What is Insomnia?
Insomnia refers to a condition where sleep problems such as difficulty falling asleep or light sleep persist, leading to difficulties in daily life. Unlike temporary difficulty falling asleep, chronic insomnia is defined as symptoms that occur three or more times a week for three or more months.
In Japan, approximately 30-40% of adults experience some form of insomnia, and one in five people suffer from chronic insomnia. A characteristic of insomnia is falling into a vicious cycle where anxiety about not being able to sleep ("What if I can't sleep again tonight?") arises when sleepless nights continue, and this anxiety further prevents sleep.
Are you experiencing any of these persistent symptoms?
- Unable to fall asleep for 30 minutes or more after getting into bed
- Waking up multiple times during the night
- Waking up early in the morning and being unable to fall back asleep
- Feeling tired even after having slept
- Having anxiety about "not being able to sleep again"
-
Experiencing strong daytime sleepiness and decreased concentration
Types of Insomnia
Symptoms of insomnia can be broadly categorized into four types. Multiple types often overlap.
| Type | Content | Characteristics |
|---|---|---|
| Difficulty falling asleep | Unable to fall asleep after getting into bed | Often unable to sleep for 30 minutes to an hour or more. Often caused by anxiety, tension, or stress. |
| Middle-of-the-night waking | Waking up multiple times during the night | The most common type. Can be associated with aging, alcohol, depression, or sleep apnea. |
| Early morning waking | Waking up two or more hours earlier than planned | Common in depression and older adults. Often unable to fall back asleep. |
| Non-restorative sleep | Sleeping but not feeling refreshed | Decreased sleep quality. Caused by stress, alcohol, sleep apnea, etc. |
Causes of Insomnia
The causes of insomnia can be broadly divided into three categories.
Psychological/Mental Factors
- Stress, anxiety, tension (work, relationships, life problems)
- Depression, anxiety disorders, PTSD
- Performance anxiety such as "What if I can't sleep?"
Physical Factors
- Physical symptoms such as pain, itching, frequent urination, difficulty breathing
- Sleep apnea syndrome, restless legs syndrome
- Menopausal symptoms (hot flashes, sweating)
- Hyperthyroidism
Environmental/Lifestyle Factors
- Late-night smartphone/PC use (blue light)
- Excessive caffeine/alcohol intake
- Irregular sleep schedule/night owl lifestyle
- Vigorous exercise before bed
- Environmental factors such as noise, light, temperature, bedding
Medication-induced
Some medications (steroids, antihypertensives, antidepressants, caffeine-containing drugs, etc.) can cause insomnia.
What happens if insomnia is left untreated?
If you continue to endure insomnia, thinking "I'll eventually be able to sleep," it is likely to become chronic.
Potential effects of persistent insomnia
| Impact | Content |
|---|---|
| Decreased daytime performance | Decreased concentration, judgment, memory; increased errors |
| Impact on mental health | Increased risk of developing depression and anxiety disorders |
| Impact on physical health | Decreased immunity; increased risk of high blood pressure, diabetes, obesity |
| Decreased quality of life | Decreased motivation for social life, interpersonal relationships, and hobbies |
| Chronic insomnia | Fear and anxiety about not being able to sleep become ingrained, creating a vicious cycle |
It is important to break the vicious cycle with early care.
Types of Sleeping Pills and How to Choose
There are several types of sleeping pills, each with different mechanisms of action and effects. We offer Dayvigo and Eszopiclone at our clinic.
Comparison of Sleeping Pills Available at Our Clinic
| Drug Name | Type | Mechanism of Action | Main Features | Dosage |
|---|---|---|---|---|
| Dayvigo (Lemborexant) | Orexin receptor antagonist | Blocks orexin, which maintains wakefulness, promoting natural sleep | Low risk of dependence, less next-day drowsiness, suitable for first-time users | 2.5mg, 5mg, 10mg |
| Eszopiclone | Non-benzodiazepine (Z-drug) | Acts on GABA receptors to promote sedation and hypnosis | Effective and suitable for those who want deep sleep. May cause a bitter taste. | 1mg, 2mg |
Dayvigo (Lemborexant)
Mechanism of Action
Lemborexant, the active ingredient in Dayvigo, blocks orexin receptors in the brain, which are neurotransmitters that maintain wakefulness, thereby switching off wakefulness and creating a state similar to natural sleep.
Features of Dayvigo
- Relatively low risk of dependence and abuse (not designated as a psychotropic drug)
- Less next-day drowsiness
- Effective for both difficulty falling asleep and middle-of-the-night waking
- Suitable for first-time users of sleeping pills and older adults
- Most people start to feel sleepy about 30 minutes to 1 hour after taking it
How to choose the dosage
| Dosage | Recommended for |
|---|---|
| 2.5mg | Those concerned about next-day drowsiness, older adults, first-time users |
| 5mg | Standard dose. For first-time users |
| 10mg | Those for whom 5mg was insufficient |
Eszopiclone
Mechanism of Action
Eszopiclone acts on GABA (gamma-aminobutyric acid) receptors, suppressing neuronal excitation and exerting sedative and hypnotic effects. It is classified as a non-benzodiazepine (Z-drug), and is considered to have fewer muscle relaxant effects and less dependence than traditional benzodiazepines.
Features of Eszopiclone
- Effective for both difficulty falling asleep and middle-of-the-night waking
- Perceivable effects, suitable for those who want deep sleep
- Some people experience a unique bitter taste (metallic taste) after taking it
- Caution is required for dependence with continuous use
How to choose the dosage
| Dosage | Recommended for |
|---|---|
| 1mg | Older adults, those concerned about next-day drowsiness |
| 2mg | Standard dose. For those who want deep sleep |
Side Effects and Precautions for Use
Main Side Effects
| Side Effect | Content |
|---|---|
| Daytime sleepiness | More likely to occur with high doses or in elderly patients. Be careful when driving or working the next day. |
| Headache, dizziness, fatigue | Common in the initial stages of administration. Often improves with continued use. |
| Bitter taste (eszopiclone only) | May experience a metallic or bitter taste. |
| Rare, serious side effects | Anaphylaxis, liver dysfunction (rare). If you experience any abnormalities, consult a doctor immediately. |
Precautions for Use
- Do not drive or operate machinery after taking the medication.
- Avoid concomitant use with alcohol (increases drowsiness and side effects).
- Be careful of residual drowsiness the next day.
- Take one tablet just before bedtime.
Who cannot take this medication:
- Those with severe renal or hepatic impairment.
- Those with severe heart failure or respiratory failure.
- Pregnant or breastfeeding individuals.
- Individuals for whom a doctor has determined the medication is inappropriate.
Lifestyle Habits to Improve Sleep Quality
By combining medication with lifestyle adjustments, you can more effectively improve insomnia.
Optimizing the Sleep Environment
- Keep the bedroom dark, quiet, and at an appropriate temperature (18-22℃).
- Use blackout curtains to block out light.
- Turn off smartphones and PCs one hour before bedtime.
Regulating Sleep Rhythm
- Wake up at the same time every day (including weekends).
- Get natural light exposure during the day.
- Keep naps to before 3 PM and under 30 minutes.
Things to Avoid Before Bed
- Avoid caffeine (coffee, green tea) after 3 PM.
- Alcohol temporarily induces sleepiness but lowers sleep quality.
- Avoid intense exercise and hot baths two hours before bedtime.
- Do not use your smartphone in bed.
Relaxation
- Take a lukewarm bath (38-40℃) 90 minutes before bedtime.
- Loosen body tension with abdominal breathing and light stretching.
- Go to bed with the mindset of "it's okay if I don't sleep."
Prescription Process at Our Clinic
Step 1: Provisional Payment & Pre-Consultation Questionnaire
Please select your desired medication, dosage, and plan, and then place your order. After ordering, please answer the questionnaire sent via LINE or email. Please accurately provide information about your insomnia symptoms, current medications, and medical history.
Step 2: Online Medical Consultation
A doctor will review your questionnaire and symptoms via video call to determine if the medication can be prescribed. All you need is a smartphone or PC.
Step 3: Same-Day Shipping (Fastest)
Orders with video calls completed by 3:00 PM daily will be shipped the same day. Packages are discreetly wrapped to protect your privacy.
