Overcoming Insomnia Doesn’t Have to be Difficult

Posted by on Sep 24, 2012 in News | 0 comments

Most of us experience difficulty falling asleep once in a while. Insomnia is defined as having poor quality of sleep due to difficulty falling asleep, difficulty maintaining sleep, or waking up too early. Ultimately, it will result in daytime sleepiness or fatigue, poor concentration, and irritability. Today, insomnia is a very common medical complaint in doctor offices. A national survey indicated that approximately 35 percent of adults have insomnia in any given year and about 10 percent of adults reported to have chronic (long-term) insomnia. Insomnia is even more common among the elderly. While it’s true that you tend to sleep less as you get older, the number of hours of sleep per night varies from person to person.

You can have acute or short-term insomnia from jet lag, stressful life events, and recent illness, but it often resolves on its own. On the other hand, long-term or chronic insomnia lasts for more than a month and may be related to medical/psychological conditions or medications you take. Your doctor will try to find the underlying causes of insomnia. If no causes are found, the doctor may try cognitive behavioral therapy, medications, or a combination of behavioral therapy with medicines. Cognitive behavioral therapy consists of stimulus control, relaxation, sleep restriction therapy, and cognitive therapy. Studies have shown that for short-term (6 weeks) treatment, both cognitive behavioral therapy and combination therapy have similar improvements in the amount of time it takes to fall asleep, time awake after sleep begins, and total sleep time compared to the time spent in bed. That being said, the best outcome was seen with combination therapy, initially followed by cognitive behavioral therapy without medication in a long-term treatment.

Before looking for over-the-counter sleep medications, there are a few changes you can make to improve your sleep hygiene. Here are some of the tips:

  • Maintain a regular sleep schedule. For instance, try to go to bed the same time and wake up the same time every day
  • Try not to take naps during the day. If you must do so, make sure you don’t nap for more than an hour
  • Try to minimize light and noises in the bedroom. Keep a moderate temperature and turn off the TV or radio
  • Try to finish your regular exercise 3-4 hours before bedtime
  • Avoid eating heavy meal close to bedtime
  • Avoid caffeinated drinks after lunch
  • Avoid nicotine close to bedtime
  • Avoid drinking alcohol late in the evening

Over-the-counter products

There are a few over-the-counter products available for insomnia, but many of them are not regulated by the FDA. Therefore, it’s difficult to be sure how effective or how safe they are for consumers. Among them, melatonin and valerian are well known products. Melatonin is a hormone produced by the pineal gland in the brain. Melatonin appears to prevent jet lag when crossing time zones. Some studies have shown that melatonin may decrease the time it takes to fall asleep, increase the number of sleep hours, and keep you alert during the day when taken for short-term (a few days or a week). A few studies suggested that melatonin works best for people over 55 years of age. Valerian and L-tryptophan are popular herbal products in the U.S, but may have potential side effects, thus why it’s best to talk to your doctor before using them. Always let your doctor know if you’re using over-the-counter products.

Contributed by Patricia Hsiao M.D.
Sources: Medscape, The National Center for Biotechnology Information, The Jama Network, University of Maryland Medical Center
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