Insomnia on the rise, treatment options available, say experts

Insomnia, a common sleep disorder that can make it hard to fall asleep and stay asleep through the night, is on the rise in Malaysia.

Hence, appropriate education, awareness initiatives, and therapies must be provided to individuals needing them, experts said.

“From clinical and daily life observations, there is indeed a significant increase in insomnia cases in Malaysia,” the founder of Alaminda Healthcare Berhad, Dr Hazli Zakaria, told Bernama.

However, he noted that there is still a lack of data from studies conducted to measure the prevalence of insomnia in the country.

Citing statistics available before the Covid-19 pandemic, he said about 35 percent of Malaysians and 53 percent of workers in the country sleep less than seven hours daily.

Another local study has shown that nine out of 10 Malaysians have experienced sleep-related problems, an issue of growing concern that needs to be addressed.

Adults aged 18 to 60 years are recommended to sleep at least 7 hours each night. Otherwise, they run the risk of becoming sleep-deprived.

Healthy sleep essential

“Sleep is not just for rest, in fact, sleep provides many benefits more than resting the body. The problem is, we do not give proper priority to getting healthy sleep until it can eventually disturb our quality of work,” Dr Hazli said.

"Sleep can give us the ability to control stress in everyday life. Sleep is also necessary for optimal attention, especially when making rational decisions.

“Without realising it, adequate sleep helps us to have a healthy life, do physical activity, and interact with the people around us since all of these require enough energy from a good sleeping habit.

“For example, if a crane operator does not have a good sleep but he has to work and operate his crane machinery, it is like we are waiting for an accident to happen," he added.

Dr Hazli said insomnia can be referred to as insomnia symptoms or insomnia disorder.

Insomnia disorder happens when patients have trouble falling asleep and maintaining their sleep, causing them to experience poor quality of sleep that ultimately causes them a discomforting experience and interferes with the functioning of their daily life.

"Insomnia can also refer to symptoms where the patients have difficulty sleeping, which can be part of the symptoms of other diseases such as anxiety or other medical illnesses like Covid-19.

“Sometimes it can also be a reminder or benchmark for the body when our stress has increased," he explained.

Not only that, a person can only be diagnosed with insomnia if they experience sleep disturbances that can occur at least three days a week for three consecutive months,” he added.

Consult your doctor

Given that insomnia is a common disorder among adults in Malaysia, Dr Hazli said it is essential for the patients to hone their skills to maintain healthy sleep and know the strategies to be taken when there are changes in their sleep patterns.

"Other than that, they should also contact their doctors to confirm the cause of insomnia. After verification is done, treatment can be given either in the form of medicine or in the form of counselling and therapy.

"Always remember that taking sleeping pills without a doctor's supervision is a high-risk action from dependence on sleeping pills.

“This addiction problem is often caused by the real cause of insomnia not being treated with the right medicine, for example, medicine for anxiety or depression, but instead, sleep medicine that is taken as a ‘short cut’ measure.

“However, prevention and early detection are always preferred,” added Dr Hazli.

Work performance affected

Meanwhile, a 22-year-old assistant manager at a local bakery in Selangor who prefers to be known as Mohd Arif said insomnia badly affected his work performance due to an unstable sleep cycle.

Arif said he can only sleep after 4 or 5 am almost daily and can't even focus on work because his head often hurts with blurred vision due to lack of sleep.

"Usually, I can only sleep after coming home from work. Even that takes a long time. For example, despite lying in bed at 9 pm, I can only sleep around 5 hours afterwards.

"To be honest, I have been suffering from this insomnia since I was pursuing my diploma at a local college in Seremban, Negeri Sembilan, in 2018. At that time, I felt ashamed to share this problem with my friends, so I had to suffer in silence.

“This problem continued until I started working at this bakery in 2022," he told Bernama over the phone.

Arif added that after about five months of working at the bakery and his work performance continued to decline, he quit his job to seek treatment for his condition at a well-known private clinic here to restore his sleep cycle.

Dayvigo treatment

On the hiccups of modern treatments available, the managing director of Eisai Malaysia, Kam Ai Teng, said the current treatment options for insomnia are focusing too much on helping patients to sleep faster (sleep onset).

In contrast, good quality sleep depends on both sleep onset and sleep maintenance.

"Previous research on insomnia has been focusing on sleep-promoting pathways in the brain. Through years of research, it was found that a neuropeptide called orexin plays a major role in maintaining wakefulness,” she told Bernama.

(Neuropeptides are chemical messengers made up of small chains of amino acids that are synthesised and released by the nervous system cells called neurons)

In this regard, Eisai Malaysia, a leading global research and development-based pharmaceutical company, has produced Dayvigo with a critical function to block the orexin signalling pathway.

It is also said to suppress wakefulness and facilitate sleep.

"There are various clinical trials conducted before the approval of Dayvigo, namely the Sunrise-1 and Sunrise-2 studies, which enrol approximately 2,000 patients from around the globe.

“Based on these studies, subjects have shown significant improvement in helping them fall and stay asleep and reported y significant improvement in daily function versus placebo (A substance or treatment designed to have no therapeutic value).

“Clinical trial has shown Dayvigo was not associated with rebound insomnia following treatment discontinuation and there was no evidence of withdrawal effects following Dayvigo discontinuation," she said.

On the difference between Dayvigo and other available insomnia treatments like benzodiazepines and z-drugs that work by activating and promoting the sleep signalling pathway in the brain, she said Dayvigo treats insomnia by blocking the wake-promoting orexin signals, which facilitate the patient's sleep by primarily reducing wakefulness.

“Eisai has positioned neurology and oncology as its therapeutic areas of expertise and focus, where there are many diseases for which adequate treatments have yet to be established,” she said.

She added that in the company’s pipeline are products that would benefit patients with Alzheimer’s disease, Parkinson’s disease and more in the future.

- Bernama