Insomnia is very often a simple disorganization of ones time, diet, or habits. But for many, the lack of sleep makes them look terrible, and feel even worse.
Naturally, when I see a patient with insomnia I prefer to start the treatment with the least offensive weapons possible, and escalate the attack only as required. This means that for many, simple harmless treatments such as investing in a better mattress, using a natural wool pad on top of the mattress, or buying a more comfortable pillow may be enough. For others, especially those on shift work, ear plugs and an eye mask may be needed to sleep through ambient distractions.
Hypnosis, the relaxation response, yoga, and hot baths may also be the answer. However, these harmless treatments may not work for everyone. People who have a snoring spouse, a noisy neighbor, or a dripping tap may truly be at their wits end due to fatigue. Others with a crying baby may be totally exhausted, yet unable to take any medications for fear of sleeping through a neonatal emergency. Still others may be plagued by medical disorders that make sleep difficult.
In many of these cases, the use of medications may indeed be appropriate for a very short term. Often, once the patient has been given a couple of good night's sleep they can recover their energy levels, and may only be given medication sporadically after that. In more severe cases, medication may be needed every night. However, it is always wise to do everything possible to avoid the latter choice, as the cure may be just as bad as the disease. Once the association has been made between sleep and a pill, there is always the potential for Hypnosis, psychological or chemical addiction.
The most common sleep disorders include:
- Insomnia: Ongoing, long-term trouble with falling asleep
- Bruxism: Involuntarily grinding or clenching of the teeth while sleeping.
- Delayed sleep phase syndrome (DSPS): inability to awaken and fall asleep at socially acceptable times but no problem with sleep maintenance, a disorder of circadian rhythms.
- Hypopnea syndrome: Abnormally shallow breathing or slow respiratory rate while sleeping.
- Excessive daytime sleepiness (EDS) often culminating in falling asleep spontaneously but unwillingly at inappropriate times.
- Night terror: abrupt awakening from sleep with behavior consistent with terror or fear.
- Periodic limb movement disorder (PLMD): Sudden involuntary movement of arms and/or legs during sleep, for example kicking the legs.
- Rapid eye movement behavior disorder (RBD): Acting out violent or dramatic dreams while in REM sleep, sometimes injuring bed partner or self
- Restless legs syndrome (RLS): An irresistible urge to move legs. RLS sufferers often also have PLMD.
- Sleep apnea: Obstruction of the airway during sleep, causing lack of sufficient deep sleep, often accompanied by snoring.
- Sleep paralysis: is characterized by temporary paralysis of the body shortly before or after sleep.
- Sleepwalking or somnambulism: Engaging in activities that are normally associated with wakefulness, which may include walking, without the conscious knowledge of the subject.
- Somniphobia: A cause of sleep deprivation. Somniphobia is a dread/ fear of falling asleep or going to bed.
Managing Stress for Better Sleep
- Assess what is stressful: The first step in getting a handle on stress is to figure out what is causing it. Take a good look at your physical condition and your daily activities. Do you suffer from pain? Are you overloaded at work? Once you identify your stressors, you can take steps to reduce them.
- Seek social support: Spending time with family and friends is an important buffer against stress. It can be helpful to share your problems with people who care for you.
- Practice thought management: What we think, how we think, what we expect, and what we tell ourselves often determine how we feel and how well we manage rising stress levels. You can learn to change thought patterns that produce stress. Thoughts to watch out for include those concerning how things should be and those that over generalize sets of circumstances (for example, "I'm a failure at my whole job because I missed one deadline.") Many commercial audiotapes and books can help you learn thought management exercises.
- Exercise: Exercise can help you blow off steam thereby reducing stress. In addition, flexible, loose muscles are less likely to become tight and painful in response to stress. If you have a medical condition or are over the age of 50, it’s best to check with your doctor before beginning an exercise regimen.
- Eat a healthy diet: Junk food and refined sugars low in nutritional value and high in calories can leave us feeling out of energy and sluggish. A healthy diet, low in sugar, caffeine, and alcohol consumption, can promote health and reduce stress.
- Get adequate sleep: A good night's sleep allows you to tackle the day's stress easier. When you are tired, you are less patient and easily agitated which can increase stress. Most adults need 7-8 hours of sleep per night. Practicing good sleep hygiene along with stress-lowering tactics can help improve your quality of sleep.
- Delegate responsibility: Often, having too many responsibilities can lead to stress. Free up time and decrease stress by delegating responsibilities.
Here's an action tip:
If you are chronically pooped, and think your problem is the result of poor sleeping habits, please see your doctor. If there are no physical reasons for your condition, then ask your doctor to recommend some alternatives to medication, such as the relaxation response, or hypnosis. If medications prove necessary, try to give yourself as little as possible, and to periodically have drug-free week-ends to help clear your system of the metabolites. Make sure your doctor is aware of all drugs, both prescription and otherwise, that you are taking. Most of all, try to aim for safe sleep.