Sweet Dreams: A Guide to Overcoming Insomnia

What are your medical options when insomnia disrupts your life?

What are your medical options when insomnia disrupts your life?
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Insomnia is a condition defined by an inability to sleep or get restful sleep. It affects anywhere from 30 to 50 percent of adults. There are different kinds of insomnia: Some people have trouble falling asleep, and some have trouble staying asleep. Others simply don't feel refreshed when they wake up in the morning.

Not getting enough sleep makes you feel tired during the day, affects your mood, makes you more likely to miss work or school and makes it hard to function or remember things. Insomnia puts you at risk for other physical and mental health problems, too. And it can raise your chances of having an accident at work or while driving. Driving a car after not getting enough sleep can be as dangerous as driving while intoxicated.

Those at higher risk for insomnia include:

• Older adults.

• Women (especially during menopause).

• People with a chronic physical or mental illness.

• People who take certain medications.

• People who work overnight or rotating shifts.

Insomnia can have many different causes. Finding out why you have trouble sleeping is the key to fixing it. Insomnia can be due to stress or changes in your sleep cycle. Sometimes insomnia can be a symptom of another disorder. For example, people with chronic pain or certain mental health conditions have insomnia rates as high as 50 to 75 percent. Your doctor will need to rule out some of these possible causes.

Insomnia Treatment

You should seek treatment when insomnia begins to have a negative impact on your life. If you feel tired or are unable to function during the day, it might be time to talk to your doctor. The goals of treating insomnia are to:

• Increase the time spent sleeping.

• Increase the quality of sleep.

• Increase your energy, attention and memory during the day.

Lifestyle Changes

The first step to getting better sleep is to make lifestyle changes, which can be quite effective. Begin by improving your sleep habits. For example:

• Going to bed and waking up at the same time each day, even on weekends.

• Avoiding naps during the day.

Limiting caffeine, alcohol and cigarettes, especially closer to bedtime.

• Doing something that relaxes you just before you go to bed.

• Avoiding exercise, heavy meals or lots of liquids within two hours of bedtime.

• Avoiding doing work, reading or watching television in bed. Try to keep your bed a place only for sleeping.

• Getting up and doing something else if you can't sleep, then trying to sleep again at a later time.

• Trying to make your bedroom as comfortable as possible.

Insomnia Medications

Sometimes even after changing your sleep habits, insomnia may continue to be a problem. At that point, you might want to consider medication. There are many drugs that can help with insomnia. Some are available only with a prescription and some are available over-the-counter. OTC products may be helpful for short-term treatment of insomnia, but should not be used on a regular basis. You should always ask your doctor or pharmacist before using any medication to help you sleep.

Many of the OTC products used for insomnia are herbal remedies. There is little scientific data supporting use of these herbs for insomnia, and some of these products have serious side effects. For example, valerian and kava are two herbal products that should be used with caution. Not only is there a lack of evidence to show they actually help people sleep, there have been cases of liver damage in patients taking these herbal products.

Melatonin is a popular OTC product for insomnia. It is a hormone found naturally in our bodies that regulates the sleep cycle. Melatonin has the most benefit in the elderly population. Chamomile is another herbal remedy found in bedtime teas; many people who drink it say it makes them feel calm and relaxed.

Although all of the products mentioned to this point have been used to improve sleep, there are only two active ingredients that have been studied and approved for use as OTC sleep aids. These drugs are diphenhydramine and doxylamine, and they are available as both single ingredients and in combination with other drugs (such as pain relievers). You might recognize these drugs from other products, as they are commonly featured in cough, cold and allergy treatments, because they are also antihistamines. These products can be useful to help you get to sleep, but may make your sleep less restful. These drugs have the opposite effect on some people, especially children and the elderly, who can become more on edge after taking them.