Sunday, October 26, 2008

Can't sleep? Try this...

Insomnia. We've all had the occasional night or two when no matter what we try, we simply cannot fall sleep. Usually those sporadic nights have an identifiable stressor- a test, a job interview, or maybe it's related to travel. For theses infrequent situations, I have no problem with my patients taking a sleep aid (prescription or over-the-counter.) 
Chronic insomnia, however, is a whole different ball game. Every night becomes a challenge and by 3:00am you're beginning to panic realizing there is no way you'll be able to function well the next day. People fall into patterns of heavy caffeine intake in the morning to "get them going", then a "pick me up" afternoon coffee or soda, and then as bedtime approaches, a glass or two of wine to "relax and wind down" from the day. Most people recognize caffeine is a stimulant (and therefore disrupts sleep, even if consumed hours before bed). Alcohol, though a sedative, may help people relax and fall asleep, but realize that it disturbs the quality of sleep. So how can you break this pattern? Here are a few ideas that might help.
Start your day with exercise. Even a quick fifteen minutes of brisk walking will release adrenaline and help decrease your need for caffeine. Regular exercise is a wonderful way to release tension. Did you know exercising 30 minutes daily yields the same amount of mood enhancement as a low dose of an antidepressant? (Don't exercise just before bed, though, because as noted above, that adrenaline release will keep you up!)
Create a bedtime routine. If you have children, you know how important this is, and it works for adults as well. Take a warm bath or shower, appeal to your senses with relaxing aromatic bath soaps or gels, and then GO TO BED. Do not pass GO and collect $200. This means no stopping to unload the dishwasher, fold clothes, check email or watch television. If you want to read or watch t.v., do it before your shower. Get in bed, close your eyes, and consider some form of relaxing breathing or meditation. 
Cover your alarm clock. Check it three times before you cover it if you need to, but if it's covered, you'll break that habit of waking up at exactly 2:17am each night. Yes, you might wake up, but if you're not seeing the clock, it's easier for your brain to go back to sleep because you're not gearing up all the emotions that come with seeing that dreaded early morning time.
BOTTOM LINE: For the once a month sleepless night, go ahead and use a sleep medicine if you'd like, but when you've developed a pattern of needing sedatives every night and stimulants every day, recognize the habits that are aggravating the problem and make some healthy changes! If you're still not seeing improvement, talk with your doctor because it may be a sign of an underlying issue such as sleep apnea, restless leg syndrome, or depression.

1 comment:

James Hubbard, M.D., M.P.H. said...

Thanks for the great tips. Don't forget about sleep apnea if you are a loud snorer.