Stress, depression, and underlying psychiatric conditions are on the rise. It is no surprise that there is a corresponding climb in the prevalence of cases of chronic insomnia .
Insomnia is defined an inability to fall asleep or stay asleep even when a person has the chance to do so, or experiencing non-restorative sleep . It becomes chronic you experience it at least 3 times a week for longer than 3 months . Insomnia is a disease that increases in prevalence with age and a study conducted by Ohayan et al revealed that up to 48% of the population suffers from insomnia-related symptoms. Women are more likely to suffer from insomnia than men .
Often times, physicians are left with the taxing task of trying to identify a useful management strategy when approaching insomnia. Patients will often present with other co-morbidities like depression, excessive stress, or another underlying psychiatric disorder that can perpetuate the insomnia and invalidate treatment regimens.
Pharmaceuticals are used in most patients to combat their chronic insomnia with muted results. Benzodiazepines are the first-line therapy but have side effects that will make any physician cautious about prescribing them. Side effects like rebound insomnia and anterograde amnesia can magnify psychiatric disorders and will do more harm than good if used for a prolonged period of time.
Non-benzodiazepine hypnotics are considered to be the second-line option but they, too, have limited efficacy and patients diagnosed with insomnia will still report of insomnia-related symptoms 58-85% of the time .
A number of alternative therapies can help patients cope with their chronic insomnia. In this article, I will present the top 5 natural methods that can help patients deal with their disorder.
Number 1: Promoting Sleep Hygiene
This is an effective way to make patients more likely to fall asleep. Spending excessive time around or in your bedroom can trigger a physiological change in your brain associating your bedroom with a place of activity instead of a place of rest. The bedroom has become a common place to watch television, study, and even eat meals. As a result, the body becomes adjusted to these habits and it can become harder to sleep. There may be a prolonged latency to fall asleep so you may crawl into bed and while tired at first, you may become more restless and find it difficult to fall asleep.
In a study aimed at determining if restricting the time in bed markedly improves sleep quality, 35 patients with a mean age of 46 were restricted to entering only their bedrooms when they were tired. After 8 weeks of this conditioning, there was significant improvement in sleep latency, total wake time, sleep efficiency, and reported satisfaction with insomnia symptoms. These parameters were all satisfactory even 36 weeks after the study concluded. 
Number 2: Psychological Consultation
Considering the probable number of patients suffering from chronic insomnia with underlying psychiatric imbalances, it is no surprise that a psychological visit could improve the response to insomnia-like symptoms. In a meta-analysis study covering 139 different samples, psychological enhancement improved the sleep pattern and the subjective experience of sleep. It was found that greater therapeutic gains were available for participants who were clinically referred and who were not regular users of sedative hypnotics .
Number 3: Increase Melatonin In Your Diet
Another remedy to fight chronic insomnia is a diet that is rich in melatonin, a chemical produced by your body naturally to help you fall asleep at night. There are synthetic pills that can help you fall asleep and remain asleep throughout the night but these can be expensive and can have a muted effect if you are using them for a prolonged period of time.
Nuts like walnuts and almonds have high levels of melatonin and you will feel more tired if you eat these 30 minutes before you go to bed.
Dairy products are another great source to help you fall asleep but not because of melatonin. Dairy has high levels of tryptophan, a precursor for melatonin in your brain. This tryptophan is the same substance you digest from that Thanksgiving turkey every year and most people have that instant desire to take a nap right after. This dairy can be in the form of a warm glass of milk, crackers and cheese, or even a yogurt.
The last group of foods to consider are those with high glycemic indexes. Foods like pretzels, chips, and rice cause your body to release a surge of insulin because of the spike in blood sugar. This indirectly leads to a spike in tryptophan and the subsequent production of more melatonin. Be cautious with this approach, however, because it is also a great way to gain weight and interfere with healthy blood sugar levels .
Number 4: Yoga Exercises To Reduce Arousal
Evidence suggests that spikes of physiological and cognitive arousal are the main triggers of insomnia. It would stand to reason that the best way to combat this would be to find ways to reduce this arousal and calm the body and mind. For the past few decades, yoga has been this panacea where participants practice calming techniques in order to relax. Chronic insomnia can be triggered by increased levels of stress so anything to help you relax will help.
A preliminary study was done to test this logic and those suffering from chronic insomnia were enrolled in one yoga class to learn how to do stretches and then asked to record a sleep diary for a 2-month period. All of the 20 participants experienced improvements in sleep efficiency, total sleep time, total wake time, sleep onset latency, and wake time after sleep onset.
Number 5: Exercising To Promote Better Sleep
Exercise is something that doctors preach constantly to our patients. It is useful for your heart, your joints, and even your mind. Exercising will help patients suffering from chronic insomnia in a number of ways. Having a sedentary life is strongly correlated with having problems sleeping and 26.3% of Americans surveyed in 2016 had not exercised in the last 30 days. This inactivity is very troubling and needs to change in order to promote a better life.
The University of Stanford conducted a study to determine if exercise could be useful in improving chronic insomnia and asked adults aged 55 to 75 to exercise for 30 minutes a day at least 4 days a week in the afternoon. This exercise was mild in intensity and often would be just walks around the neighborhood. At the conclusion of the study, the average improvement in participants was a 50% reduction in the time required to fall asleep and participants being able to stay asleep for an extra hour each night.