A holistic approach to insomnia

Insomnia affects almost a quarter of the world’s population. It is associated with poor mental health, cardiovascular disease, and type 2 diabetes, among other health complications. Increased fatigue, reduced work productivity, decreased quality of life, and dissatisfaction with relationships are also common in people with insomnia.

Approximately 6% to 20% of adults suffer from insomnia. Insomnia is characterized by persistent difficulty falling asleep or staying asleep. This increases the risk of health conditions such as heart disease and stroke, which can lead to death. Vgontzas et al.¹ (2010) conducted interviews with 4,365 men and 12,219 women who experienced insomnia. They defined insomnia as sleeping less than 6 hours.

Associated health risks

People with insomnia are more likely to experience mental health problems such as generalized anxiety disorder, bipolar disorder, and major depressive disorder (MDD). It is important to note that insomnia is not secondary to a sleep disorder, but rather precedes diagnosis. Furthermore, the response rate for people with MDD and insomnia is slower than for people without insomnia.

“This research insomnia About MDD patients. According to ISI, HAMD, and SCL-90 scores, the MDD patient’s sleep quality improved from his second week and gradually improved with increasing prognosis time. Additionally, recovery remains consistent between: insomnia And M.D.D. This study proves that there is a clear correlation between the two. insomnia And M.D.D. ”

Postma et al.² (2019) studied idiopathic REM sleep behavior disorder (iRBD) as a predictor of Parkinson’s disease or Lewy body dementia from 24 international sleep centers. RBD or iRBD is a type of sleep disorder or insomnia that causes vivid dreams and nightmares that keep you awake throughout the night. Researchers found a correlation between iRBD and an increase in neurodegenerative diseases. This rate tends to increase each year, as the prodromal phase of neurodegenerative conditions can last up to 10 years.

Research: Acupuncture for insomnia

A case study conducted in Tampa, Florida, collected data from 12 participants who suffered from insomnia. Insomnia varied by symptoms, comorbidities, and additional symptoms. Participants varied in gender, age, race, and socioeconomic status.

Data was collected from January 2019 to October 2022. This included her eight women (seven Caucasians and one African American). and four men, all white. Participants were between 30 and 65 years old. Health history information was collected through a thorough system check from Subjective, Objective, Assessment, and Plan (SOAP) notes via electronic health system.

A diagnosis was assigned to each participant describing the type of insomnia identified in traditional Chinese medicine (TCM) differentials and ICD codes. Participants may or may not have other diagnoses, but these were not considered in this study. TCM acupuncture technique was applied. It is not five element or dry needling.

result

Of the 12 participants in the study with an average age of 46.91 years, 10 fully recovered after treatment. The frequency of treatments was weekly and the number of treatments varied. Some participants who fully recovered received only two treatments, while others received up to 14 treatments. Three patients received 6 treatments and 1 received 14 treatments. One patient discontinued treatment after six treatments with little benefit.

Delivery system: medical model

What is the current medical model for minimizing insomnia? Cognitive behavioral therapy (CBT) is a psychotherapy that aims to break maladaptive patterns of thinking and behavior, and is used to treat insomnia. It is known as a cutting-edge treatment. CBT consists of a combination of behavioral components (stimulus control, sleep restriction, and relaxation) with cognitive components (managing sleep-related worries, head racing, and intrusive thoughts) and educational components (sleep hygiene) .

In a study by Norrell Clark³ (2015), 64 participants diagnosed with insomnia and depressive disorders were randomized to receive CBT or relaxation training (RT). The primary endpoint was assessed before and 6 months after treatment. Results showed that CBT was more effective in reducing insomnia, but as effective as RT in reducing depressive symptoms.

Norell-Clarke said: “CBT was associated with reduced functional impairment, sleep onset latency, and post-sleep onset awakenings, but both treatments produced similar improvements in sleep quality, early morning awakenings, and total sleep time.” (p .90).

Bentley etc.^Four (2022) studied two separate cost interventions for insomnia in caregivers of patients with Alzheimer’s disease. One was CBT for him and the other was Mindfulness Awareness Practice (MAP). After considering individual and group distribution, we found that his MAP was the most cost effective. The cost difference was $1,884 and $1,377 for MAP compared to $3,978 and $1,981 for CBT.

One of the newest delivery systems for CBT is digital or DCBT. This is done using an automated web platform or mobile app. Espy et al.^Five (2019) studied the effects of day and night on insomnia. These include functional health, psychological well-being, and patient-generated sleep-related quality of life. They aimed to improve insomnia domains and insomnia-related personal functioning at 4, 8, and 24 weeks in 1,711 participants.

The treatment consisted of six sessions lasting 20 minutes each. These were tailored to the individual and participants could receive the intervention for up to 12 weeks. Components include behavioral, cognitive, and educational interventions. Overall, this study showed that not only is CBT effective for insomnia and its impact on daytime functioning, but digital CBT is also effective. However, only 26% to 43% of patients achieve complete remission of insomnia with CBT.

Adopting a holistic approach: options

When conventional treatments fail, many people turn to complementary and alternative medicine (CAM) for relief. The National Health Interview Survey (NHIS) revealed that 1.6 million people use her CAM to treat insomnia. These include acupuncture, herbs, mind-body therapies such as meditation and yoga.

Ongu et al.⁶ (2014) applied mindfulness meditation, which focuses attention on the present moment, as a means to relax the nervous system. At post-treatment follow-up, participants increased their sleep time by 43.75 minutes.

Hartescu et al.⁷ (2015) conducted a randomized controlled trial of increased physical activity in 30 women. They recommended activity levels set out in public health guidelines. This involved her performing less than 150 minutes of moderate-to-vigorous intensity physical activity per week for 6 months. Baseline 6-month reduction in insomnia symptoms decreased by 4 points.

Williams et al.⁸ (2014) studied a telephone intervention for obstructive sleep apnea (OSA). This study was a mixed methods approach. A two-arm randomized controlled design to evaluate the effectiveness of a culturally and linguistically tailored telephone intervention in 340 Black participants at risk for sleep apnea, with two treatments. were randomly assigned to one of the conditions (170 people in each). At the end of the trial, researchers also conducted focus groups to assess participants’ overall impressions of the intervention.

Obstructive sleep apnea (OSA) is characterized by episodes of complete or partial collapse of the airway, accompanied by decreased oxygen saturation and arousal from sleep (Slowick et al., 2022).⁹ The result is fragmented and non-restorative sleep, which impacts cardiovascular health, mental illness, quality of life and driving safety.

The theoretical framework of the study was developed by Prochaska & Velicer.^Ten (1997) consists of five stages that individuals go through in order to modify problem behavior. The first stage begins with precontemplation. At this stage, a person is not thinking about change and often does not realize that there is a problem that needs to be fixed. It progresses to the maintenance phase, where the individual successfully changes behavior (over 6 months) and focuses on maintaining this new way of life.

Between these two stages, a person may contemplate change, prepare for change, and take action to initiate behavioral change. The trial began in 2010 and so far 311 people have participated. Although this intervention is designed to be practical and applicable, the results are still inconclusive.

Zhou et al.¹¹ (2022) studied three different interventions for sleep problems to determine differences in effectiveness. In this 333-part, single-blind, three-arm, randomized clinical trial, researchers investigated whether insomnia disorder could be effectively treated in a population via the Internet, and intervention engagement could be increased. I tried to determine whether They utilized only a standard Internet intervention (SHUTI) and a culturally tailored Internet intervention (SHUTI-BWHS) and sleep education.

They found that participants receiving SHUTI or SHUTI-BWHS had reduced insomnia at 6-month follow-up. The greatest outcomes were those who received SHUTI-BWHS, then those who received SHUTI, and finally those who received patient education. Her culturally tailored SHUTI-BWHS program was more effective in engaging participants in the program, as more participants completed the full intervention. After completing the program, I saw a significant improvement in my sleep.

practical points

There are a variety of holistic treatments to choose from for people suffering from insomnia. Acupuncture can be an effective way to treat insomnia, regardless of its pattern. Acupuncture research is promising, but further research is needed to clarify the specific mechanisms of action in larger and more diverse populations.

References

1. Vgontzas AN, Fernandez-Mendoza J, Bixler EO et al. Persistent insomnia: The role of objective short sleep duration and mental health. sleep2012;35(1):61-68.
2. Postuma RB, Iranzo A, Hu M, Risk and predictors of dementia and parkinsonism in other idiopathic REM sleep behavior disorders: a multicenter study. brain2019;142(3):744-759.
3. Norell-Clarke A, Jansson-Fröjmark M, Tillfors M, et al. Group cognitive behavioral therapy for insomnia: Effects on sleep and depressive symptoms in a sample with comorbidities. action less, 2015;74:80-93. [url=https://doi.org/10.1016/j.brat.2015.09.005]https://doi.org/10.1016/j.brat.2015.09.005[/url]
4. Bentley TGK, Castillo D, Sadeghi N, et al. Costs associated with the treatment of insomnia in caregivers of Alzheimer’s disease: A comparison of mindfulness meditation and cognitive behavioral therapy for insomnia. BMC Health Service Representative2022;22(1):231.
5. Espie CA, Emsley R, Kyle SD et al. Effects of digital cognitive behavioral therapy for insomnia on health, psychological well-being, and sleep-related quality of life: a randomized clinical trial. JAMA Psychiatry2019;76(1):21-30.
6. Ong JC, Manber R, Segal Z, et al. A randomized controlled trial of mindfulness meditation for chronic insomnia. sleep2014;37(9):1553-1563.
7. Hartescu I, Morgan K, Stevinson CD. Increasing physical activity improves sleep and mood outcomes in inactive people with insomnia: A randomized controlled trial. J sleep tolerance2015;24(5):526-534.
8. Williams, N.J., Jean-Louis G., Brown CD, et al. Telephone-based behavioral intervention for black people with sleep apnea and metabolic syndrome: Research protocol for a randomized controlled trial. ordeal2014;15:225.
9. Slowik JM, Sankari A, Koren JF. obstructive sleep apnea. StatPearls Publishing, 2022.
10. Prochaska JO, Bellisar WF. A transtheoretical model of health behavior change. Amj Health Promotion1997;12(1):38-48.
11. Zhou ES, Ritterband LM, Bethea TN, et al. Effects of culturally tailored internet-delivered cognitive behavioral therapy for insomnia in black women: A randomized clinical trial. JAMA Psychiatry2022;79(6):538-549.