For three weeks we have all been awake to the sound of red alert warnings and mental stress. The cumulative lack of sleep hours causes not only fatigue, but a significant impairment in quality of life, functional ability and increased risk of accidents. Insomnia, or sleep disturbance, is one of the most common disorders in the Western world, with a noticeable impact on both physical and mental health. While sleep medications are available and help in the short term, many of them may cause side effects and lead to dependence. Therefore, in the past decade there has been growing interest in non-pharmacological treatments based on research, which offer more effective and safer solutions for treating insomnia.
Sleep hygiene
If you also suffer from insomnia, like tens of thousands of Israelis, especially in the current period of high stress and countless alerts and sirens, the first step is to maintain sleep hygiene: A set of habits and behaviors that alone can bring a dramatic improvement in sleep quality. Among the recommendations: Maintaining a dark, quiet and ventilated room; avoiding screens about two hours before bedtime; avoiding caffeine and alcohol in the evening hours; avoiding noise (you can also use earplugs if you have no control over the noise source) and maintaining a consistent sleep routine – that is, going to sleep and waking up at fixed times every day. It is also important to avoid physical activity in the evening hours, to move the clock away from the bed to prevent anxiety סביב the time, and to prefer calm reading or quiet music before sleep.
Cognitive behavioral therapy
The most recommended treatment today by experts for chronic insomnia is CBT - A structured treatment designed to break the cycle of anxiety and behaviors that perpetuate sleep disturbances. Studies have shown that about 70% of patients experience a significant improvement in their sleep problem, and the major advantage is that the results are maintained over time. The treatment is provided individually, in groups or even digitally, and allows people to learn tools for changing habits and negative thoughts related to sleep. Some HMOs allow this treatment to be carried out via telemedicine, remotely.
Relaxation techniques
Relaxation techniques have also been found in reports in the literature to be effective: Breathing exercises, progressive muscle relaxation, meditation and guided imagery – all of these help reduce stress and anxiety, two main factors in insomnia. Techniques such as 4-7-8 breathing, abdominal breathing and muscle relaxation by groups can release the body from the pressure accumulated during the day and prepare it for restful sleep.
Acupuncture
Chinese acupuncture continues to gain popularity as a natural solution for insomnia, with studies showing improvement in measures such as sleep quality and duration. The assumption is that acupuncture affects the secretion of melatonin and other hormones that regulate the sleep cycle. However, it is important to remember that the studies are still not conclusive, and one should consult a certified practitioner and ensure that the treatment is personalized. Make sure, of course, that the practitioner receives patients near a protected space and close to your place of residence.
Light therapy (phototherapy)
For those who suffer from disruptions in the biological clock rhythm – for example, people who have difficulty falling asleep early or wake up too early – light therapy can be an excellent solution. Through daily exposure to light at an intensity of 10,000 lux in the morning, it is possible to reset the biological clock and help improve sleep. There are also devices that simulate sunrise, gradually illuminating the room and helping a more natural and pleasant awakening.
Melatonin: A temporary aid
Melatonin is a natural hormone that regulates the sleep cycle, and is available in supplements mainly intended for problems related to disruptions in the biological clock, such as jet lag or shift work. In Israel, melatonin is not sold without a doctor’s prescription, but it can be obtained on websites such as iHERB in various dosages: 1 mg for children, 3 mg for teenagers and young adults, 5 mg for adults, and up to 10 mg for more complex situations. However, it is important to emphasize that the use of melatonin should be temporary only for several days until the sleep cycle is regulated, because prolonged use may lead to habituation and impairment in the body’s natural ability to produce the hormone.
Natural remedies and herbal tea
In recent years there has been a growing turn to natural remedies and herbal teas as means of relaxation and improving sleep quality. Chamomile tea is considered one of the most popular beverages in this context, thanks to an active component called apigenin, which binds to GABA receptors in the brain and induces a sense of calm and relaxation. In addition to chamomile, other herbal infusions can be found that contain valerian, passionflower, lemon balm, lavender and hops root – all with calming properties known in traditional medicine and in some cases also supported by research. A combination of several components in a dedicated sleep tea may enhance the feeling of relaxation and encourage easier falling asleep. However, it is important to note that the effectiveness of natural remedies varies from person to person, and sometimes they may mainly have an effect in the psychological aspect of creating a calm evening routine. In addition, in cases of prolonged use or alongside other medication, it is recommended to consult a doctor or certified practitioner to ensure there are no interactions or possible side effects.
If it does not help
In a case where there is no significant improvement in sleep quality after several weeks of adhering to non-pharmacological treatments, you can consult your physician for further evaluation and consideration of temporary medicinal assistance. However, it should be emphasized that all sleep medications cause habituation, and therefore if you have started treatment, it is important to do so under supervision, at the lowest possible dosage, and if possible not every day and not for a long period.
Chronic insomnia that is not treated may lead to serious consequences: Sleep deprivation increases the risk of road accidents and work accidents, impairs daily functioning, triggers feelings of irritability and stress, and may worsen and even cause the onset of depression and anxiety disorders. Adequate sleep is essential for physical and mental health, and therefore prolonged sleep disturbances should not be taken lightly. A doctor may prescribe sleep-inducing medications such as Zodorm, Stilnox, Nocturno or Orexin, but again it should be emphasized that these medications are intended for short-term use only due to a high potential for habituation. In addition, they may cause daytime fatigue and may even pose a risk of impairment to cognitive function and memory in the long term, and therefore their use must be especially controlled and cautious.