Insomnia (sleeplessness) is a common sleep disorder in which a person experiences difficulty falling asleep, difficulty staying asleep or wakes up too early. Insomnia can lead to long periods of wakefulness and difficulty initiating sleep. It can also cause a person to wake up early, and not be able to fall back asleep or maintain sleep. Tossing, turning in bed and restlessness are common signs of insomnia. Homeopathic medicine for insomnia works by treating the underlying physical and psychological conditions that may be causing the disorder. The top homeopathic medicines recommended for insomnia include Kali Phos, Coffea Cruda and Ignatia Amara.
Every person tends to experience sleeplessness occasionally, and usually, it gets resolved on its own with a good night’s sleep. Diagnosis of insomnia is made when a person faces difficulty sleeping for three nights in the span of a week for a minimum of three months, and it is causing significant distress in everyday life.
What Happens if a Person Doesn’t Get Enough Sleep?
Not getting enough sleep can lead to the following effects:
– waking up unrefreshed, tired in the morning
– feeling sleepy in the daytime
– feeling weak, tired, fatigue during daytime
– remaining irritable during the day
– having low mood
– depressed feeling
– mood swings
– having difficulty concentrating during daytime
– reduced alertness
– poor performance at job or school
– high risk of accidents
– chronic insomnia may lead to weight gain. It does so by affecting the way our bodies process and store carbohydrates
– Chronic insomnia is a risk factor to develop type 2 diabetes mellitus, hypertension, heart disease and stroke
Homeopathic Remedies for Sleeplessness
Conventional treatment for insomnia employs the use of sleeping pills or ‘sedative hypnotics’ to induce or maintain sleep. The different types of sleeping pills include specific hypnotics, benzodiazepines, and barbiturates.
Common benzodiazepines like Valium, Xanax, Librium, and Ativan increase drowsiness, thereby enabling sleep. Most of these drugs are potentially addictive and are known to cause memory and attention problems. In most cases, they are not recommended for long-term treatment of sleeping problems.
Some new drugs are now replacing benzodiazepines, which are not as habit-forming, but still can cause physical dependencies.
Some common side effects of sleeping pills are:
– changes in appetite
– drowsiness during daytime
– dry mouth/throat
– tingling sensation in limbs
– difficulty maintaining balance
– memory and attention problems
– stomach-related issues
Another serious, potential side effect of sleeping pills is parasomnia. Parasomnias are involuntary behaviors and movements like sleepwalking, over which an individual has no control. During an attack of parasomnia, the person is asleep and unaware. Sleeping pills are usually prescribed on a short-term basis since they tend to stop working once the body builds a tolerance to the drugs with time.
Homeopathic Medicines for Insomnia have No Side-Effects
Homeopathic medicines for insomnia have no side effects since they are made of natural substances. They work at a psychosomatic level to treat the root cause of insomnia. Kali Phos, for example, is a highly effective homeopathic medicine for insomnia that occurs due to stress.
Homeopathic Remedies are Natural
As an ancient 200-year-old medical science, homeopathic remedies are derived from nature to help restore the natural healing processes of the body. While conventional medicines affect the chemical or hormonal levels in the body, homeopathic medicines work in harmony with the body to naturally restore the sleep cycle.
Homeopathy and its Holistic Approach to Treat Insomnia
Homeopathy treats the problem internally, by understanding the cause of different symptoms instead of suppressing them. Often, Insomnia is the result of an underlying problem, and homeopathy works cohesively to treat the psychological and physical symptoms that may be causing the disorder.
Homeopathy offers Individual Treatment
Homeopathy works by analyzing the possible individual causes of insomnia in a person. Every person is treated according to the particular symptoms. Insomnia can be of different kinds; while some people find it difficult to fall asleep, others may find it difficult to stay asleep. These distinctions are important, and homeopathy treats these unique problems.
Homeopathic Medicines are Safe
Homeopathic remedies for insomnia do not cause any psychological or physical dependency. Once the problem has been resolved, one can gradually stop the medication, or take it intermittently (if required). Homeopathy also works especially well for chronic sleep issues and can help resolve the problem for good.
Top Homeopathic Medicines for Insomnia
Kali Phos – Homeopathic Medicine for Insomnia due to Stress/Worries
Kali Phos is a very useful homeopathic medicine for insomnia. Insomnia from stress and worries, sleeplessness (mainly during the latter part of the night), excessive yawning, a sad, gloomy disposition, extreme fatigue both on mental and physical level and sudden waking from sleep in children due to night terrors are the common symptoms that indicate the need for a dosage of Kali Phos for insomnia.
Key indications for using Kali Phos for Insomnia:
– Insomnia from stress/worries
– Sleeplessness during the latter part of the night
– Night terrors in children causing disturbed sleep
Coffea Cruda – Homeopathic Medicine for Insomnia due to Constant Thoughts
Coffea Cruda is a beneficial homeopathic medicine for insomnia arising from constant thoughts in mind. During bedtime, many ideas crowd the mind. The person remains restless at night and experiences sleeplessness, tossing from side to side. Palpitations and nervousness may attend. This medicine is also helpful in children who are playful at night and are sleepless. Coffea Cruda is also well indicated for early waking from sleep (usually around 3:00 am) with difficulty in falling asleep again. Insomnia during the phase of convalescence (i.e., during recovery from some illness) is also treated with Coffea Cruda. This remedy also offers help in cases of disturbed sleep from excessive dreams.
Key indications for using Coffea Cruda for Insomnia:
– insomnia from constant thoughts in mind
– early waking from sleep with difficulty to fall asleep again
– disturbed sleep from excessive dreams
Ignatia Amara – Homeopathic Medicine for Insomnia from Grief, Depression
Ignatia Amara is a homeopathic medicine for insomnia arising from grief and depression. The person needing Ignatia Amara is depressed and full of cares and worries. He/She may get entirely absorbed in profound grief that leads to sleeplessness. Other attending features are a desire to be alone, tearfulness, and sadness with deep sighs. The person keeps thinking about the sad occurrences in the past. Excessive brooding, moaning, and an indifferent behavior to everything may also be present.
Key indications for using Ignatia Amara for Insomnia:
– insomnia from grief, depression
– Cares and worries
– Sadness, weeping, brooding
Other Important Homeopathic Medicines for Insomnia
Pulsatilla Nigricans – Homeopathic Medicine for Insomnia during First Half of Night
Homeopathic medicine Pulsatilla Nigricans is prepared from the plant named ‘windflower’ of the natural order Ranunculaceae.
Pulsatilla Nigricans is a homeopathic medicine for insomnia appearing during the first half of night. The person stays awake and restless during the first half of the night. A fixed thought keeps revolving in the mind that prevents sleeping. An extreme restlessness is present along with sleeplessness. The person eventually falls asleep during the late hours (towards dawn). The person wakes up feeling tired and may experience excessive yawning and sleepiness during the daytime.
Nux Vomica – Homeopathic Medicine for Insomnia during Latter Half of Night
Nux Vomica is a valuable homeopathic medicine for insomnia when sleeplessness occurs during the second half of the night. A person requiring Nux Vomica have no trouble falling asleep, but wakes up around 3:00 am – 4:00 am after which sleep becomes difficult. During daytime, intense drowsiness, tiredness and weakness appear. Nux Vomica also works in cases where sleep is not sound, and the person often wakes from sleep. It also treats sleeplessness linked with an excessive intake of coffee or alcoholic stimulants or tobacco. Sleeplessness due to gastric troubles is also an indication for using homeopathic medicine Nux Vomica.
Arsenic Album – Homeopathic Medicine for Insomnia Linked with Anxiety
Arsenic Album is a useful homeopathic medicine for insomnia linked with anxiety. There is anxiety about issues like health, future and or the family’s well being. The anxiety is mostly worse after the midnight. Along with anxiety, an extreme restlessness may be present. The person continually tosses and turns in the bed at night. The restlessness also prevails during daytime with continual movement from one place to another, with a feeling of weariness of the eyes.
Chamomilla Vulgaris – Homeopathic Medicine for Disturbed Sleep from Frightful Dreams
Chamomilla Vulgaris is a natural homeopathic medicine prepared from the plant ‘German Chamomile.’ It belongs to the plant family Composite. Chamomilla Vulgaris is an important homeopathic medicine for disturbed sleep resulting from frightful dreams. The person wakes suddenly with a start; and be weeping or fearful. These episodes occur several times at night resulting in disturbed sleep. The person is sleepless till about 2:00 am. Sleeplessness from illusions of sight and hearing is another indication for using homeopathic medicine Chamomilla Vulgaris. The person may be highly irritable and sleepy during the day.
Opium – Homeopathic Medicine for Insomnia where Person is Sleepy but Unable to Sleep
Opium is a homeopathic medicine for insomnia where a person feels sleepy but is unable to sleep. He/She may remain awake for long, there is restless at night with constant tossing and tumbling in bed. The person may have acuteness of hearing, and small noises may disturb the person and cause sleeplessness.
Calcarea Carb – Homeopathic Medicine for Sleeplessness at Night with Daytime Drowsiness
Calcarea Carb is another excellent homeopathic medicine for the treatment of insomnia. The individual requiring Calcarea Carb is sleepless at night and very drowsy during the daytime. He/She may sleep for a short duration, and experience sleeplessness post 2 am. At night, a heated sensation, agitation and pulsating in the head appears due to insomnia. The person often feels exhausted in the morning with a desire to sleep, and the head may feel heavy.
Robinia – Homeopathic Medicine for Insomnia due to GERD
Homeopathic medicine Robinia is prepared from the plant known as ‘yellow locust.’ The natural order of this plant is Leguminosae. A person needing Robinia suffers from GERD and experiences worsening of symptoms at night, which disturbs sleep. Symptoms like heartburn and sour belchings become worse at night, disturbing the sleep. Homeopathic medicine Robinia treats GERD and its acid reflux symptoms, and this usually resolves the problem of disturbed sleep.
Rhus Tox – Homeopathic Medicine for Disturbed Sleep from Chronic Pain
Rhus Tox is a useful homeopathic medicine to treat disturbed sleep that results from chronic pain. The person needing Rhus Tox suffers from chronic pain in the joints or back (mostly during rest time). Worsening of pain during rest interferes with sleep, and the person keeps on tossing in bed with restlessness from pain.
Zincum Met – Homeopathic Medicine for Insomnia due to Restless Leg Syndrome
Zincum Met is homeopathic medicine for restless legs syndrome that leads to troubled sleep. The person needing this medicine experiences restlessness of the feet or lower limbs. They keep on moving them constantly, and this uneasiness is worse at night. The lower limbs also feel heavy. In some cases drawing pain and cramping in legs arises. Formication (sensation like insects crawling over the skin) of feet at night may also attend.
Passiflora Incarnata – Homeopathic Medicine for Insomnia in Elderly People
Passiflora Incarnata is a prominently indicated homeopathic medicine for treating insomnia in older persons. This medicine is prepared from a plant named ‘passion flower’ belonging to natural order Passifloraceae. The person needing Passiflora Incarnata remains wakeful and restless at night. Mental worries may also be present with insomnia. This medicine is also indicated for insomnia in infants.
Cina – Homeopathic Medicine for Insomnia in Children
Cina is a homeopathic medicine prepared from a plant named ‘Artemisia maritime’ belonging to family Composite. Cina works well to treat insomnia in children. Its use is considered when the child cannot sleep and tends to scream and kick off bedclothes. The child is cranky, irritable and restless. Cina is also indicated in children who sleep for a very short time, or in cases where a child experiences night terrors and wakes up screaming and frightened.
The Causes and Triggers of Insomnia
Insomnia is usually the symptom of an underlying health condition or an erratic, unhealthy lifestyle. A person’s lifestyle habits have a direct impact on the sleep patterns and overall health. Unhealthy lifestyle practices usually trigger insomnia and making amendments usually helps resolve the problem fairly quickly.
Some common triggers relate to lifestyle habits that can cause insomnia include:
Poor Sleep Habits
– People who work at home in the evenings often find it difficult to unwind and relax before bedtime. This can cause increased brain activity and stress, apart from affecting the working of the sleep hormones. The mind becomes preoccupied with the details of work when it is time to sleep.
– Afternoon naps can also disrupt night sleep by confusing the body’s internal clock. While some people feel refreshed after a quick afternoon nap, others may find it difficult to sleep at night if they have a nap in the afternoon.
Small, Constant Stress Triggers
While major stressful events naturally can cause insomnia, modern lifestyle has small, but constant stress triggers that can become a chronic problem. In case of a perceived threat, the stress response in the body gets triggered and leads to a chain of physical reactions like shallow breathing and the release of chemicals like cortisol and adrenaline for energy. The triggering of this response to everyday stressors like relationship conflicts, traffic, and commute, being on time, etc. leads to chronic stress, especially if it is not resolved through relaxation.
Blue Light from Screens
– Using laptops and mobile phones right before bedtime has been scientifically proven to cause sleep problems. The blue light emitted from these gadgets makes the brain more alert and disturbs the functioning of sleep hormones like melatonin.
Working in Irregular Shifts
– People who work in shifts with irregular hours often find it difficult to fall asleep at all. Periodically changing schedules, late night shifts and irregular sleeping hours disturbs the body’s natural rhythm and can lead to insomnia.
Noise and Environmental Disturbances
– People living in the city or near places where there is noise pollution find it difficult to fall asleep or stay asleep. Loud noises from the television or other activities, bad odors in the air from garbage dumps or industrial plants in the vicinity can also disturb sleep.
Medications for Other Health Issues
– Certain medicines that are used to treat a variety of health issues can contribute to insomnia. These include:
– Anti-arrhythmics for heart problems
– Beta blockers for angina and high blood pressure
– Corticosteroids for asthma and inflammation
– Medications containing coffee
– Medications for cold, flu and cough that contain alcohol
– serotonin reuptake inhibitors (SSRIs) for anxiety and depression
– Substances to replace nicotine
The Effect of Smoking on Sleep
– Smoking affects sleep quality in a variety of ways. The main ingredient in tobacco is nicotine, which is both a drug and a stimulant. Consumed too close to bedtime in high quantities, it can affect the sleep physiology. Smokers also tend to experience disruptive sleep, and may not be getting the adequate hours of deep, restorative sleep.
Obstructive sleep apnea is another condition experienced by smokers, caused by smoke that irritates the nose and throat tissues and causes swelling that can restrict air flow.
Stimulating Effects of Caffeine
– Caffeine is a stimulant and temporarily increases alertness by increasing the production of adrenaline. This interferes with the production and action of sleep-inducing chemicals. Further, caffeine is absorbed by the system within 15 minutes, and its effects can last for over 6 hours.
Insomnia usually starts as an occasional problem, but gradually becomes a long-term problem if it is not addressed. People tend to adopt unhealthy sleeping habits after a few sleepless nights, by working late, drinking alcohol to fall asleep or resorting to sleeping pills.
Medical Conditions that can lead to Insomnia and Disturbed Sleep
Hyperthyroidism (or a hyperactive thyroid) can lead to insomnia. This disorder tends to over-stimulate the nervous system, making it difficult to fall asleep. An overactive thyroid can also cause a person to wake up frequently during the night.
GERD (Gastroesophageal reflux disease) / Acid Reflux
GERD (Gastroesophageal reflux disease) refers to a condition that causes heartburn (burning behind the sternum), chest pain, sour belching/vomiting due to reflux of stomach acid from a weak lower esophageal sphincter (LES).
This condition usually gets worse at night because upon laying down, it is easier for the stomach acid to rise in the food pipe and resist gravity. Additionally, stomach acid is highly concentrated at night as compared to daytime.
Acid reflux tends to get worse at night, and its symptoms can lead to disturbed sleep. These symptoms include:
1. waking up from sleep due to heartburn or chest pain
2. sleep apnea (that is common with GERD). Sleep apnea refers to repeated momentary stoppage of breathing during sleep that leads to frequent waking at night.
3. a coughing episode or choked sensation if the stomach acid finds a way to the larynx.
Restless legs syndrome (RLS)
Restless Leg Syndrome is a condition in which a person has an irresistible urge to move the legs to relieve the discomforting sensation felt in the legs. In a recent study, it was found that the neurotransmitter glutamate is found to be high in people having RLS. This hormone is linked with arousal.
People with sleep apnea are also at risk of disturbed sleep and insomnia. Sleep apnea is the conditions where a person experiences momentary pauses in breathing. It leads to a drop in oxygen levels. These factors cause a person to wake up briefly many times throughout the night causing disturbed sleep.
Chronic Pain due to Other Conditions
People dealing with chronic pain due to conditions like arthritis, backache, fibromyalgia also tend to suffer from insomnia or disturbed sleep.
Other conditions that can lead to insomnia include asthma, heart disease, Alzheimer’s disease and Parkinson’s disease.
The mental health disorders related to insomnia include depression, PTSD (post-traumatic stress disorder), and anxiety disorders.
Why Do We Need Sleep?
A good night’s sleep is equally important for maintaining overall health as is eating well. Sleep is required to give rest to the body and prepare it to work the next day. During sleep, our brain processes and stores information gathered throughout the day. Sleep is also needed to help in muscle growth, tissue repair, regulation of metabolism and replenishment of energy.
In addition to this release of certain hormones is at peak during sleep like growth hormone ( that spurs growth in children and adolescents). Proper rest helps in improving memory, improves concentration, sharpens attention, lowers stress, and improves immune function. Sleep helps keep the heart and blood vessels healthy.
The Phases of Sleep
Sleep is a relaxed state of mind and body, with reduced awareness, reduced perception of environmental stimuli and reduced responsiveness.
There are two phases of sleep:
1. Non – REM (Non – rapid eye movement) /slow wave sleep
2. REM (rapid eye movement sleep)
Non-REM (Rapid Eye Movement) Sleep
The first phase is non-REM sleep, which is followed by the phase of REM sleep. This cycle gets repeated about 4 to 6 times a night, depending on the duration of sleep.
Non-REM sleep is divided into three stages (of 5 to 15 minutes):
Stage 1 – During this stage the eyes get drowsy, but the person can be easily awakened.
Stage 2 – It is a light stage of sleep, where the heart rate slows, and body temperature falls.
Stage 3 – This is the stage of deep sleep, and it is difficult to wake a person up from this phase.
REM (Rapid Eye Movement) Sleep
This phase arises approx one and a half hour after a person falls asleep. During this phase, rapid movement of the eye in different directions occurs, and the heart rate and breathing quicken. A person tends to dream in this phase, and there is high brain activity.
Body’s Natural Circadian Rhythm
Physiological changes that occur on roughly a 24-hour cycle in the body are together referred to as the circadian rhythm or body clock. It is this clock that tells our bodies when to sleep, rise, eat food and more. A part of the hypothalamus controls the circadian rhythm. Factors like light, darkness, and temperature can also affect it.
When it’s dark at night, a signal is sent to the brain to release the hormone melatonin, which induces sleep. Circadian rhythm works best when a person has a regular sleep pattern. Disruption in the circadian rhythm leads to irregularity in the sleeping pattern. For example, people who work during night shifts often have sleeping troubles due to a disrupted circadian rhythm.
Melatonin and Sleeplessness
The pineal gland produces the hormone Melatonin in the body which regulates sleep and wakefulness. This gland is inactive during the daytime. When it grows dark, the pineal gland activates and starts producing melatonin to release it in the blood. Following its release, a person begins to feel less alert and sleepy. Detection of light and dark by the retina of eyes influences the production of melatonin.
When the retina detects light, the melatonin production is stopped.
When the retina detects darkness, melatonin production is stimulated. Melatonin production during the night promotes sleep.
Serotonin and Sleeplessness
Serotonin is a neurotransmitter (brain chemical). It is the chemical that creates a state of wellbeing and happiness; it regulates emotions, mood, social behavior, appetite, and digestion. It is the precursor for melatonin and plays an important role in regulating sleep cycles. Low serotonin levels are linked to sleep disorders, including insomnia. In case of stress, low serotonin levels are seen that further leads to disrupted sleep. In addition to causing sleep disturbance, low serotonin also leads to a depressed mood, poor memory, poor self-esteem, and anxiety.
Dopamine and Sleeplessness
Dopamine has a role to play in sleeplessness by stopping the effects of norepinephrine. Norepinephrine is a hormone that is involved in controlling the making and release of melatonin. The dopamine’s inhibiting effects on norepinephrine leads to decrease making and release of melatonin effects. Low melatonin keeps the person awake.
Insomnia in Older Adults
Insomnia becomes more common with age due to physiological changes in the body. For most people, their sleep patterns change, and sleep tends to become less restful. Getting tired earlier in the day means that older people are more likely to sleep early and wake up earlier.
Also, chronic health conditions like arthritis, depression, bladder problems (and more) that are common in older adults tend to disrupt sleep. Increased use of medications for health issues can also affect the sleep patterns.
Insomnia in Younger Adults
Children, teenagers, and younger adults usually have delayed internal clocks, which makes them want to sleep late and wake up late.
Insomnia in Women
Women experience hormonal changes in the body during their menstrual cycle and during menopause, which can disrupt sleep.
Women going through menopause may experience hot flashes and night sweats which can also disturb sleep.
Pregnancy can also cause insomnia.
How Much Sleep is Ideal?
Depending on the age group, the National Sleep Foundation recommends the following number of hours of restful sleep:
School-going children (ages 6-12 years): 9 to 11 hours
Teenagers (ages 13-19 years): 8 to 10 hours
Young adults (age 18-25 years): 7-9 hours
Adults (age 26-64): 7-9 hours
Older adults (above 65 years of age ): 7-8 hours
Managing Insomnia with Diet and Lifestyle Changes
Some measures one can take to ensure a good night’s sleep, and reduce the chances of developing insomnia over time are:
Changing Lifestyle Habits to accommodate better sleep:
A Regular Schedule:
A regular schedule which dictates a specific window for sleeping and waking up trains the body to be energized or in a restful state during particular times of the day.
Avoid oversleeping (more than 9 hours a day for adults) on some days (like weekends) which can throw off the sleep schedule. Consistency is key.
Keep the bedroom dark with the help of blinds and shades, and remove any light-emitting devices.
A slightly cool temperature helps aid sleep. One can turn down the heat and use a light blanket if necessary.
The bed you sleep on can directly affect your sleep. A firm mattress with no bulges or dips is ideal.
Smoking just before bedtime can disturb hormone production and mess up sleep since (nicotine is a stimulant).
Exercising too close to bedtime can increase the levels of cortisol as well as the heart rate, making it difficult to wind down.
Use of Electronics:
Avoid watching television, working on the computer or even browsing your phone just before bedtime. The blue light emitted from these electronics stimulates the pineal gland in the brain, making it difficult to fall asleep. If you must use electronics before bedtime, try switching to the ‘night-mode’ on the device, which reduces the amount of blue light emitted.
Ensuring Regular Exercise
Exercise creates endorphins or ‘happy hormones’ in the body, and it helps tire out the body and prepares it for rest. Picking the right time to exercise is important, and is a very personal choice.
If exercising in the evening tires you out and makes you want to sleep, then an evening workout might be good. If exercise recharges your system and makes you feel energized, a morning workout is better.
Foods to Eat
The food we eat affects our entire system; it normalizes the production of hormones and other neurotransmitters. Also, what time you eat matters, since eating too close to bedtime can stimulate the system, while eating the last meal of the day too early can cause disturbed sleep due to low blood sugar levels. Eating 2-3 hours before bedtime suits most people.
Tryptophan for Production of Serotonin
Tryptophan is an amino acid that stimulates the production of serotonin, a hormone that promotes relaxation. Foods that are high in protein usually include animal protein like turkey and tuna. These should be supplemented with fats and complex carbohydrates.
Complex carbs, like those found in starchy vegetables, sweet potatoes, and butternut squash help release serotonin in the system. However, simple carbs and sugar should be strictly avoided as they tend to spike energy levels at night.
Foods that Contain Magnesium
Magnesium is a mineral that promotes relaxation in the body and decreases the incidence of muscle cramps and headaches. Oats, green leafy vegetables, sunflower seeds, sesame seeds and fermented dairy products are good sources of magnesium.
The Vitamin B Group
B vitamins help optimize the working of the nervous system and are found in foods like green leafy vegetables, brewer’s yeast and organic meat. Also, B-complex vitamins are proven to reduce the incidence of insomnia.
Foods to Avoid
Too Much Caffeine
Caffeine is a popular stimulant and can stay in the body for over 6 hours. Therefore, it is not advisable to drink caffeine-infused drinks like coffee and energy drinks post noon. Green tea serves as a great alternative to coffee.
That Evening Drink
Alcohol should not be taken too close to bedtime (ideally at least 2 hours before bedtime), and should always be consumed in moderation.
Mind the Allergens
Any potential food allergens that can lead to digestive issues and restlessness should be monitored and avoided.
Sugar and Carbohydrates
Consuming too many carbs and sugars in the evening mean that the body will be working to process them, and this activity can warm up the body and make it difficult to fall asleep. Also, too much variation in the blood sugar levels lead to anxiety and discomfort and make it difficult to fall asleep.
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