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No More Sleepless Nights: Dealing With Insomnia
Finding the Causes of Insomnia
- Use of stimulants, including caffeine, nicotine, and ingredients in common drugs such as cold and weight-loss medicines. Some people have difficulty falling asleep, others wake during the night.
- Use of alcohol. While it may help you fall asleep, alcohol consumption is likely to produce interrupted sleep and is not recommended as an insomnia treatment.
- Working night or rotating shifts.
- Lack of regular exercise.
- Exercising too close to bedtime
- Eating too close to bedtime.
- Excessive time on the computer or watching television.
Treating Insomnia With Lifestyle Changes
- Going to bed at the same time each night
- Reserving your bed for sleep and sex
- Watching television or reading in another room
- Avoiding caffeine, alcohol, and cigarettes, especially in the afternoon and evening
- Not laying in bed watching the clock. If you cannot fall asleep 15-20 minutes, get up and listen to calming music or read
- Exercising often, but not too close to bedtime
- Limiting naps
- Sleeping in a place with very little light and noise distraction
- Relaxation techniques—A multidisciplinary team, including medical doctors, specializing in sleep disturbances can train and guide people in such approaches as yoga, meditation, deep relaxation, biofeedback, hypnosis, massage, and/or guided imagery. Practicing one of these techniques within 30 minutes of bedtime may be helpful. Simple changes in bedtime routine may also be effective. These include taking a warm bath, listening to soothing music, and drinking warm milk.
- Acupuncture—Positive effects of the use of this ancient Chinese practice have been shown; however, more proof is needed before it can be recommended as an effective treatment for insomnia. A typical protocol is to receive acupuncture treatments weekly until a normal sleep pattern is achieved, followed by maintenance sessions. However, a licensed and certified acupuncturist will determine the most appropriate treatment regimen for each individual.
- Light therapy—For night-shift workers suffering from insomnia, light therapy may effective. This therapy involves using very bright lights in the work setting and then, when trying to sleep during the day, doing so in a very dark room while wearing sunglasses or a sleep mask.
- Cognitive therapy—This behavioral method involves addressing misconceptions and unrealistic expectations about both insomnia and the nature of sleep. Some issues addressed during cognitive therapy include napping to compensate for poor sleep at night, anxiety about bedtime, fear of sleeplessness, beliefs about necessary hours of sleep, and attributing insomnia to age, ability to sleep, and/ or possible chemical imbalance.
Treating Insomnia with Prescription Sleep Medications
- Short-acting sedative-hypnotics known as non-benzodiazepines. Zolpidem (Ambien), Zaleplon (Sonata), and Eszopiclone (Lunesta) fall into this category.
- Melatonin receptor agonists.
- Benzodiazepines (tranquilizers).
Treating Insomnia With Herbs and Supplements
Treating Insomnia with Melatonin
Substances to Avoid
Putting Insomnia to Rest
National Heart Lung and Blood Institute http://www.nhlbi.nih.gov
National Sleep Center http://www.sleepfoundation.org
Better Sleep Council Canada http://www.bettersleep.ca
Canadian Sleep Society http://www.canadiansleepsociety.com
Acupuncture. EBSCO Natural and Alternative Treatments website. Available at: http://www.ebscohost.com/healthLibrary. Updated September 26, 2012. Accessed February 7, 2013.
Bain KT. Management of chronic insomnia in elderly persons. Am J Geriatr Pharmacother. 2006;4(2):168-92. Review.
Becker PM. Pharmacologic and nonpharmacologic treatments of insomnia. Neurol Clin. 2005;23(4):1149-63. Review.
Can't sleep? What to know about insomnia. National Sleep Foundation website. Available at: http://www.sleepfoundation.org/article/sleep-related-problems/insomnia-and-sleep. Accessed February 7, 2013.
Insomnia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what. Updated January 15, 2013. Accessed February 7, 2013.
Insomnia treatment. American Academy of Family Physicians Family Doctor website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/insomnia/treatment.html. Updated February 2011. Accessed February 7, 2013.
Mayers AG, Baldwin DS. Antidepressants and their effect on sleep. Hum Psychopharmacol. 2005;20(8):533-59. Review.
Ringdahl EN, Pereira SL, Delzell JE Jr. Treatment of primary insomnia. J Am Board Fam Pract. 2004;17:212-219.
Sleep aids and insomnia National Sleep Foundation website. Available at: http://www.sleepfoundation.org/article/sleep-related-problems/sleep-aids-and-insomnia. Accessed February 7, 2013.
Sleep disorders and CAM. National Center for Complementary and Alternative Medicine website. Available at: http://nccam.nih.gov/health/sleep/ataglance.htm?nav=gsa. Updated September 2010. Accessed February 7, 2013.
Sleep drive and your body clock. National Sleep Foundation website. Available at: http://www.sleepfoundation.org/article/sleep-topics/sleep-drive-and-your-body-clock. Accessed February 7, 2013.
World Health Organization. Diseases and disorders that can be treated with acupuncture. Traditional Chinese Medicine and Acupuncture Health Information Organization website. Available at: http://tcm.health-info.org/WHO-treatment-list.htm. Accessed August 20, 2007.
Valerian. EBSCO Natural and Alternative Treatments website. Available at: http://www.ebscohost.com/healthLibrary. Updated August 1, 2010. Accessed November 5, 2010.
11/5/2010 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Fernández-San-Martín MI, Masa-Font R, Palacios-Soler L, et al. Effectiveness of Valerian on insomnia: a meta-analysis of randomized placebo-controlled trials. Sleep Med. 2010;11(6):505-511.
- Reviewer: Brian Randall, MD
- Review Date: 02/2013
- Update Date: 02/07/2013