Health Journal: Fighting incesant insomnia

Can’t sleep? Many people have experienced the negative impact of a poor night’s sleep, often referred to as “waking up on the wrong side of the bed.” In fact, studies show that as many as 30 percent of adults worldwide If you’re experiencing sleep challenges, have experienced insomnia symptoms and it could be insomnia disorder 10 percent of patients have insomnia disorder. Insomnia is on the rise due to the panBRANDPOINT demic and the massive upheavals people are experiencing to their everyday routines. “Based on my experience, the myriad

of shifts in our day-to-day lives is a perfect storm for sleep challenges,” said Russell Rosenberg, Ph.D., D.ABSM, sleep specialist and former chair of the Board of the National Sleep Foundation.

WHAT CAUSES INSOMNIA? Insomnia, an inability to fall and/or stay asleep, can be influenced by many things, including lifestyle habits (i.e. caffeine intake and lack of a wind-down routine), as well as a person’s sleeping environment (i.e. bedroom temperature).

Certain types of brain functioning may also impact sleep, such as the inability to turn down wake signals in the brain. These wake signals are regulated by a neuropeptide in the brain called orexin.

“Orexin signaling is believed to promote periods of wakefulness. For people who frequently struggle with sleep, it is possible that orexin signaling is not functioning normally,”said Rosenberg.

DIAGNOSING INSOMNIA DISORDER For adults who have insomnia disorder, obtaining the recommended seven to eight hours of sleep per night may seem like an impossible task.

A healthcare provider might diagnose you with insomnia disorder if you:

Have trouble falling asleep or staying asleep for three out of seven nights each week for a period of at least three months.

Struggle socially, at work, in school or in other important areas of functioning due to your insomnia.

TREATING INSOMNIA DISORDER “We must continue to give sleep the attention it deserves as we seek to combat the negative effects of the COVID-19 environment on our health and wellbeing,” said Rosenberg. “People struggling with sleep consistently should take it seriously and make an appointment with a doctor or healthcare professional to see if they may be struggling with insomnia disorder. Once this initial step is taken, the conversation can begin about what treatment options may be best.”

Doctors have several options when treating patients with insomnia disorder, but often start with the least invasive treatment approach. Cognitive behavioral therapy for insomnia, known as CBT-I, typically includes “sleep restriction” (i.e. limiting the amount of time people spend in bed when they are unable to sleep) and “stimulus control” (i.e. keeping the bedroom dedicated to sleep and sex, as well as getting out of bed when you can’t sleep).7

For people who cannot manage their symptoms through behavioral and/or environmental changes, there are several prescription treatment options which may be considered when discussing your symptoms with a doctor.

Four main classes of prescription medications are used to treat sleep issues: sedatives, antidepressants, melatonin agonists and orexin receptor antagonists. Each class has a different mechanism of action that affects the central nervous system in a specific way.

Orexin receptor antagonists (blockers) belong to a class of medications that inhibit the effect of orexin, a chemical in the brain that plays an important role in keeping people awake. In people with normal daily sleep-wake rhythms, orexin signaling is believed to promote periods of wakefulness.

For example, lemborexant 5mg and 10mg tablets, a prescription medication, is part of this class of orexin receptor antagonists and is a prescription medicine for adults age 18 years and older who have trouble falling or staying asleep. In a clinical trial, patients reported falling asleep faster and staying asleep longer with lemborexant.

“It is crucial to offer patients treatment options that may help them fall asleep and stay asleep,” said Dr. Rosenberg.

As we continue to deal with the pandemic, adequate sleep is an important aspect of health and well-being that many struggle with. It’s important for patients to speak with their doctor to determine which treatment approach is best for them. All prescription medications should be used as directed by the prescribing doctor.

“We must continue to give sleep the attention it deserves as we seek to combat the negative effects of the COVID-19 environment on our health and wellbeing.”