Insomnia

Insomnia, or trouble sleeping, is an occasional problem for almost everyone, but it is a chronic problem for 15 to 20 million people in the United States. It is defined not only as a lack of sleep but the inability to get enough restful sleep. Insomnia may involve trouble falling asleep, staying asleep, or waking up too early in the morning without being able to return to sleep.

Causes

For many people, insomnia happens occasionally in response to life events. These events, exciting or stressful, can keep you awake and thinking late into the night. Other people develop poor sleep schedules, sleeping late into the morning or napping during the day. This makes sleep at night more difficult.

Insomnia may be a symptom of depression. If you are feeling down, are fatigued, and are having trouble falling asleep or are waking up early, you may be depressed. There are helpful treatments for depression that may cure your insomnia if the two problems are related.

Some prescribed and over-the-counter medicines, herbs and supplements can cause insomnia. Examples are: some antidepressants, high blood pressure medicines, steroids, weight-loss products, and decongestants.

As people age, sleep patterns change and people are more easily awakened.

Insomnia may also be a symptom of a sleep disorder or medical problem that causes pain or discomfort such as arthritis or gastroesopheageal reflux disease. Finding the cause of your insomnia can help your doctor determine what treatment you need.

Treatment

Insomnia sends many people to the doctor, often to get sleeping pills. Yet most doctors believe sleeping pills should be avoided whenever possible. Many over-the-counter sleep medications rely on what doctors call the placebo effect, which means they only work because you think they will. Prescription medications are likely to really knock you out, rather than producing a natural, restful sleep.

Self-Care Steps for Insomnia

There are several self-care steps you can take to get a better night's sleep. It may take a few weeks to establish a new, natural sleeping routine. If you are unable to make progress after trying the following steps, call your doctor for advice:

• Avoid drinking alcohol in the evening. Although alcohol is a short-term sedative and may quickly bring on sleep, it interferes with deep sleep. You may wake up suddenly after its effects have worn off.

• Don't smoke, especially at bedtime. Nicotine is a stimulant, which can keep you awake or disrupt your sleep.

• Avoid or reduce your intake of caffeine. Caffeine stays in your system for as long as 12 to 24 hours. Remember that in addition to coffee, caffeine is present in chocolate and many colas and teas. If you suspect caffeine is contributing to your sleeplessness, try avoiding any caffeinated products for at least 12 hours before you go to bed.

• Be aware of other medications that may affect your sleeping patterns. Many over-the-counter decongestants and products with pseudoephedrine can be as stimulating as caffeine. Before starting a medication, ask your pharmacist if it might keep you awake and if another product can be substituted.

• Avoid eating large meals just before going to bed. The uncomfortable feeling of having a full stomach may delay sleep. Try a light snack instead. This will satisfy your hunger without interfering with your sleep. Many people swear by the virtues of a glass of warm or cold milk. Try adding a touch of honey, cinnamon, or vanilla to this bedtime standby.

• Take a warm bath an hour or two before bedtime. This can soothe tense muscles and help make you sleepy. However, taking a bath immediately before going to bed may be too stimulating and keep you awake. Experiment with the timing to see what works best for you.

• Get regular physical activity. This will help relieve tension and clear your head. It will also tire you out, so you can sleep more soundly. Avoid strenuous physical activity for several hours before going to bed. It may stimulate you and interfere with falling asleep.

• Your bedroom should be quiet and dark. If noise is a problem, try ear plugs or "white noise." Many people like the sound of a fan or air conditioner as they drift off to sleep.

• A cool room temperature -- between 60 and 65 degrees Fahrenheit -- is best for sleeping. A firm, comfortable mattress is also important for a good night's sleep.

• Avoid long, late afternoon naps. Short "catnaps," lasting no more than 20 minutes, can be surprisingly refreshing. Longer naps and those taken later than 4 p.m. may disrupt normal sleep patterns and contribute to insomnia.

• Read in bed for a few minutes before turning out the light. This helps you relax and can increase feelings of drowsiness.

• Counting sheep is not recommended. Counting requires focusing the brain on a specific activity. Instead, try picturing yourself in a pleasant place, and use your imagination to hear relaxing sounds as you drift off to sleep.

• Reserve your bed for pleasurable, restful activities. Avoid doing activities in bed that can cause stress or anxiety, such as watching horror movies or balancing your checkbook.