Learn about insomnia, its cause, and its treatments.
Insomnia is a miserable condition that affects a lot of people. How many? It depends on what you read, but studies I’ve read suggest that between 1/3 and 2/3 of the American adults deal with insomnia on a regular basis. This podcast will cover what insomnia is, and what you can do to treat it.
What Is Insomnia?
Insomnia is defined as a problem falling asleep or staying asleep. It’s not the lack of sleep that matters; it’s the consequences of not sleeping that make insomnia a problem.
These consequences include:
Fatigue and sleepiness (obviously)
Increased errors in judgment
Accidents, some of which can be serious (such as automobile accidents)
Headaches, stomach problems, and other physical problems
Difficulty with social interactions (in other words, major grumpiness)
Anxiety and depression due to all of the above.
What Causes Insomnia?
Insomnia has many possible causes, including:
Stressors – Good stressors, such as a new job the next morning, or bad stressors, such as having a bad job to go to, can cause sleep problems. The good news is that this is usually limited in duration.
Poor sleep environment – I’ll go into more detail later, but where you sleep will have a big effect on how well you sleep.
Psychiatric Conditions – Conditions such as clinical depression and anxiety disorders are very common causes of sleep problems. That is a bad thing, because poor sleep can make these conditions worse.
Caffeine – It seems obvious, but many people don’t make the connection between their sleep problems and the Red Bull and Starbucks they are drinking.
Alcohol – Alcohol is often used to help sleep, but it actually does the opposite. It has been shown to make sleep much less restful (and that’s not just from getting up during the night to use the potty).
Medications – Stimulant drugs like Ritalin are obvious culprits for sleep disturbance, but asthma medications, steroids used for asthma or arthritis, blood pressure pills, decongestant cold medicines, and some antidepressants can also interfere with sleep.
Medical Problems – Many conditions interfere with sleep, including:
Sleep apnea, restless leg syndrome and gastroesophageal reflux, which wake you up during the night.
Prostate, urinary tract, and endocrine problems, which make you get up to pee a lot during the night.
Painful conditions and those that just make you uncomfortable (such as a bad head cold).
How to Treat Insomnia
How you treat insomnia depends on its severity, cause, and consequences. The first step is to remove anything that interferes with sleep. Don’t drink coffee or Red Bull after lunch, and don’t use alcohol to help you sleep. If you are on any regular medications, ask your doctor or pharmacist if these could be hurting your sleep. Finally, if you have medical or psychiatric problems causing trouble, get those treated.
Quick and Dirty Tips for Insomnia
This brings me to the last group of insomniacs: those with none of these problems, who simply can’t fall asleep. Some have it for a short period, whereas others have a lifelong battle with insomnia. It is to those people I will address my quick and dirty tips. After all else has been treated or ruled out, you should do the following:
Tip 1: Have Good Sleep Habits
These habits include:
Having a regular bedtime
Exercising at least 20 minutes per day
Not going to sleep hungry
Avoiding caffeine, tobacco, and alcohol – especially later in the day
Dealing with your stressors
Tip 2: Control Night Time Stimuli
Minimize what you can - Keep your bedroom as quiet and dark as possible.
Turn off the TV - Some people fall asleep to the television, but studies clearly show TV interferes with sleep.
Wind down - Give yourself time to wind down if you have had significant mental or emotional stimulation. The time in my life I had the hardest time sleeping was during medical school, when I would intensely study and then go to bed. Finding an activity to wind down helped a lot.
Don’t force things – If you can’t get to sleep after 20-30 minutes and are starting to think about it, get up and find a relaxing activity like reading or listening to soft music. Don’t do this in bed if you can help it; bed should be a place for sleep.
Tip 3: Have a Routine
Have as regular of a routine before going to bed as possible. The more of a routine you have, the less you have to think. The less you have to think, the easier sleep will come. If reading helps, then read, but keep it to light reading that won’t get your mind working again.
Tip 4: Medicate when Appropriate
For some people, using medication on a long-term basis is necessary. Most people, however, will only need medication for the short term while they build a new sleep routine. This is the best way to use medication.
What Medications Should You Use for Insomnia?
Common medications for sleep include:
Melatonin – This is a very mild over-the-counter medication that replaces a hormone in your body that has a role in sleep. It’s not a real strong medication, but it does help, and there is no risk of dependency.
Antihistamines – The most common over-the-counter sleep medication is diphenhydramine, which is the active ingredient in Benadryl. This is very safe and can be used in the long-term, but it can give a hangover the next morning, and men with prostate problems should avoid it.
Prescription medications – The class of medicines used most in the past was the benzodiazepines, which includes medicines like Valium and Xanax. But regular use of these medications caused dependency, so stopping them made sleep more difficult. The newer sleep medications, like Ambien and Lunesta, have fewer problems with dependency and so can be used safely long-term. But there are downsides, as some have reported sleepwalking and doing other strange things while taking them. That is rare, but it underlines the fact that it’s always better to fix a problem without a medication if possible, and your doctor should monitor your use of medication closely.
That’s it for insomnia. I hope I haven’t put you all to sleep…or maybe not.
Let me remind you that this podcast is for informational purposes only. My goal is to add to your medical knowledge and translate some of the weird medical stuff you hear, so when you do go to your doctor, your visits will be more fruitful. I don’t intend to replace your doctor; he or she is the one you should always consult about your own medical condition.
Catch you next time! Stay Healthy!