Treatments for Sleep Problems and Insomnia

Sleep Problem Treatments

Do you have problems falling asleep, staying asleep or never feel rested and are always tired? When is the last time you had 7 hours of restorative sleep?

Sleep problems, disturbances and disorders is a major problem in our society today with the stressful life and pace we live and especially if you had some form of brain injury, such as a concussion, stroke, MS or Parkinson Disease.

Sleep Problems Caused by Concussion

There are four types of sleep disturbances that can follow a Concussion. The first, Insomnia, is the inability to fall asleep or remain asleep. It is the most common sleep problem among the world’s population and has increased with the fast pace of today’s lifestyle. Insomnia often occurs immediately following a Concussion and if not treated, may continue for years. Hypersomnia is the inability to become fully awake or the need for excessive quantities of sleep. This is a very common symptom after a concussion, as in my own case when I would sleep for 19 hours a day. Sleep/Wake Cycle Disturbance, or Circadian Rhythm Disturbance is an interference with one’s inner clock that regulates periods of sleep and wakefulness. This condition may predate a concussion but be worsened by the injury, or it may be caused by the injury itself. Finally, parasomnias are a type of motor problem that includes night terrors, nightmares, periodic leg kicking, or the twitching of restless leg syndrome.

Specific Treatments for Sleep Problems

There are many types of treatments that are very effective to help you gain restorative sleep. These methods and approaches DO work to help with the symptoms and causes of sleep problems and insomnia. Some are reimbursed or paid by insurance. These are referred to as conventional approaches, while complimentary may or may not be paid by insurance. The last group is alternative approaches, which are NOT covered. Payment is not based on whether an approach is effective or even it vast research has been done. Payment is decided by a limited group of executives in insurance companies.

Conventional Treatments

There are two conventional medical avenues to the treatment of sleep disturbances. The first is behavioral and/or environmental intervention, the second is pharmacological.

Behavioral

  • Chronotherapy, or stabilized time of waking. It is important to go to bed and wake up at the same time each day.
    Reduction of or avoidance of caffeine and alcohol
  • Elimination of tobacco
  • Eating a higher protein diet while eliminating sugar, artificial sweeteners, and processed foods
  • Phototherapy, or careful use of and exposure to light
  • Environmental controls such as turning off lights and minimizing background noises
  • Regular exercise; however, do not work out within four hours of your bedtime
  • Limited time in bed by not watching TV in the bedroom
  • Napping, or not napping. Recent research shows that a 90-minute nap during the day promotes restorative sleep at night. It is recommended that you discuss this with your doctor
  • Selection of the proper bed, pillow, and mattress for the promotion of restorative sleep
  • Psychotherapy; specifically Cognitive Behavioral Therapy to learn new cognitive approaches to sleeping and daily living and/or Trauma Therapy to minimize the effect of PTSD.

Pharmacological

  • Melatonine (Ramelteon): 8 mg at bedtime helps improve total sleep
  • ABA : a neurotransmitter that is helpful in promoting sleep
  • Desyrel (Trazodone) and some other low-dose antidepressants may help sleeping problems, though their side effects may worsen such symptoms as daytime fatigue and memory difficulties
  • Zolpidem (Ambien), Zaleplon (Sonata), and Eszopiclone (Lunesta) are nonbenzodiazepines used to treat transient insomnia
  • Acetylcholinesterase Inhibitors (Aricept, Reminyl, and Exelon) and wake-promoting agents that increase vigilance while increasing verbal and visuospatial memory.

Complementary Treatments

Acupuncture and Scenar are very effective at correcting many aspects of sleep disturbance., along with changes in your what you eat. On our team of experts, we have several specialist in sleep problems including Martha Lindsay, our nutritional educator, Tom Tam and Bill Mogan who specialized in acupuncture, Neurofeedback is an extremely helpful non pharmacological approach The drawback is that many insurance companies do not cover neurofeedback. It can take thirty-plus sessions over the course of several years to complete the treatment. Dr. Diane® and Paul Soper specialized in this area.

A highly cost effective method is cranial electro stimulation (CES), which is a FDA-approved medical device for insomnia. The blinking glasses of pRoshi help the brain to regulate itself whether you wear them or have them blinking against the wall during the night. Quantum Wave Light therapy has a specific setting for sleep, while the Q1000 can be used with acupuncture points to improve sleep. Oxygen therapy has also been found to be helpful. (This is different from the continuous positive airways pressure (CPAP) or automatic positive airway pressure (APAP) used to manage sleep apnea.

Alternative Treatments

Reiki and QiGong are very effective ways to treat sleep disturbances. Clara Diebold is our team Reiki expert, while Dr. Diane® has been trained in both along with being a Bach Flower Practitioner. Bach Flower Rescue Remedy Sleep may also help. A Bach Flower practitioner can assess whether other remedies, such as Star of Bethlehem, are appropriate for you. Aroma therapy with lavender or chamomile oil is often used to promote sleep, as are a variety of homeopathic remedies and herbal preparations such as valerian root. It is important to consult with a naturopath or homeopathic practitioner with a background in working with mTBI patients before using any alternative products.

Over-the-counter sleep products are designed for the general population, not as remedies for specific physical conditions or disorders. Before purchasing an over-the-counter product, please consult with your doctor. Remember that each post concussive sleep disturbance is as unique as the person who was injured. An experienced professional can give you the best information about remedies especially suited to your symptoms and needs.

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Coping with Concussion and Mild Traumatic Brain Injury

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Dr. Diane® Roberts Stoler, Ed.D.
7 Hodges Street
N. Andover, MA 01845
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Within each person shines an inner light that illuminates our path and is the source of hope. Illness, trauma, suffering and grief can diminish the light and shroud hope. I am a catalyst for hope and change, offering a way to rekindle this inner light.

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