Dear Doc | I have problems sleeping
Q Dear Doc, I have been having problems sleeping. It takes forever to fall asleep and then, when I do, it’s only for a short time. I am now miserable during the days and making mistakes and falling asleep at work. Is there anything that I can do, or any medication I can take, to help me fall asleep and stay asleep.
A You seem to be having insomnia. Insomnia is a problem affecting sleep, and persons who have insomnia have trouble falling or staying asleep, or they do not feel rested when they wake up.
Insomnia is not about the number of hours of sleep a person gets. Everyone needs a different amount of sleep. Some people require little sleep and can function without difficulty after sleeping for only a few hours. People who sleep less, but have no resulting daytime sleepiness or other symptoms, are called short sleepers and do not have a sleep problem. You also need less sleep as you get older.
People with insomnia often complain of:
- Having trouble falling or staying asleep.
- Feeling tired or sleepy during the day.
- Forgetting things or having trouble thinking clearly.
- Getting miserable, anxious, irritable, or depressed.
- Having less energy or interest in doing things.
- Making mistakes or getting into accidents more often than normal.
These symptoms can be so severe that they start affecting a person’s relationships and work life. It is important to note is that these symptoms can occur even in people who seem to be getting enough hours of sleep.
Insomnia may have many causes
Short-term insomnia lasts less than three months and is usually associated with a stressor. Possible stressors may include:
- Changes in sleeping environment (temperature, light, noise).
- The loss of a loved one, a divorce, or job loss.
- Recent illness, a surgery, or pain.
- Use or withdrawal from certain medications, illegal drugs, or alcohol.
Short-term insomnia is often resolved when the stressor is resolved.
There are also situations that will disrupt your normal sleep cycle and cause insomnia, such as jet lag and shift work.
Long-term (or chronic) insomnia lasts longer than three months and occurs at least three nights per week. This type of insomnia occurs with other conditions such as:
- Mental health problems, eg, depression, anxiety disorders, and post-traumatic stress disorder.
- Medical illnesses, especially those that cause pain, stress, or difficulty breathing.
- Neurological disorders, such as Parkinson’s disease and Alzheimer’s disease.
Insomnia can also occur on its own.
To improve your insomnia, you can follow what we call good ‘sleep hygiene’. This means that you:
- Sleep only long enough to feel rested and then get out of bed.
- Go to bed and get up at the same time every day.
- Do not try to force yourself to sleep. If you can’t sleep, get out of bed and try again later.
- Have coffee, tea, and foods that have caffeine only in the morning.
- Avoid alcohol in the late afternoon, evening, and at bedtime.
- Avoid smoking, especially in the evening.
- Keep your bedroom dark, cool, quiet, and free of reminders of work or other things that cause you stress.
- Solve problems you have before you go to bed.
- Exercise several days a week, but not right before bed.
- Avoid looking at phones or reading devices that give off light before bed (tablets, laptops).
If these fail, you may need to work with a counsellor or psychologist to deal with the problems that might be causing you poor sleep.
There are medicines to help with sleep, but you should try them only after you try the techniques described above. You should not use sleep medicines every night for long periods of time, because you can become dependent on them for sleep.
If after reading this you do believe that you have insomnia, and it is troubling you, see your doctor. He or she might have other suggestions on how to fix the problem, and also determine if your insomnia is caused by mental-health problems. In such a case, you might be prescribed an antidepressant rather than a sleep aid. Antidepressants often improve sleep and can help with other worries, too.
A common myth is that having an alcoholic drink before bed will help with sleep.
No! Do not use alcohol as a sleep aid. Even though alcohol makes you sleepy at first, it disrupts sleep later in the night.