Strategies for Getting a Good Night’s Sleep

Here’s some excellent information on avoiding insomnia and getting a good night’s sleep using common-sense sleep hygiene. It’s from my friends at the Natural Medicines Comprehensive Database. However, I find that many of my patients are not aware of some (or even most) of this information. So, here’s to a good night’s sleep for each of you.

What Is Insomnia?

Insomnia is a common complaint. Some symptoms of insomnia are difficulty falling asleep, difficulty staying asleep, and difficulty with early morning awakening.

Sometimes insomnia only lasts for a short time and can be easily managed. Persistent insomnia is more troublesome and can affect work, school, social relationships, and health.

Many conditions are associated with insomnia such as depression, anxiety, allergies, and pain. Much of the time insomnia is simply the result of poor sleep habits.

How Is Insomnia Treated?

Insomnia treatment in adults may include use of an over-the-counter medication or, in other cases, use of a prescription sedative.

Over-the-counter sleep medications (diphenhydramine [Benadryl]) may worsen insomnia in children.

It is important to determine the cause of insomnia before treatment begins. Maintaining a sleep diary for one to two weeks is a good way to start. Keeping track of sleep times, caffeine and alcohol ingestion, etc. may provide clues as to the cause of insomnia.

Behavioral changes are often all that’s needed to improve sleep. By maintaining good sleep habits (sleep hygiene) the need for medication may be avoided. In children, ensure a regular sleep schedule and calming bedtime routine.

PRINCIPLES OF SLEEP HYGIENE

  • Stick to a regular sleep schedule—even on weekends.
  • Exercise regularly—avoid exercise in the late evening.
  • Go to bed only when sleepy.
  • Put your worries away when you go to bed.
  • Do something relaxing and enjoyable before bedtime.
  • Make your bedroom quiet and comfortable.
  • Avoid large meals just before bedtime.
  • Use your bedroom only for sleep and sexual activity.
  • If you cannot sleep within 15 to 20 minutes get up and go to another room. Return to bed only when drowsy.
  • Remove the clock from eyesight.
  • Do not nap during the day. If you must nap, limit it to 30 minutes in the early afternoon.
  • Avoid alcohol, nicotine, and caffeine use.
  • Avoid frequent use of sedatives.
  • Schedule outdoor time at the same time each day.
  • Have your pharmacist check your medications for potential sleep effects.
  • Avoid bright lights (e.g. from TV, computers, video games) before bed.

Adapted from Jermain DM. Sleep disorders. PSAP. 1995:139-154.

What If Nondrug Treatment Fails?

If you or your child are still having difficulty getting a good night’s sleep, you should talk to your pharmacist or other healthcare provider. The cause of your insomnia will need to be determined and a medication may be needed.

Even if medication is used for insomnia, sleep hygiene principles should still be followed and can provide added benefit.

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