The best ways to Rx Insomnia - spoiler, they are drug free! | Boosting your brainpower with 24 Hacks

 Given that we mostly treat pain or provide prevention programs to minimise pain, we must understand how sleep and pain influence each other. The next step is understanding if we can influence insomnia (poor sleep quality and quantity). Many medical interventions flow fast towards a medication model, so it is great news for us when a first-line treatment for something we see isn't medication.

Cognitive behavioural therapy for insomnia: A meta-analysis of long-term effects in controlled studies DOI: 10.1016/j.smrv.2019.08.002

The meta-analysis by van der Zweerde et al. (2019) investigates the long-term effects of cognitive behavioural therapy for insomnia (CBT-I) through data from 30 randomised controlled trials (RCTs). CBT-I was compared to non-active control groups, assessing its efficacy at 3, 6, and 12 months post-treatment. Results show significant improvements in insomnia severity, sleep onset latency, and sleep efficiency, with moderate to large effects at three months and smaller but still clinically meaningful effects at 12 months (Hedges' g). Despite declining effect sizes over time, CBT-I demonstrated sustained benefits, supporting its use as a durable treatment option for insomnia.

Insomnia affects approximately 6% of the population as a clinical disorder and up to 30% with symptoms impacting daily functioning and quality of life. While pharmacotherapy provides short-term relief, CBT-I is preferred due to its comparable effectiveness without the risks of side effects, dependency, or relapse associated with medication. This meta-analysis fills a research gap by synthesising evidence on the long-term outcomes of CBT-I. The findings affirm its role as the first-line treatment for insomnia, emphasizing its ability to improve sleep-related outcomes up to a year after therapy completion.

The effect of physical exercise interventions on insomnia: A systematic review and meta-analysis DOI: 10.1016/j.smrv.2024.101948

The systematic review and meta-analysis by Riedel et al. (2024) examine the effects of exercise interventions on insomnia symptoms, incorporating data from 19 randomised controlled trials with 1,233 participants. The review evaluated subjective and objective sleep parameters, including sleep quality, total sleep time, and sleep efficiency, comparing exercise interventions to inactive control groups. Results revealed significant improvements in subjective sleep outcomes (SMD = 0.90) and objective sleep efficiency (SMD = 0.66), with moderate heterogeneity observed across studies. Higher exercise intensity, older participant age (these two factors can be contradictory in my experience), and a higher proportion of female participants were associated with stronger effects.

The findings suggest that exercise can be an effective and accessible treatment option for insomnia, offering benefits beyond those provided by traditional treatments like cognitive behavioural therapy for insomnia (CBT-I). While the study highlights the potential of exercise interventions, limitations such as heterogeneity, moderate risk of bias, and a lack of long-term follow-up data warrant further research. Future studies should focus on standardised protocols, explore the combination of exercise with CBT-I, and evaluate long-term efficacy to strengthen treatment recommendations.

Boost Your Brainpower: 24 Daily Sleep Hacks for Active Lifestyles DOI: 10.3390/app14156701

This 2024 literature review "Boost Your Brainpower: 24 Daily Sleep Hacks for Active Lifestyles" provides a comprehensive guide to optimising sleep quality for physically active individuals. It covers most sleep hygiene topics and references our scoping review paper on sleep posture and pain. The review is divided into three phases: pre-sleep, during sleep and post-sleep.

The pre-sleep phase emphasises practices like maintaining consistent sleep schedules, minimising blue light exposure, and incorporating relaxation techniques such as mindfulness and slow breathing. Proper dietary habits and limiting intense exercise before bedtime are key strategies. Additionally, creating a dark, quiet sleep environment and using aids like eye masks or earplugs can reduce disturbances. These approaches aim to align sleep patterns with natural circadian rhythms, promoting better rest and recovery.

During sleep, it is recommended to maintain optimal room temperature, choose ergonomic mattresses and pillows, and reduce electromagnetic exposure. Nighttime interruptions should also be minimized by regulating food and fluid intake earlier.

In the post-sleep phase, exposure to natural light upon waking (i.e.,10-15 minutes of direct sunlight) and regular daytime exercise are crucial for resetting the body's internal clock and boosting overall energy levels. Avoiding prolonged daytime naps and managing caffeine intake further support quality nighttime sleep. These hacks provide a structured framework to enhance sleep and overall health.

Here's to a nation of better sleepers - with our assistance as needed,