Insomnia and other sleep disorders are common problems that patients present to their doctors.
Sleeping pills are usually not the best solution.
They sedate the brain and by doing so may increase our risk for accidents including falls. This is particularly risky in the elderly who happen to be the group that is prescribed the most sleeping pills. Sedation may persist into the morning, impairing our judgment and alertness at home, at work and on the road.
The regular use of sleeping pills may result in dependence – when your brain requires a pill every night to fall asleep and tolerance – when the same dose no longer works and you have to switch to a stronger medication.
Instead, you and your doctor could think of sleeping difficulties as a symptom – a marker for a more significant problem. Together you can treat the underlying cause.
Early insomnia – or difficulty falling asleep – can be due to anxiety, stress or stimulants. Avoid exciting activities (i.e. vigorous exercise and arguments) just before bedtime along with caffeinated drinks. Reduce unnecessary stress, and adopt strategies to manage anxiety during the day. These might include meditation, self-reflection, debriefing with your friends or professional counseling. Moderate exercise earlier in the day is often helpful.
Middle and late insomnia, such as early morning awakening can sometimes be a symptom of depression. If you are having persistent symptoms, don’t hesitate to talk to your doctor.
Some medical conditions can interrupt your sleep. These include bladder problems (such as enlargement of the prostate), congestive heart failure (when individuals feel more short of breath when lying flat) and asthma (wheezing or bronchospasm that is often worse at night or in the early morning). Nocturnal symptoms suggest that something more is needed to adequately control the underlying condition.
Nonrestorative sleep can be a sign of a respiratory problem, including obstructive sleep apnea. If you have significant daytime sleepiness, talk to your doctor. The diagnosis can be confirmed with noninvasive tests.
Next: non-drug sleeping solutions.
Dr. Davidicus Wong is a physician and writer. His Healthwise column appears regularly in the Burnaby Now, Vancouver Courier and Royal City Record. You can find his posts at davidicuswong.wordpress.com.