How to fix it
Insomnia is not normal at any age, but there are a number of sleep treatments and therapies that may help. Because it’s not unusual for insomnia to have more than one cause, you may need to combine several fixes.
Keeping a sleep journal, which records your sleep/wake patterns, can help your doctor determine why you can’t sleep. If your physician suspects you have sleep apnea, which causes you to stop breathing briefly many times in a night, or PLMD, in which you experience frequent muscle jerks and spasms (usually in the legs) during sleep, she may send you to a sleep center for a polysomnograph. This overnight test records your brain waves, revealing a picture of your sleep cycles.
Many sleep experts consider stress and anxiety to be a prime cause of short-term insomnia. Anxiety that causes a few sleepless nights can lead, in some people, to a condition called psychophysiologic insomnia, where a person focuses on his sleep problems and develops habits that lead to chronic insomnia.
Chances are good that making modifications to your lifestyle will help you get a good night’s sleep. Most experts say sleep medications should be used only as a last resort, or only short term, to provide relief while you work on implementing lifestyle changes.
Treat underlying conditions
Cause: depression
Treatment: Although antidepressants are not sleep medications, regular doses may improve sleep both by elevating mood and reducing anxiety and by boosting levels of serotonin in the brain. In addition, some antidepressants (such as tricyclics) have sedating effects.
Cause: anxiety
Treatment: Relaxation techniques and behavior modification
Cause: pain
Treatment: Talk to your doctor about medications that can better manage your pain. Stronger drugs, such as opioids and narcotics, are designed for short-term use and can leave you feeling sleepy the next day. For some people with chronic pain, low-dose antidepressants can interrupt the pain cycle and help them sleep better. You may have to try several medications before you find one that resolves your issues with pain and sleep.
Cause: Restless legs syndrome (RLS) or periodic limb movement disorder (PLMD)
Treatment: Medications such as ropinirole (Requip) or pramipexole (Mirapex) that increase the amount of dopamine in the brain
Cause: Sleep apnea
Treatment: Using a continuous positive airway pressure (CPAP) mask to keep the airway open
Tips for better sleep
Although it’s often dismissed as too simple, creating good sleep habits – known as sleep hygiene – can be an important first-step sleep treatment. The goal is to eliminate any stimulants that may be keeping you up and to train your mind to associate your bedroom with sleep – successful sleep, says Andrew Jamieson, MD, associate clinical professor of psychiatry, the University of Texas Southwestern Medical Center at Dallas.
Good sleep practices include the following:
• Eliminate caffeine
• Avoid naps
• Don’t drink alcohol
• Don’t eat a large meal near bedtime
• Exercise
• Go to bed and get up at the same time every day
• Reserve your bedroom for sleep and sex – no TV, piles of laundry to sort or even books
• If you can’t sleep, get up after 20 minutes. Go into another room and read or listen to music until you’re sleepy.
• Don’t use bright lights or watch TV
