Thursday, June 18, 2009

Problems with your “Z’s”: New research on treatment of persistent insomnia – help is more than just medication.

The May 20th issue of JAMA (Journal of the American Medical Association) includes an article on treatments for persistent insomnia. Insomnia is the most common of all the sleep disorders and is described as having problems with the ability to gain sufficient sleep or to feel rested and characterized by difficulty getting to sleep or staying asleep. Insomnia may be situational, recurrent, or chronic. Most people know if they have problems with sleep, and most of us have had personal experience with occasional bouts of insomnia.

Lack of adequate sleep over time, or persistent insomnia, can have a very big impact on daily functioning; it will lower your quality of life and can contribute to various health and emotional problems. When untreated, insomnia can also contribute to major depression and other physical problems. When you get behind the wheel with not enough quality sleep, you not only put your life at risk, but those around you as well. A large number of auto accidents are attributed to driving while drowsy. Although it may be tempting to use alcohol as a sleep aid, it will work in the opposite way and create insomnia and other health-related issues as well. And…of course this will not help your driving either!

Here are some sleep-promoting tips that can work well to help you get into a healthy sleep routine:

1. Maintain a regular bedtime and awakening time schedule including weekends. Get up about the same time every day, regardless of what time you fell asleep.
2. Establish a regular, relaxing bedtime routine. Relaxing rituals prior to bedtime many include a warm bath or shower, aroma therapy, reading, or listening to soothing music.
3. Sleep in a room that is dark, quiet, comfortable, and cool; sleep on comfortable mattress and pillows.
4. Use your bedroom only for sleep and sex. Have work materials, computers, and TVs in another room.
5. Finish eating at least 2-3 hours prior to your regular bedtime.
6. Avoid caffeine within 6 hours; alcohol & smoking within 2 hours of bedtime.
7. Exercise regularly; finish a few hours before bedtime.
8. Avoid naps.
9. Go to bed only when sleepy. Lay in bed only for sleeping, not for work or watching TV.
10. Designate another time to write down problems & possible solutions in the late afternoon or early evening, not close to bedtime.
11. After 10-15 minutes of not being able to get to sleep, go to another room to read or watch TV until sleepy.

This latest research in JAMA shows that CBT (Cognitive Behavioral Therapy), a structured form of psychological treatment that focuses on modifying thoughts and behavioral patterns, was effective for treating persistent insomnia. The addition of a sleep medication to CBT treatment like zolpidem (generic name for a prescription sleep medication) produced some benefits, although such benefits were modest to treatment outcomes. Such findings suggest CBT may provide an added benefit in treatment of insomnia.

Since you are awake anyway, sign on and leave a comment about how your sleep is going. All comments from those who are sleep-deprived and others are always welcome. Sweet Dreams!


Anonymous said...

Thanks for the tips, they look really good.

Anonymous said...

If you are suffering from sleep problems such as insomnia or obstructive sleep apnea, you need to consider this problem seriously and adopt specific measures at the earliest to get back your sleep. Regular exercising is one of the options to ensure sound sleep at night. Altogether, if you are unable to get adequate sleep during night, you can undertake certain initiatives to overcome your sleep problems such as fixing your sleeping as well as waking schedule and abstaining from alcohol, nicotine, tea, coffee et al before hitting the bed.

Anonymous said...

I appreciate the tips here. My doctor has been too quick to recommend sleep medications, but I don't want to take that route. One must be prudent not to exercise too closely to bedtime, as this is one sure-fire way to keep me awake most of the night.

Brenda Ballard said...

I've tried some of these tips, but if I waited to go to bed before getting sleepy it usually tends to be aprrox 6:00 am the next day. I also have alot of leg pain that is keeping me awake now. I have trouble sleeping in the dark, but will try that one anyway. I'm getting the exercise started and the new puppies have been keeping me moving as well.