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QDear Doc, I had problems sleeping. It takes forever to fall asleep and then, when I do it, it's only for a short time. I am now miserable during the days and make mistakes and fall asleep at work. Is there anything I can do, or any medicine that I can take, to help me fall asleep and stay asleep?
A You seem to have insomnia. Insomnia is a problem that affects sleep. Insomniacs have difficulty falling asleep or staying asleep, or feeling restless when they wake up.
Insomnia does not affect the number of hours a person sleeps. Everyone needs a different amount of sleep. Some people need little sleep and can function without difficulty after only a few hours of sleep. People who sleep less, but do not have daytime sleepiness or other symptoms, are called "short sleepers" and have no sleep problems. You also need less sleep as you get older.
People suffering from insomnia often complain of:
n You have trouble falling asleep or staying asleep.
n Feeling tired or sleepy during the day.
n Forget things or have trouble thinking clearly.
n Be miserable, anxious, irritable or depressed.
n Have less energy or interest in doing things.
Make mistakes or have accidents more often than usual.
These symptoms can be so severe that they begin to affect a person's relationships and work life. It is important to note that these symptoms can occur even in people who seem to sleep enough hours of sleep.
Insomnia can have several causes
Short-term insomnia lasts less than three months and is usually badociated with a stressor. Possible stressors may include:
n Changes in the sleeping environment (temperature, light, noise).
n The loss of a loved one, a divorce or a loss of employment.
n Recent illness, operation or pain.
n Use or withdrawal of certain drugs, illegal drugs or alcohol.
Insomnia in the short term is often resolved when the stressor is resolved.
There are also situations that can disrupt your normal sleep cycle and cause insomnia, such as jet lag and shift work.
Long-term (or chronic) insomnia lasts more than three months and occurs at least three nights a week. This type of insomnia occurs with other conditions such as:
n Mental health issues, p. ex. depression, anxiety disorders and post-traumatic stress disorder.
n Medical conditions, especially those that cause pain, stress or difficulty breathing.
n Neurological disorders, such as Parkinson's disease and Alzheimer's disease.
Insomnia can also occur alone.
To improve your insomnia, you can follow what we call a "good sleep hygiene". It means that you:
n Sleep only as long as you feel rested, then get out of bed.
n Go to bed and get up at the same time every day.
n Do not try to force yourself to sleep. If you can not sleep, get out of bed and try again later.
n Drink coffee, tea and caffeine-rich foods only in the morning.
n Avoid alcohol in the late afternoon, evening and bedtime.
n Avoid smoking, especially at night.
n Keep your room dark, cool, calm, and free of any reminders of work or anything else that causes you stress.
n Solve problems that you have before going to bed.
n Exercise several days a week, but not before going to bed.
n Avoid looking at phones or reading devices that emit light before going to bed (tablets, laptops).
If these solutions fail, you may need to see a counselor or psychologist to help resolve problems that may prevent you from sleeping well.
There are medications to help sleep, but you should only try them after trying the techniques described above. You should not use sleeping pills every night for long periods of time because you can become addicted to them.
If, after reading this, you think you have insomnia and it troubles you, consult your doctor. He or she might have other suggestions on how to solve the problem and also determine if your insomnia is caused by mental health issues. In such a case, you might be prescribed an antidepressant rather than a sleeping pill. Antidepressants often improve sleep and may also help to solve other problems.
A common myth is that having an alcoholic drink before going to bed will help you sleep.
No! Do not use alcohol to help you sleep. Even though alcohol makes you sleepy at first, it disrupts sleep later in the night.
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