OUR HEALTH TIPS – On the occasion of International Sleep Day, which takes place on Friday, focus on this problem which affects more than one in ten French people.
Whole nights scrutinizing the ceiling without being able to close the eye, untimely night awakenings without being able to find the arms of Morpheus … Who has never experienced insomnia at least once in his life? If it remains occasional for most people, 15% to 20% of French people are regularly affected. With the key, a diminished physical form and an unstable mood. So to sleep successfully, a third of these chronic involuntary night owls take sleeping pills. Medicines which are not without risk in the long term. What are the alternatives? Le Figaro make the point.
What is insomnia?
Before treating your insomnia, you must be certain that you are insomniac. “Chronic insomnia meets specific criteria”, explains Professor Damien Leger, head of the sleep center at the Hôtel-Dieu hospital in Paris. “There are three types of insomnia: insomnia when falling asleep, when the patient takes more than 30 minutes to fall asleep; sleep maintenance insomnia, when he wakes up more than 30 minutes several times during the night; and early waking insomnia when he wakes up an hour before the scheduled time. “ Insomnia is only talked about if one or more of these signs have been shown several times a week for more than three months, with repercussions on daily life.
To overcome insomnia, you must first try to find the cause, which is not always easy. This inability to sleep can be due to an illness or disorder, such as sleep apnea, chronic pain, or the side effects of certain medications. Insomnia can also be the consequence of psychological problems (anxiety disorders, depression …).
But things are not always so compartmentalized: the body and the mind being intimately linked, insomnia caused by chronic pain can in turn lead to depression, which will reinforce insomnia. “A psychic cause is often incriminated without there having been previously the search for an organic cause”, however warns Professor Leger. Hence the importance of a precise interrogation of the person, accompanied by a rigorous clinical examination and, in some cases, a blood test.
If sleeplessness is the result of an illness, you should start by managing the illness. In the case of chronic pain for example, painkillers are often essential to find better sleep.
Whatever the cause, the treatment of insomnia starts with common sense measures. Go to bed and get up at regular times; avoid consumption of coffee, alcohol and tobacco before bed; regulate the temperature of your room; do not use a screen for 30 minutes before falling asleep; do not eat too much in the evening; avoid all sources of noise pollution; Finally, practice regular physical activity.
Cognitive behavioral therapy: an effective alternative
In addition, several non-drug alternatives have proven their effectiveness. This is the case with cognitive behavioral therapy (CBT), practiced by psychologists and specialist doctors, which aim to change certain habits and erroneous thoughts. The goal is to reduce the anxiety generated by insomnia as it is an aggravating factor.
“In my hospital service, CBT sessions take place over 5 2-hour sessions with groups of 8 to 10 people”, explains Professor Leger. “Thanks to a sleep diary that he fills in daily, the patient identifies bad habits and thoughts that promote his insomnia and then learns how to modify them. It dramatizes his disorder and reduces the anxiety that disrupts his sleep. ” However, there are still too few units such as that of the Hôtel-Dieu and only a hundred sleep specialists in TBI (doctors and psychologists) practice throughout the territory.
Relaxation methods like sophrology, based on breathing exercises, can also improve the quality of sleep.
Other therapies exist but the scientific data show that their effectiveness is more modest. This is particularly the case of hypnosis, which has its place only when insomnia is due to a well identified traumatic event, as well as light therapy (daily exposure to a lamp with ultraviolet rays which reproduce effects of the sun for a few minutes), which is only useful if the sleep-wake rhythm is shifted.
As for melatonin, the sleep hormone, it is only recommended for elderly people with a proven deficit demonstrated by a blood test. Finally, herbal teas such as valerian, linden or passionflower have not shown scientifically validated effectiveness but they can be beneficial by promoting a moment conducive to relaxation before bedtime.
The last resort solution is taking hypnotic drugs, sleeping pills, which cause a state of artificial drowsiness. “These drugs should be used for the shortest possible time (less than 1 month, note) because they can create long-term addiction and stop withdrawal syndrome “, underlines Professor Leger. “However, in a large number of severe insomniac patients, hypnotics remain the only truly effective option.”