Ellen Campbell Grizzle - Pharmacy Today FALLING ASLEEP is difficult for many persons. Some awake frequently during sleep, get up earlier than usual and are not refreshed by sleep. These persons usually have tried several self-help techniques, including counting sheep, and have failed. Experts agree that adults need seven to nine hours of sleep per day and children 10 to 11 hours.
There are several conditions and circumstances that lead to consistently interrupted or delayed sleep (insomnia). These range from stress, anxiety, depression, jet lag, adjustments to shift work, delayed sleep phase syndrome (you can't fall asleep and wake on time) or advanced sleep phase syndrome (you fall asleep and wake too early).
Other factors identified are snoring, sleeplessness during pregnancy and restless leg syndrome (uncomfortable twitching in the legs that produce an urge to move the legs) particularly in the elderly population. Medication can also interfere with sleep. Common offenders are among asthma treatments, nasal decongestants and some drugs used to treat high blood pressure. Stimulants in your over-the-counter medicines can also affect your sleep pattern.
Sleep disorders also may be signs of underlying physical and mental illnesses. These can lead to reduced productivity at the workplace and increase the risk of accidents and drug abuse. Among common treatable sleep disorders are sleep apnea (disorder due to blockage of upper airway tract) and narcolepsy (sudden, dramatic and uncontrolled sleep attack).
Experts agree that the best defence against sleep problems is good sleep hygiene that ensures adequate and good quality rest. In some cases, medication is needed. If you have a sleeping problem, practise good sleeping habits and:
stick to a regular bedtime schedule and avoid daytime napping
avoid stressful actions and vigorous exercise, two hours before bedtime
try yoga or other means of meditation; exercise regularly
make your bedroom dark, quiet and cool; take the television out of your bedroom
if you are unable to fall asleep within 20 minutes, leave your bedroom and try reading or listening to relaxing music
avoid caffeine found in coffee, tea, soft drinks and diet pills
avoid alcohol at bedtime as this disrupts sleep continuity.
If you snore, try to sleep on your side, avoid alcohol, cigarette smoking and sleeping pills, and seek treatment for allergies and nasal obstruction.
There are some persons for whom doctors will prescribe medication. These often induce sleep or reduce anxiety. Dosages will vary, particularly for the elderly who tend to eliminate drugs more slowly and will need lower doses. Great care must be taken with the use of these drugs as some have the potential for dependence or abuse. Improve the outcome of your treatment by telling your doctor and pharmacist if you are taking any other medication and herbal preparations to avoid drug interactions.
DO NOT:
increase the prescribed dose or period of treatment
drive or operate machinery if your treatment makes you drowsy
share your medication with others
take alcohol with sleep medication
If you are unable to obtain sleep of sufficient length and quality to feel refreshed when you get up, you need help. If you are suffering from an underlying physical or mental condition, these must be treated. Remember, sleeping pills are not permanent crutches. If they do not work within the prescribed period, you need to see your doctor again.
If you want to know more about how your medication works to relieve sleep disorders, ask your pharmacist, you have the right to know!
Ellen Campbell Grizzle, President, The Caribbean Association of Pharmacists (CAP) and Director, Information & Research, National Council on Drug Abuse (NCDA).
