Sleeplessness is defined as either an inability to fall asleep, an inability to stay asleep, or early morning awakening. Research has shown that 40 percent of Americans suffer from intermittent insomnia, and 15 percent have severe or chronic insomnia.

Sleep architecture changes with age. Cycles or stages of sleep become attenuated and different. A decrease in REM (rapid eye movement) sleep with age along with an increase in nocturnal interruptions interfere with restful sleep.

Many people with chronic insomnia have no identifiable underlying disease state. Those with cardiovascular disease, arthritis, and possibly osteoporosis have a greater risk of sleep disorders. Alzheimer's disease often is accompanied with nocturnal restlessness. Hormonal imbalances, such as menopause and PMS, as well as psychological disorders or psychological distress are obvious targets for insomnia.

Sleep apnea is increased among the elderly and also associated with obesity. There is also some evidence to suggest the nation's sleeplessness could be a factor in the cause of obesity. Sleep reduction in children is creating stress responses that have been associated with childhood obesity.

Evidence indicates sleep deprivation leads to changes in the body's overall stress response. Healthy sleep cycles involve hormone secretions, insomnia leads to changes in these secretions. Sleep deprivation causes changes in the hormone processes that regulate gastrointestinal function and appetite.

Sleeping pills that range from benzodiazepine, non-benzodiazepine or short-acting hypnotics, antidepressants, and over-the-counter antihistamine sleep aides all come with their own safety issues. Long-term usage is associated with behavioral changes, eating disorders, nocturnal falls, hip fractures, cardiovascular arrhythmia, bladder problems, nocturnal confusional episodes, and delusional episodes in the elderly.

Regular bedtime routines and sleep hygiene are important, especially in children. Environmental controls can be beneficial, such as, pillows and good mattresses. Healthy nutrition is paramount. Anti-stress and calming herbs can be very helpful. Valerian, chamomile, ashwagandha, passionflower, lemon balm, skullcap, catnip and hops all have real adaptogenic functions in the brain. Magnesium and calcium help with inducing short-term relaxation. Melatonin can be effective, but at lower doses of 2 mg. Higher dosing can increase blood pressure, cause frank depression, fatigue and exacerbate sleep apnea.

Age related hormonal decline plays a pivotal role in many cases of insomnia. Correcting these deficiencies using bio-identical hormones is an important aspect of improving sleeping problems.

Good quality and restful sleep are vital to a healthy life. Nutritional support with a combination of dietary supplementation, hormone balancing and lifestyle changes are the best initial interventions to deal with simple insomnia.

For more information, contact Jan Nelson, MSN, NP-C, ABAAHP, at Balanced Wellness Medical Clinic, (509) 919-4575, jnelson@balancedwellnessmed.com, www.balancedwellnessmed.com.