Insomnia is a sleep disorder in which one has difficulty falling asleep, staying asleep, or getting quality sleep. According to a recent study by the University of Pennsylvania School of Medicine, one in four Americans develop insomnia each year, but fortunately, about 75% of these individuals recover without developing persistent insomnia while the other 25% progress to acute insomnia.
People over the age of 60 tend to experience sleep disturbances more often than younger people. Females are also twice as likely to have sleep problems compared to males. There are a multitude of possible causes for insomnia, including:
- emotional stress,
- mental health disorders, such as depression or anxiety,
- chronic pain,
- heart failure,
- restless leg syndrome,
- circadian rhythm disruptions, such as jet lag or working night shifts,
- sleep apnea,
- certain medications,
- heavy smoking, and
- excessive alcohol intake.
Insomnia is agonizing, exhausting, and frustrating. Some people turn to sleeping pills, either over-the-counter or prescription, which may help improve sleep while you are taking them. But insomnia usually returns once they are stopped because medications do not treat the underlying causes of insomnia.
Melatonin is a natural sleep hormone that is sold as a supplement. It is helpful for occasional sleep problems and jet lag. Individuals who report that melatonin does not work often make the mistake of taking too high a dose of several grams. Very often, as little as 300 mcg is already sufficient. Always start with the lowest dose before increasing the dosage. It is also beneficial to get the “timed release” melatonin as it will help you stay asleep longer. However, melatonin also does not address the underlying causes of insomnia.
A more successful approach to insomnia is to improve sleep hygiene and make lifestyle changes in conjunction with cognitive behavioral therapy. Dozens of studies have proved that this strategy is extremely helpful in treating insomnia. In the following, we will examine these techniques in more detail.
Sleep Hygiene And Lifestyle Changes
The goal is to help you fall asleep more easily, wake up less often and for shorter periods of time, and fall back to sleep more easily.
- Regular rising time. Set an alarm clock and get out of bed around the same time every day, no matter how little or poorly you have slept. Do not try to sleep in on weekends because by doing so, you will disrupt your body’s circadian rhythm.
- Reducing time in bed. Do not go to bed early because you did not sleep well the prior night. This will actually exacerbate insomnia. Determine your earliest allowable bedtime by starting from your desired wake-up time and subtracting the amount of time you want to stay in bed. The time in bed is your average sleep time plus 1 hour and can range from a minimum of 6 hours to a maximum of 9 hours. If you sleep on average 5 hours or less at night, your time in bed should be 6 hours. If you sleep 8 hours, your time in bed should be 9 hours. In other words, your time in bed should closely match the amount of sleep you are averaging per night. The purpose is to avoid the bed becoming a cue for wakefulness more than a cue for sleep. For insomniacs who are already exhausted, the hardest part is to stay awake until the allowable bedtime. Try to engage in a light activity and refrain from going to bed. As you start to sleep better and more hours, you can move the allowable bedtime earlier.
- Wind down gradually in the hour before bedtime by engaging in relaxing activities. Avoid stimulating activities such as phone calls, arguments, emotional discussions, work-related activities, surfing the internet, bill-paying, or unpleasant TV programs.
- If you need to nap after a poor night of sleep, limit your nap to 45 minutes and do not take it later than 4 pm.