Sleep Medicine

Insomnia

Insomnia refers to repeated problems falling asleep, staying asleep, or unrefreshing sleep. Short term insomnia is very common and usually is a response to stressful life experiences. This form of insomnia usually gets better on its own after the stress is relieved. If the insomnia continues and seems to take on a life of its own, then the condition is called chronic insomnia. This form of insomnia is less likely to get better without treatment.

Having difficulty sleeping is not necessarily a problem unless it interferes with the way you feel or impairs your ability to function when you are awake.

Chronic insomnia is almost always a combination of multiple factors. Some people have a tendency to get insomnia whenever they experience stressful life circumstances. Work hours that continuously change, such as rotating shifts, can make it difficult to establish a regular sleep routine. Caffeine is a stimulant and consuming any caffeine within eight hours of bedtime could make it harder for some people to sleep. Nicotine is also a stimulant and may interfere with sleep. Certain prescription and over-the-counter medications can make insomnia worse. Finally, certain physical, mental, and other sleep disorders can impact how you sleep.

Below is a list of good sleep practices that can help many people that suffer with insomnia.

• Avoid caffeinated coffee, tea, soda, or energy drinks within eight hours of bedtime.
• Avoid alcohol within four hours of your bedtime. You may feel that alcohol helps you fall asleep, but it can disrupt the second half of your sleep.
• Avoid heavy meals close to bedtime.
• Exercise regularly but avoid heavy workouts close to bedtime.
• Use your bed and bedroom for sleep and sexual activity only. Do not read, watch television, talk on the phone, eat, do work, or pay bills in bed.
• Do something relaxing for 1-2 hours before going to sleep, like pleasure reading, television watching, or taking a warm bath.
• Your bedroom should be quiet, dark, and a little bit cool.
• Go to bed only if you are sleepy.
• Position your alarm clock so that you can not see it.
• If you lie in bed awake for more than a few minutes, get up and go to a different room. Do something relaxing like watching television, pleasure reading, or playing solitaire. Then return to bed when you are sleepy. Do this as many times during the night as needed.
• Get up at the same time each morning, no matter how little you have slept the night before. This needs to be done seven days a week.
• Do NOT take daytime naps. The ONLY exception is if you get sleepy while driving. If this occurs, you should immediately pull off the road and take a brief nap.

Sleeping pills can help some people but are not a cure for chronic insomnia. Sleeping pills might help in the short term, but they could stop working after several weeks to months of regular use. There is a form of therapy called cognitive-behavioral therapy that can be helpful for many people that suffer with chronic insomnia.

RECOMMENDED READING FOR INSOMNIA

Sound Sleep, Sound Mind by Barry Krakow, MD – Discusses the psychological aspect and treatment of sleeping difficulties, while still covering the physiological components.

The Insomnia Answer by Paul Glovinsky, PhD and Art Spielman, PhD – Provides more detail about the theory behind the development of insomnia problems. Covers treatment as well.

No More Sleepless Nights by Peter Hauri, PhD – This is a classic insomnia self-help book that is easy to understand and follow.

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