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Insomnia: How to Get a Better Night’s Sleep

Insomnia is the inability to get the amount of sleep you need to feel rested and function well during the day. An estimated 1/3 of Americans suffer from insomnia at any one point in time! Fortunately, the majority of cases are short-term and resolve within weeks. However, up to 20 million Americans complain of problems with chronic insomnia that may significantly effects their life.

Insomnia can usually be divided into two broad categories: trouble falling asleep at the start of the night (also known as sleep-onset insomnia) and difficulty staying asleep during the night (also known as sleep-maintenance insomnia). Some individuals may experience problems with both. Many factors contribute to insomnia and may include one or more of the following; a poor sleep environment (i.e. noisy bedroom, bedroom too bright or too warm), learned poor sleep habits (i.e. watching TV to fall asleep), excessive use of stimulants (both medications and common substances such as caffeine and nicotine), certain medications, stress or anxiety, pain, medical conditions that may make it uncomfortable or difficult to breath well when lying down, heartburn, restless legs syndrome (an irresistible need to move the legs when awake at night) and circadian rhythm disturbances (when the body?s biologic rhythms are out of synchrony or delayed). Occasionally no underlying cause contributing to insomnia can be found and the condition is labeled as ?idiopathic insomnia? or insomnia for which a cause can not be found.
Most cases of insomnia can be managed without the use of sleep-inducing medications. If a specific cause of the insomnia can be identified, then treatment should be directed at that issue. Often times, behavioral therapy can be very effective for individuals whose insomnia is the result of a poor sleep environment, poor sleep habits or psychological conditions. Improving ?Sleep Hygiene? can make a dramatic impact in some cases and these steps are listed below: 
Recommendations for good sleep hygiene:

  • Use your bed for sleep and sex only, not watching TV or eating. 
  • Establish a regular bedtime and wake up time and continue this on weekends. Make your sleeping environment comfortable, quiet, dark, cool and well-ventilated. 
  • Place your clock out of sight to avoid anxiety about the time. Use an alarm clock to ensure a scheduled wake up time. 
  • Take time to relax before bedtime. Engage in quiet activity: read, journal, practice focused breathing and progressive muscle relaxation. 
  • Take a warm bath or shower 30 – 60 minutes before bedtime. 
  • Avoid beverages with caffeine for at least 6 hours before bedtime. Caffeine is a strong stimulant, and its effect lasts for hours. 
  • A light protein snack before bedtime may be helpful. 
  • Limit fluids just before bedtime. 
  • Avoid alcohol in the evening.  
  • Alcohol is a poor sleep aid. 
  • Avoid naps in the daytime.
  • Exercise regularly.  It’s best to exercise early in the day, before dinner. 
  • Stop smoking. This eliminates the stimulating effects of nicotine. 
  • If you do not fall asleep after 30 minutes, get up and do something relaxing with low impact lighting, such as listening to music or looking at a magazine, or something totally boring, such as reading a book about something that does not interest you. Return to bed when you feel sleepy. 
  • Consider synthetic Melatonin 1 mg about 30 minutes before bedtime. Look for the USP marking on the label. Contact your physician if you are considering this option. 

If you feel you are practicing good sleep hygiene but continue to have problems getting a good night’s sleep, discuss your problems with your physician. Referral to a sleep specialist may help in evaluating and treating this condition. 

This material was developed by Addiction Services at Talbot Hall, University Hospitals East, The Ohio State University, and adapted for use on NetWellness with permission, 2010.

For more information:

Go to the Addiction and Substance Abuse health topic.