 | This article needs more reliable medical references for verification or relies too heavily on primary sources .(January 2023) |  |
Sleep induction is the deliberate effort to bring on sleep by various techniques or medicinal means, is practiced to lengthen periods of sleep, increase the effectiveness of sleep, and to reduce or prevent insomnia.
Dim or dark surroundings with a peaceful, quiet sound level are conducive to sleep. [1] Retiring to a bedroom, drawing the curtains to block out daylight and closing the door are common methods of achieving this. When this is not possible, such as on an airplane, other methods may be used, such as masks and earplugs for sleeping which airlines commonly issue to passengers for this purpose.
To relax and encourage sleep, a meditation in the form of guided imagery may be used. The stereotypical method is by counting sheep, imagining sheep jumping over a fence, while counting them. [2]
In most depictions of the activity, the person envisions an endless series of identical white sheep jumping over a fence, while counting the number that do so. The idea, presumably, is to induce boredom while occupying the mind with something simple, repetitive, and rhythmic, all of which are known to help humans sleep. It may also simulate REM sleep, tiring people's eyes.
According to a BBC experiment conducted by researchers at Oxford University, counting sheep is actually an inferior means of inducing sleep. [3]
The daily sleep/wake cycle is linked to the daily body temperature cycle. For this reason, a hot bath which raises the core body temperature has been found to improve the duration and quality of sleep. A 30-minute soak in a bath of 40 degrees Celsius (104 °F) – which raises the core body temperature by one degree – is suitable for this purpose. [4]
A systematic review and meta-analysis of 17 different studies found that taking a warm bath or shower 1–2 hours before bedtime for as little as 10 minutes shortens the sleep onset time and improves sleep efficiency and subjective sleep quality and increases the amount of deep sleep. [5]
Sexual intercourse, and specifically orgasm, may have an effect on the ability to fall asleep for some people. [6] The period after orgasm (known as a refractory period) is often a time of increased relaxation, attributed to the release of the neurohormones oxytocin and prolactin. [7]
Yawning is commonly associated with imminent sleep, but it seems to be a measure to maintain arousal when sleepy and so prevents sleep rather than inducing it. [8] Yawning may be a cue that the body is tired and ready for sleep, but deliberate attempts to yawn may have the opposite effect of sleep induction.
Hypnotics, sometimes referred to as sleeping pills, may be prescribed by a physician, but their long-term efficacy is poor and they have numerous adverse effects including daytime drowsiness, accidents, memory disorders and withdrawal symptoms. [9] If they are to be taken, the preferred choices are benzodiazepines with short-lasting effects such as temazepam or the newer Z-medicines such as zopiclone. [10] Alternatively, in isolated cases sedatives such as barbiturates may be prescribed.
A number of nonprescription medications have shown to be effective in promoting sleep. The amino acid tryptophan and its related compounds 5-HTP and melatonin, have common use, with the prescription medication ramelteon operating on the same biochemical pathway. [11] The herb valerian can also be effective in gently inducing a relaxed state which is conducive to sleep. [ citation needed ]
An urban legend states that certain foods such as turkey and bananas are rich in tryptophan and thus assist sleep, although this has not been confirmed by research.
An alcoholic drink or nightcap is a long-standing folk method which will induce sleep, as alcohol is a sedative. However, when the alcohol blood level subsides, there is a rebound effect: the person becomes more alert and so tends to wake up too soon. Also, if they continue to sleep, REM sleep is promoted, and this may cause vivid nightmares which can reduce the quality of the sleep. [12]
A cup of warm milk or a milk-based drink is traditionally used for sleep induction. [13] Hot chocolate is also a traditional bedtime drink but this contains high levels of xanthines (caffeine and theobromine), which are stimulants and therefore may be counterproductive. Also, a pinch of turmeric powder with warm milk reduces stress and induces sleep.[ verification needed ] [14] The flavor of the milk can be improved by adding honey and/or vanilla. [15]
Hypnotic, or soporific drugs, commonly known as sleeping pills, are a class of psychoactive drugs whose primary function is to induce sleep and to treat insomnia (sleeplessness).
Sleep is a state of reduced mental and physical activity in which consciousness is altered and sensory activity is inhibited to a certain extent. During sleep, there is a decrease in muscle activity, and interactions with the surrounding environment. While sleep differs from wakefulness in terms of the ability to react to stimuli, it still involves active brain patterns, making it more reactive than a coma or disorders of consciousness.
Insomnia, also known as sleeplessness, is a sleep disorder where people have trouble sleeping. They may have difficulty falling asleep, or staying asleep for as long as desired. Insomnia is typically followed by daytime sleepiness, low energy, irritability, and a depressed mood. It may result in an increased risk of accidents of all kinds as well as problems focusing and learning. Insomnia can be short term, lasting for days or weeks, or long term, lasting more than a month. The concept of the word insomnia has two possibilities: insomnia disorder (ID) and insomnia symptoms, and many abstracts of randomized controlled trials and systematic reviews often underreport on which of these two possibilities the word insomnia refers to.
A sedative or tranquilliser is a substance that induces sedation by reducing irritability or excitement. They are CNS depressants and interact with brain activity causing its deceleration. Various kinds of sedatives can be distinguished, but the majority of them affect the neurotransmitter gamma-aminobutyric acid (GABA). In spite of the fact that each sedative acts in its own way, most produce relaxing effects by increasing GABA activity.
Triazolam, sold under the brand name Halcion among others, is a central nervous system (CNS) depressant tranquilizer of the triazolobenzodiazepine (TBZD) class, which are benzodiazepine (BZD) derivatives. It possesses pharmacological properties similar to those of other benzodiazepines, but it is generally only used as a sedative to treat severe insomnia. In addition to the hypnotic properties, triazolam's amnesic, anxiolytic, sedative, anticonvulsant, and muscle relaxant properties are pronounced as well.
Zopiclone, sold under the brand name Imovane among others, is a nonbenzodiazepine used to treat difficulty sleeping. Zopiclone is molecularly distinct from benzodiazepine drugs and is classed as a cyclopyrrolone. However, zopiclone increases the normal transmission of the neurotransmitter gamma-aminobutyric acid (GABA) in the central nervous system, via modulating GABAA receptors similarly to the way benzodiazepine drugs do.
Flurazepam is a drug which is a benzodiazepine derivative. It possesses anxiolytic, anticonvulsant, hypnotic, sedative and skeletal muscle relaxant properties. It produces a metabolite with a long half-life, which may stay in the bloodstream for days. Flurazepam was patented in 1968 and came into medical use the same year. Flurazepam, developed by Roche Pharmaceuticals, was one of the first benzodiazepine hypnotic medications to be marketed.
Sleep hygiene is a behavioral and environmental practice developed in the late 1970s as a method to help people with mild to moderate insomnia. Clinicians assess the sleep hygiene of people with insomnia and other conditions, such as depression, and offer recommendations based on the assessment. Sleep hygiene recommendations include: establishing a regular sleep schedule; using naps with care; not exercising physically or mentally too close to bedtime; limiting worry; limiting exposure to light in the hours before sleep; getting out of bed if sleep does not come; not using bed for anything but sleep and sex; avoiding alcohol as well as nicotine, caffeine, and other stimulants in the hours before bedtime; and having a peaceful, comfortable and dark sleep environment. However, as of 2021, the empirical evidence for the effectiveness of sleep hygiene is "limited and inconclusive" for the general population and for the treatment of insomnia, despite being the oldest treatment for insomnia. A systematic review by the AASM concluded that clinicians should not prescribe sleep hygiene for insomnia due to the evidence of absence of its efficacy and potential delaying of adequate treatment, recommending instead that effective therapies such as CBT-i should be preferred.
Zaleplon, sold under the brand name Sonata among others, is a sedative and hypnotic which is used to treat insomnia. It is a nonbenzodiazepine or Z-drug of the pyrazolopyrimidine class. It was developed by King Pharmaceuticals and approved for medical use in the United States in 1999.
Nonbenzodiazepines, sometimes referred to colloquially as Z-drugs, are a class of psychoactive drugs that are benzodiazepine-like in uses, such as for treating insomnia and anxiety.
Quazepam, sold under brand name Doral among others, is a relatively long-acting benzodiazepine derivative drug developed by the Schering Corporation in the 1970s. Quazepam is used for the treatment of insomnia including sleep induction and sleep maintenance. Quazepam induces impairment of motor function and has relatively selective hypnotic and anticonvulsant properties with considerably less overdose potential than other benzodiazepines. Quazepam is an effective hypnotic which induces and maintains sleep without disruption of the sleep architecture.
Butabarbital is a prescription barbiturate sleep aid and anxiety medication. Butabarbital has a particularly fast onset of effects and short duration of action compared to other barbiturates, which makes it useful for certain applications such as treating severe insomnia, relieving general anxiety and relieving anxiety before surgical procedures; however it is also relatively dangerous particularly when combined with alcohol, and so is now rarely used, although it is still prescribed in some Eastern European and South American countries. Its intermediate duration of action gives butabarbital an abuse potential slightly lower than secobarbital. Butabarbital can be hydrolyzed to Valnoctamide.
Lormetazepam, sold under the brand name Noctamid among others, is a drug which is a short to intermediate acting 3-hydroxy benzodiazepine derivative and temazepam analogue. It possesses hypnotic, anxiolytic, anticonvulsant, sedative, and skeletal muscle relaxant properties.
Chlordiazepoxide, trade name Librium among others, is a sedative and hypnotic medication of the benzodiazepine class; it is used to treat anxiety, insomnia and symptoms of withdrawal from alcohol and other drugs.
Caffeine-induced sleep disorder is a psychiatric disorder that results from overconsumption of the stimulant caffeine. Caffeine is one of the most widely consumed psychoactive drugs: almost 90% of Americans in a survey consume some type of caffeine each day. "When caffeine is consumed immediately before bedtime or .... throughout the day, sleep onset may be delayed, total sleep time reduced, normal stages of sleep altered, and the quality of sleep decreased." Caffeine reduces slow-wave sleep in the early part of the sleep cycle and can reduce rapid eye movement sleep later in the cycle. Caffeine increases episodes of wakefulness, and high doses in the late evening can increase sleep onset latency. In elderly people, there is an association between use of medication containing caffeine and difficulty in falling asleep.
A nightcap is a drink taken shortly before bedtime. For example, a small alcoholic drink or glass of warm milk can supposedly promote a good night's sleep.
Postprandial somnolence is a normal state of drowsiness or lassitude following a meal. Postprandial somnolence has two components: a general state of low energy related to activation of the parasympathetic nervous system in response to mass in the gastrointestinal tract, and a specific state of sleepiness. While there are numerous theories surrounding this behavior, such as decreased blood flow to the brain, neurohormonal modulation of sleep through digestive coupled signaling, or vagal stimulation, very few have been explicitly tested. To date, human studies have loosely examined the behavioral characteristics of postprandial sleep, demonstrating potential shifts in EEG spectra and self-reported sleepiness. To date, the only clear animal models for examining the genetic and neuronal basis for this behavior are the fruit fly, the mouse, and the nematode Caenorhabditis elegans.
Lactation describes the secretion of milk from the mammary glands and the period of time that a mother lactates to feed her young. The process naturally occurs with all sexually mature female mammals, although it may predate mammals. The process of feeding milk in all female creatures is called nursing, and in humans it is also called breastfeeding. Newborn infants often produce some milk from their own breast tissue, known colloquially as witch's milk.
Sexual anhedonia, also known as pleasure dissociative orgasmic disorder, is a condition in which an individual cannot feel pleasure from an orgasm. It is thought to be a variant of hypoactive sexual desire disorder.
Having fun in bed is not only good for a relationship, but also good for you