“Okay, I get it! My insomnia is officially out of control, and it’s time to do something about it. But what? I’ve tried everything – is there something I missed?”
Well, you’ll never know until you objectively consider your symptoms, efforts to date, and what’s available to help.
Yesterday, we began a two-part series on insomnia – given so many chipur readers struggle with it. We chatted what it looks like, and its causes. Be sure to read it.
Today we’ll delve into what to do about it…
If You Take Nothing Else From This Article
You’ll likely swear by all that’s holy that the cause of your insomnia is some mysterious outside force. And I’m going to lay odds the cause is something over which you have direct control.
In addition to what you’re about to read, be sure to check-out the comprehensive list of potential causes in yesterday’s piece. If you see something that applies to you, get after it, affect change, and move on!
Checking-In With Your Doc…
Okay, you’ve had enough; and you’re ready to smack your insomnia upside the head. A great place to start is chatting with your physician.
It’s so important to be prepared when you visit the doc’s office. Have a well-considered plan and agenda. As you prepare, be thinking, “Short of a miracle cure, what would have to happen to make this appointment worth my time and money?”
Just a thought here. If you’re going to chat with your doc regarding a sleep problem, wouldn’t it be a great idea to have a detailed sleep log with you? ‘Course that means you’ll have to keep one (hint, hint).
What else might your doc want to know (and you’ll be prepared to answer)? Just a few thoughts…
When did your insomnia begin? How long does it take you to fall asleep? Do you snore or awaken choking for breath? Do you feel refreshed when you awaken? What’s your bedtime routine and sleep environment?
What meds are you taking? Do you use tobacco and/or other substances? Any recent stressful events? Are you consumed with worry over your inability to sleep? Have you traveled recently?
There are all sorts of things you can do to defeat insomnia. Sticking with our checklist format, here’s plenty to consider…
Cognitive and Behavioral Approaches
- Learn good sleep habits.
- Use relaxation techniques at bedtime: progressive muscle relaxation, biofeedback, breathing exercises.
- Overcome learned insomnia by replacing your worries about not sleeping with positive thoughts.
- Stimulus control – associate your bed and bedroom with sleep and sex. Otherwise, keep out!
- Sleep restriction – decrease the time you spend in bed, which will result in degrees of sleep deprivation. It serves to make you more tired the following night. When your situation improves, spend more time in bed.
- Light therapy – if you’re falling asleep too early, and subsequently waking too early; use a light to manipulate your internal clock. You can use natural sunlight (when available) or a light box.
Need help? Work with a counselor – individually or in a group.
- Non-benzodiazepine hypnotic: zolpidem (Ambien), eszopiclone (Lunesta)
- Sedative-hypnotic: zaleplon (Sonata)
- Melatonin receptor agonist: ramelteon (Rozerem).
- Antidepressant: trazodone (Desyrel), doxepin (Silenor), mirtazapine (Remeron)
- Benzodiazepine: lorazepam (Ativan), clonazepam (Klonopin), alprazolam (Xanax), etc.
Over the Counter Meds
Too many to list, but many OTC sleep aids use antihistamines to make you drowsy. Keep in mind, antihistamines may reduce the quality of your sleep; and can lead to issues such as daytime sleepiness, dry mouth, and blurred vision.
- Find and stick to a daily sleep-time schedule.
- Not sleepy? Give it 20 minutes and get out of bed! Turn to a relaxing activity, such as reading.
- Do not try to sleep. Not only will it not work, you’ll just become all the more awake. Bide your time in another room, participating in that relaxing activity.
- Your bed is for sleeping and – well – sexual activity. That’s it!
- Try a warm bath before retiring. Perhaps your partner will give you a massage. See if you can come up with a set bedtime ritual.
- Be careful with the length and timing of your naps.
- Is your bedroom sleep comfy? Door closed? Nice background noise? Temp? No TV or computer.
- Exercise daily, but not within five to six hours of bedtime.
- Caffeine or nicotine after lunch time? No way. Alcohol just before bedtime? Nope. A large meal before sleepy-time? No.
- Make sure your medicines aren’t contributing to the problem. Using OTC meds? Check for pseudoephedrine.
- Pain? Get it under management.
- Set your alarm, but hide the clocks.
One final note. If you’re considering an OTC med or supplement, please be sure to run it by your doc.
That’ll Do It
And so that completes our two-part series on insomnia. Do I really have to ask you this question? What could be worse for someone enduring a mood or anxiety disorder than not being able to sleep?
But I really do have to ask you this one. What are you doing to be proactive in solving your insomnia dilemma?
Now, you may be thinking, “Is he kidding me?” But take the time to objectively consider the information presented in the series. What you find just might surprise (and help) you!
Then it’s on to reassessing your strategies and techniques.
As always, thanks to mayclinic.com for the resource material.
If you’d like to see a list of all 75 chipur articles on the biology of the mood and anxiety disorders, click away right here.