How to Beat Insomnia

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If you are reading this article in the middle of the night because you can’t sleep, STOP! Close the journal, turn off the light and start to slow down your brain and relax your body until you fall sleep. You can read the rest of this in the morning after you wake up.

What is insomnia? Insomnia is not a disease; rather, it is a symptom. It is defined as the inability to initiate or maintain sleep. It may arise from poor quality or quantity of sleep.

Insomnia is very common and occurs in about 30-50% of the population. It is more common in the elderly and in women rather than in men. It can be short-term or long lasting.

What causes insomnia? The causes of insomnia are many and are far beyond what can be covered in this article. However, I will briefly mention some important and common causes.
Some obvious causes include such things as stress related to work, divorce or separation, loss of a job, loss of a loved one, preparing for an examination, jet lag, or changes in schedule of shift workers.  These are typically short-term and resolve without medical intervention, although you may consult your doctor if you wish.

Causes of chronic or longstanding insomnia are more complex. They can be grouped in those caused by an underlying medical or psychiatric condition and those caused by primary sleep disorders. The former is much more common simply because the higher prevalence of medical and psychiatric disorders.  

What are symptoms of insomnia? Symptoms of insomnia include daytime sleepiness and fatigue, difficulty with memory and concentration, impaired coordination, and irritability.

When should I tell my doctor about insomnia? Many patients with insomnia seek medical attention when the problem because chronic or long lasting and interferes with their daily life. A thorough medical history and examination including screening for psychiatric diseases and drug and alcohol use may lead your doctor to the underlying cause of insomnia. If sleep apnea is suspected, then a referral to a sleep specialist may be necessary.  Your primary doctor can determine that.

How can insomnia be treated? It is important to note that treating the underlying medical or psychiatric condition is the cornerstone of treatment. This can be combined with therapies towards insomnia itself.

Therapies for insomnia are usually classified under non-medical or behavioral and medical. The best treatment is the one tailored for you depending on your particular cause. Most successful results are achieved when the two modalities of therapy are combined.

What is sleep hygiene? These are some simple steps that can be taken to help you sleep better. Any or all of these may apply to your particular situation. I will list them as follows:
Sleep as much as you need to feel rested, but do not oversleep.
Exercise routinely at least 20-30 minutes daily, ideally 4-5 hours before your bedtime.
Avoid forcing yourself to fall asleep.
Keep a regular bedtime and rise time schedule.
Do not consume caffeine later than the afternoon (tea, coffee, soft drinks etc.)
Avoid “night caps.” Alcohol causes disrupted sleep.
Do not smoke cigarettes, especially in the evening.
Do not go to sleep hungry.
Adjust the room environment to a comfortable setting (lights, temperature, noise, etc.)
Do not try to sleep with your worries and stress. Try to resolve them before going to bed.

These are only some of the measures than can taken to improve your sleep. Other non-medical approaches include:
Prior to going to bed, exercise some relaxation techniques such as dimming the lights, playing soothing music, relaxing your muscles and your brain. Consider meditation techniques.
Avoid watching TV, reading, eating, performing business, talking on the phone while in bed.
Use your bedroom only to sleep, not as your office or living room.
Go to bed only when are ready to sleep.
If you are in bed for more than 30 minutes without falling sleep, get out of bed and try the relaxation steps again.

As far as medical therapies are concerned, there are a number of medications available and covering them is beyond the scope of this article. However, they should be prescribed by your doctor and tailored individually for you. And remember again, these should be combined with non-medical practices mentioned above for the best results.

If you think you suffer from ongoing insomnia, consider these simple steps and discuss your concerns with your doctor.

Have a good night and sleep well!

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