Insomnia

Insomnia is frequent trouble falling and/or staying asleep. Insomnia can be a long term problem or a short term problem. Both are common. Insomnia can be a short term problem when the wakefulness is related to a certain stress or worry. Long term insomnia is often related to ongoing stress during waking hours and/or poor sleeping habits. Overtime, sleep deprivation itself can make the problem worse. Every little thing feels more severe because you are overtired and your ability to cope is decreased.

CAUSES

  • Stress, anxiety, and depression.

  • Poor sleeping habits.

  • Distractions such as TV in the bedroom.

  • Naps close to bedtime.

  • Engaging in emotionally charged conversations before bed.

  • Technical reading before sleep.

  • Alcohol and other sedatives. They may make the problem worse. They can hurt normal sleep patterns and normal dream activity.

  • Stimulants such as caffeine for several hours prior to bedtime.

  • Pain syndromes and shortness of breath can cause insomnia.

  • Exercise late at night.

  • Changing time zones may cause sleeping problems (jet lag).

It is sometimes helpful to have someone observe your sleeping patterns. They should look for periods of not breathing during the night (sleep apnea). They should also look to see how long those periods last. If you live alone or observers are uncertain, you can also be observed at a sleep clinic where your sleep patterns will be professionally monitored. Sleep apnea requires a checkup and treatment. Give your caregivers your medical history. Give your caregivers observations your family has made about your sleep.

SYMPTOMS

  • Not feeling rested in the morning.

  • Anxiety and restlessness at bedtime.

  • Difficulty falling and staying asleep.

TREATMENT

  • Your caregiver may prescribe treatment for an underlying medical disorders. Your caregiver can give advice or help if you are using alcohol or other drugs for self-medication. Treatment of underlying problems will usually eliminate insomnia problems.

  • Medications can be prescribed for short time use. They are generally not recommended for lengthy use.

  • Over-the-counter sleep medicines are not recommended for lengthy use. They can be habit forming.

  • You can promote easier sleeping by making lifestyle changes such as:

  • Using relaxation techniques that help with breathing and reduce muscle tension.

  • Exercising earlier in the day.

  • Changing your diet and the time of your last meal. No night time snacks.

  • Establish a regular time to go to bed.

  • Counseling can help with stressful problems and worry.

  • Soothing music and white noise may be helpful if there are background noises you cannot remove.

  • Stop tedious detailed work at least one hour before bedtime.

HOME CARE INSTRUCTIONS

  • Keep a diary. Inform your caregiver about your progress. This includes any medication side effects. See your caregiver regularly. Take note of:

  • Times when you are asleep.

  • Times when you are awake during the night.

  • The quality of your sleep.

  • How you feel the next day.

This information will help your caregiver care for you.

  • Get out of bed if you are still awake after 15 minutes. Read or do some quiet activity. Keep the lights down. Wait until you feel sleepy and go back to bed.

  • Keep regular sleeping and waking hours. Avoid naps.

  • Exercise regularly.

  • Avoid distractions at bedtime. Distractions include watching television or engaging in any intense or detailed activity like attempting to balance the household checkbook.

  • Develop a bedtime ritual. Keep a familiar routine of bathing, brushing your teeth, climbing into bed at the same time each night, listening to soothing music. Routines increase the success of falling to sleep faster.

  • Use relaxation techniques. This can be using breathing and muscle tension release routines. It can also include visualizing peaceful scenes. You can also help control troubling or intruding thoughts by keeping your mind occupied with boring or repetitive thoughts like the old concept of counting sheep. You can make it more creative like imagining planting one beautiful flower after another in your backyard garden.

  • During your day, work to eliminate stress. When this is not possible use some of the previous suggestions to help reduce the anxiety that accompanies stressful situations.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.