Insomnia what are the alternatives to sleeping pills

 OUR HEALTH ADVICE - On the occasion of International Sleep Day which takes place this Friday, focus on this problem which affects more than one in ten French people.

Insomnia what are the alternatives to sleeping pills

Whole nights of scrutinizing the ceiling without succeeding in closing the eye, untimely nocturnal awakenings without being able to find Morpheus' arms ... Who has never experienced insomnia at least once in their 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 be able to sleep, a third of these chronic involuntary night owls take sleeping pills. Medicines that, in the long term, are not without risk. What are the alternatives? Le Figaro takes stock.

What is insomnia?

Before treating your insomnia, you still need to be sure you are an insomniac. "Chronic insomnia meets specific criteria," explains Professor Damien Léger, head of the sleep center at the Hôtel-Dieu hospital in Paris. “There are three types of insomnia: insomnia on falling asleep, when the patient takes more than 30 minutes to fall asleep; sleep-maintenance insomnia, when he wakes up for more than 30 minutes several times during the night; and insomnia from early awakening, when he wakes up an hour before the chosen time. " We only talk about insomnia if one or more of these signs have appeared several times a week for more than three months, with an impact on daily life.

A psychic cause is often incriminated without first having searched for an organic origin.

The best way to overcome insomnia is to try to find the cause, which is not always easy. This inability to get to sleep may 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: with body and mind is intimately linked, insomnia caused by chronic pain can, in turn, lead to depression, which in turn increases insomnia. "A psychic cause is often incriminated without first having searched for an organic cause", warns Professor Léger, however. Hence the importance of a precise interview of the person, accompanied by a rigorous clinical examination and, in some cases, a blood test.

If insomnia is the result of an illness, you have to start by managing that illness. In the case of chronic pain, for example, pain medication is often essential to get better sleep.

Whatever the cause, the treatment of insomnia starts with common-sense measures. Go to bed and get up at regular times; avoid the consumption of coffee, alcohol, and tobacco before going to bed; regulate the temperature of his room; do not use a screen for 30 minutes before falling asleep; do not overeat at night; 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 therapies (CBT), practiced by psychologists and specialized 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 department, CBT sessions take place over 5 sessions of 2 hours with groups of 8 to 10 people,” explains Professor Léger. "Thanks to a daily sleep diary, the patient identifies the bad habits and thoughts that promote his insomnia and then learns to change them. It de-dramatizes his disorder and thus reduces the anxiety that disturbs his sleep. " However, there are still too few units like the one at the Hôtel-Dieu and only around a hundred sleep CBT specialists (doctors and psychologists) practice throughout the country.

Relaxation methods such as sophrology, based on breathing exercises, also help improve the quality of sleep.

Other therapies exist, but scientific data shows that their effectiveness is more modest. This is particularly the case with hypnosis, which has its place only when insomnia is due to a well-identified traumatic event, as well as light therapy (daily exposure to an ultraviolet ray lamp which reproduces the effects of the sun for a few minutes), which is only useful if there is a shift in sleep-wake rhythm.

As for melatonin, the sleep hormone, it is only recommended for the elderly with a proven deficit demonstrated by a blood test. Finally, herbal teas from plants such as valerian, linden, or passionflower have not shown scientifically validated efficacy, but they can be beneficial by promoting a moment of relaxation before bed.

The last resort solution is to take hypnotic drugs, sleeping pills, which induce an artificial state of drowsiness. "These drugs should be used for the shortest time possible (less than 1 month, Editor's note) because they can create long-term addiction as well as a withdrawal syndrome on stopping", underlines Professor Léger. "However, in a large number of severe insomniac patients, hypnotics remain the only truly effective option."

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