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Sleep Disorders

Interrupted sleep

04/11/2006

Question:

For about 2 weeks now i have been finding it very easy to fall asleep, but find that after about an hour I wake up. I find it easy to get back to sleep but I often wake up many times a night. I smoke but do not drink (not even coffee) I go to school and even though my GCSE`s are coming up I do not find myself worrying about them. My home life is ok I guess although I have recently been through an extremely difficult break up from my partner of 4 months and I am finding it hard to get over this. I admit I think about this alot during the day and often before I fall asleep. Is there any link between this and my disturbing sleep? Waking up in the night is affecting my school work and is making me lethargic and unable to concentrate on work. I also feel like I cannot be involved in every day life and feel isolated. Can you help?

Answer:

Your problem is that of sleep-maintenance insomnia in that you are able to fall asleep readily at the beginning of the night but wake up many times thereafter. It is also of relatively recent onset since it started about 2 weeks ago. From what you have written, there are at least 2 major factors that I can identify for your insomnia- the fact that your GCSEs are coming up and that you have recently been through an extremely difficult break-up from your partner. Anxiety and/or depression are very common causes of insomnia and you may want to discuss these issues with your primary care physician as the symptoms appear to affect your daily functioning.

In general, practicing good sleep habits, regular exercise, and avoiding nicotine use close to bedtime are helpful. Some simple steps you can take to improve your sleep include the following:

1) Maintain a regular wake time, even on days off work and on weekends.

2) Try to go bed only when you are drowsy.

3) Keep a regular schedule. Regular times for meals, medications, chores and other activities help keep the inner clock running smoothly.

4) Avoid napping during the daytime. If you do nap, try to do so at the same time every day and for no more than one hour. Mid-afternoon (no later than 3 PM) is best for most people.

5) Do not spend excessive amounts of time in bed. Use your bed only for sleep, intimacy, and times of illness.

6) A relaxing pre-sleep ritual such as a warm bath, light bedtime snack, or 10 minutes of reading may help. Avoid heavy meals before bedtime.

7) Try to exercise regularly. Vigorous exercise should be limited to earlier in the day, at least six hours before bedtime. Mild exercise should be done no more than 4 hours before bedtime.

8) Avoid ingestion of caffeine within 6 hours per day. "Reasonable" caffeine consumption is considered to be the equivalent of about 1-2 cups of coffee per day.

9) Do not drink alcohol when sleepy. Even a small dose of alcohol can have a significant effect when combined with tiredness and alcohol tends to cause sleep disruption after the first few hours of sleep. Do not drink alcohol while taking sleeping pills or other medications.

10) Avoid the use of nicotine close to bedtime or during the night.

Judicious use of a prescription sleep aid may also be of benefit. If your insomnia lasts more than one month, I would suggest consulting Sleep Specialist. More information about good sleep habits can be found on the website for the National Sleep Foundation.

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Response by:

Ulysses J Magalang, MD Ulysses J Magalang, MD
Clinical Professor of Pulmonary, Allergy, Critical Care & Sleep
Clinical Professor of Neuroscience
College of Medicine
The Ohio State University