Help! I can’t sleep! Advice for insomniacs
VCU School of Pharmacy faculty, alumni and students have provided the Dr. Rx column for Richmond’s Fifty Plus magazine since December 2009. We now share those columns on the SOP website, as well, for those who might not have seen the most recent issue.
Serving as Dr. Rx for June 2014 was Laura Petrozza, who received her doctor of pharmacy degree in May and is working in community pharmacy with CVS. She earned her undergraduate degree in biology at Virginia Tech.
Dear Dr. Rx: For the past few weeks, I have had trouble sleeping and can’t seem to find a way to regulate my sleep routine. I want to use sleep aids only as a last resort. Is there anything I can do to help my insomnia before trying medication?
Insomnia is one of the most common conditions in general medicine, with more than half of the population struggling with it at some point in their lifetime. It is characterized by one or more of the following: difficulty falling asleep, difficulty staying asleep or experiencing non-restful sleep.
Insomnia can result in daytime fatigue, anxiety, poor concentration and overall impaired functioning. It can be short-term, lasting for a few days or weeks, or chronic, in which the problem persists for more than three weeks.
Some of the best ways to improve sleep quality and quantity do not involve medication at all – rather, they challenge us to modify our behavior. These techniques, called sleep hygiene and stimulus control, are simple steps designed to change the way we approach sleep. The following methods can be useful first steps toward resolving both short-term and chronic insomnia.
- Establish a bedtime routine that you repeat every night. This can help your body recognize when it is time to sleep. Set regular times to go to sleep and wake up, and stick with this schedule even on the weekends. Do something relaxing before bed to help yourself wind down – for example, take a hot bath and catch up on a book.
- Create a comfortable sleep environment. Keep your room quiet, dark and cool. White noise, such as from a fan or noise machine, may help you sleep, too.
- Limit how much time you spend awake in bed. Go to bed only when you feel sleepy, sleep only as long as you need to feel rested and then get out of the bed.
- Do not try to force yourself to sleep. If you are not able to fall asleep within 20 minutes, get out of bed and perform an activity that you find relaxing (such as reading or doing a puzzle) until drowsy.
- Avoid daytime naps, especially late in the day.
- Exercise routinely, but at least three hours before bedtime to avoid increasing wakefulness.
- Reduce alcohol, caffeine and nicotine use, especially in the evening.
- Avoid drinking large quantities of liquid in the evening so you do not have to get up to use the bathroom during the night.
You might also find it helpful to keep a sleep diary to help pinpoint the source of your insomnia – write down the times you go to bed and any time you wake up during the night, as well as what is on your mind or is happening in the room at these times.
It is also important to remember that sleep aids are available if these practices do not work. Many people find relief with a short course of medication in combination with behavioral changes. However, it is important to remember always to talk first to your doctor or pharmacist before taking any over-the-counter or prescription sleep aids.
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