ≥ 90.67.67

Patients who had difficulty initiating and maintaining sleep — two symptoms of insomnia — had a 13% increased risk for MI compared with other patients (RR = 1.13, P = .003).

However, patients who had nonrestorative sleep and daytime dysfunction despite adequate sleep — which is common — did not have an increased risk of MI compared with other patients (RR = 1.06, P = .46).

Women with insomnia had a 2.24-fold greater risk for MI than other women, whereas men with insomnia had a 2.03-fold greater risk for MI than other men.

Patients with insomnia had a greater risk for MI than those without insomnia in subgroups based on patients’ age (< 65 and > 65), follow up duration (≤ 5 years and > 5 years), and co-morbidities (diabetes, hypertension, and hyperlipidemia).

Therapy, Ambien Are Equally Effective at Treating Insomnia: Study

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Learning techniques to improve sleep or taking the medication Ambien were similarly effective at improving daytime functioning in people with insomnia, according to a new study in the journal JAMA Psychiatry.

Insomnia is a common sleep disorder, and its symptoms can include trouble falling asleep, trouble staying asleep, or poor quality sleep. People with insomnia typically experience daytime sleepiness.

Most people who seek treatment for insomnia do so because the condition impacts their ability to function normally during the day, the researchers noted. Their study was designed to examine whether behavioral therapy or a common medication therapy was better than the other when it came to improving daytime functioning. A second phase of the study looked at whether adding a second type of treatment resulted in better daytime functioning among people whose insomnia didn’t improve from just medication or from just therapy.

For the study, 211 adults in the U.S. and Canada with chronic insomnia were randomly assigned to either take the drug zolpidem, which is sold under the brand name Ambien, or to participate in behavioral therapy where they learn to limit the amount of time they spend in bed as well as limit the activities they do in bed. The average age of people in the study was 46 years old, and 63% of them were women.

An Overview of Insomnia

WebMD explains the symptoms and causes of insomnia, and offers tips for getting a good night’s sleep.

Chronic insomnia was defined as occurring three or more nights per week, and people in the study reported having trouble falling asleep or staying asleep for more than one month.

Both the Ambien and the therapy group experienced similar improvement in daytime outcomes, including a reduction in depression symptoms, reduced fatigue, and overall better mental health and functioning. The therapy group reported more improvement in anxiety symptoms than the Ambien group.

The authors suggested that the therapy group may have experienced reduced anxiety because the people in the study fell asleep faster and spent less time awake in the middle of the night, which may have “reduced anxiety and worry when initiating sleep and during midnight awakenings,” the researchers wrote. 

“In addition, [behavioral therapy] may also reduce sleep-related anxiety or distress through modifying participants’ perception of sleep,” they noted. 

In a second phase of the study, those whose insomnia didn’t improve in the first phase were randomly assigned to an additional insomnia therapy, such as Ambien, behavioral therapy, another medication called trazodone, or another therapy called cognitive behavioral therapy. Adding a second treatment resulted in further improvements in those people’s daytime functioning.

The improved functioning and mental health of the people in the study continued during a 12-month follow-up period, the authors noted.

As many as 1 in 3 adults have insomnia symptoms, and about 10% of people meet the criteria to be diagnosed with an insomnia disorder, according to Cleveland Clinic.

The authors noted that further research is needed to confirm the findings due to some study limitations, such as not having a control group as part of the study design.