Insomnia Part 2

Dear Dr. Spence,
Why can’t I seem to get a good night sleep? What can I do other than pop pills every night?
Signed,
Sleepless in Marianna


In my last writing I had been discussing some of the causes and implications of insomnia. The solution to improving sleep hygiene, however, is more complex. There are many options available to patients. Some are by prescription, some are over the counter remedies and some are just plain common sense. First and foremost, of course, is fixing any problem that may have led to the insomnia originally. If a patient is depressed for example, proper therapy may be an antidepressant as opposed to a sleep aide.
Changing sleep habits is a simple and occasionally effective way of combating the problem. Maintaining regular sleep and wake times are crucial at helping regulate the body’s natural circadian rhythms. Many people incorporate behavioral therapy into the mix. Techniques include muscle relaxation, breathing exercises and cognitive therapies that try to replace worry about sleep with more positive thoughts.
There are of course some basics when it comes to sleep hygiene. You should keep the same sleep schedule regardless of whether it is a weekend or not. Try to avoid the temptation of sleeping in once Saturday and Sunday roll around. You should sleep as much as you need to in order to feel rested. If you cannot sleep for fifteen minutes, it is recommended that you engage in another activity for a while (i.e. reading a book or watching T.V.) Do not read, eat, watch T.V. or work in bed. The bedroom should be a place of comfort; cool with minimal distractions like noise or light. Get rid of the computers and T.V. Those who engage in regular exercise generally report better sleep. Lastly, limiting alcohol and/or caffeine at bedtime can also help prevent insomnia.
Finally, medications can be used if all else fails. Over the counter medications like valerian and melatonin have been used for years with varying degrees of success. Most studies do not support their efficacy. Your physician can prescribe a host of agents that may help induce sleep. Popular agents like lunesta and ambien can be beneficial but may be potentially addictive and may be problematic in older adults due to their sedative properties. Rozerem claims to work by helping maintain the natural sleep architecture through sleep-wake cycles and does not appear to have the adverse effects or dependence that is seen with other agents. Your physician can assist you in finding the right medication for you.
Do you have any medical questions or concerns that you would like addressed? You can contact Dr. Spence by email at panhandledailydose@hotmail.com or by mailing your question to Daily Dose, P.O. Box 6107, Marianna, FL 32446.

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