How to Treat Insomnia if a History of Drug Addiction Is Present
Insomnia is a common sleep disorder that refers to the inability to fall asleep or stay asleep even when presented with the opportunity to do so, as defined by the National Sleep Foundation (NSF). Whether experiencing insomnia for a few days or a few months, you often wake up feeling fatigued and unable to recover from each day.
Types of Insomnia
The two main types of insomnia are acute (short-term) insomnia and chronic (long-term) insomnia. Acute insomnia is the most common type of insomnia and often caused by a specific life event, such as a test at school or work that causes anxiety or stress that makes you unable to sleep. Acute insomnia tends to pass on its own and does not require treatment.
Chronic insomnia, however, may require treatment to allow regular sleep patterns to resume. Insomnia qualifies as chronic if it occurs at least three nights a week for at least three months in a row. Causes of chronic insomnia can be poor sleep environment and sleep habits, new medications, mental health problems, or medical issues.
NSF reports that approximately 30 percent of the US population reports some form of sleep disruption. Ten percent of adults across the country report sleep problems that meet the diagnostic criteria for insomnia. One report from the National Institute of Neurological Disorders and Stroke (NINDS) found that almost 60 million Americans experience insomnia each year and wake up feeling unrefreshed.
Symptoms of insomnia include:
- Lying awake, unable to fall asleep at night
- Being awake for most of the night
- Only being able to sleep for short periods of time
- Waking up too early
- Waking up feeing unrefreshed as if you never slept
Short-Term and Long-term Effects
NSF explains that short-term effects of insomnia can include fatigue, loss of energy, poor concentration, changes in mood, stress, and irritability. In the short-term, these symptoms may be manageable, but they can quickly increase in severity if the causes of insomnia are not addressed properly.
Long-term effects of insomnia put individuals at higher risk for serious medical conditions as well as mental health issues. Type 2 diabetes, stroke, asthma, seizures, decreased immune system, increased sensitivity to pain, inflammation, obesity, high blood pressure, and heart disease have all been linked to chronic insomnia. Anxiety, depression, confusion, and frustration have also been seen in patients who suffer from insomnia for an extended period of time.
In addition to the above medical and mental health conditions, overall performance suffers with chronic insomnia. Performance at work and school, sex drive, memory, and judgment are all impacted when the body and mind do not receive enough sleep and recovery time. Daytime sleepiness is also of great concern, as the risk for accidents increases.
Medication, therapy, and lifestyle changes are all modes of treatment for insomnia. Medication can be used for the short-term in order to force a better sleep pattern. Sleeping medications can cause dependency, however, without adding a significant amount of quality sleep. Studies have shown that sleeping pills only add around 8–20 minutes of extra sleep to the average night. People still take a long time to fall asleep at night and wake up early in the morning even when taking pharmaceutical sleep aids.
Side effects of prescription sleep aids include:
- Unsettled feelings
- Chronic insomnia
- Memory loss
- Allergic reactions
- Pill dependency
Specific medicines that have been developed to treat insomnia include sedative-hypnotics, benzodiazepines, nonbenzodiazepines, antidepressants, antihistamines, and melatonin. Sedative-hypnotics cause users to feel sleepy, so they are most helpful for those who are struggling to fall asleep.
Benzodiazepines help to reduce anxiety, relax muscles, and induce sleep. They are habit-forming and dangerous to use with other drugs and alcohol, so they are only meant for short-term use.
Nonbenzodiazepines also induce sleep, but they have fewer side effects than benzodiazepines, so they are safer to use for slightly longer periods of time. They are shorter acting and less likely to cause residual sleepiness than benzodiazepines.
For people whose insomnia makes it difficult to stay asleep, low doses of antidepressants may be helpful. Few antidepressants have been approved for the treatment of insomnia, however, and they are most effective for people who also have depression. Additionally, antidepressants can cause sleepiness during the day.
CBT can be used to treat the causes of insomnia while the individual is taking sleeping medication, if necessary.
Some people have also found that antihistamines are useful for helping them sleep, as they often produce drowsiness as a side effect. Little clinical research supports this claim as a treatment for insomnia.
Individual therapy, such as Cognitive Behavioral Therapy (CBT), has been proven useful in treating underlying symptoms of anxiety and stress than could be causing insomnia. The American Academy of Sleep Medicine and the American College of Physicians recommend using CBT first to treat insomnia rather than going straight to medication. Another benefit of CBT is that it can be used much longer than medication can, and it has been shown to have longer lasting impacts on sleep than medication has.
On their own or in conjunction with medication and therapy, healthcare providers will often recommend lifestyle changes that can promote better sleep. Creating a dark and quiet sleeping environment, eliminating caffeine in the afternoon, limiting substance use, getting regular exercise, eating a well-balanced diet, and reducing stress are all examples of lifestyle changes that can lead to improved sleep.
Treatment with a History of Drug Addiction
If you have a history of drug addiction, treating insomnia with medication may not be the safest choice, as prescription drug abuse is a concern. Prescription sleep aids can be habit-forming, so the risk of misuse is possible. Both physical and psychological dependence have developed in individuals following prescription sleep aid use.
Instead, your healthcare provide may recommend focusing on therapy and/or lifestyle changes to improve your sleep patterns. Many complementary health approaches, such as mind and body practices, herbs, and dietary supplements, have been identified by the National Center for Complementary and Integrative Health (NCCIH) as useful for treating insomnia.
- Mind and body practices identified by NCCIH include relaxation techniques, mindfulness-based stress reduction, yoga, hypnotherapy, massage therapy, and acupuncture.
- Dietary supplements that include melatonin and/or L-tryptophan have been shown to help people fall asleep faster, sleep longer, and sleep better.
- Herbs, such as chamomile, kava, valerian, lemon balm, and passionflower, are said to have sedative properties that encourage sleep, though little clinical research has been done to support these claims.
Like all medications, even these complementary approaches to treating insomnia can have side effects. Natural dietary supplements and herbs can interact with traditional medications, so it is important to talk to your healthcare provider before trying any new supplements. For people with a history of misusing drugs, these alternative treatments for insomnia may be a safe and effective solution.
Insomnia is a difficult condition that can impact many aspects of daily life. While it can be tempting to want to target the insomnia itself right away, treatment of the underlying causes of your poor sleep will make a greater and longer lasting impact on your sleep problems. Pharmaceutical medications offer a temporary and slight improvement on symptoms of insomnia, but behavioral therapy and lifestyle changes are much more likely to create a lasting impact on positive sleep patterns.