Sleeping difficulty
Alternative names:
dyssomnia; inability to sleep; insomnia; sleeplessness; wakefulness
Home care:
ADULTS
Exhaust every possible option before resorting to drugs to cure insomnia.
Avoid using alcohol in the evening. Avoid caffeine for at least 8 hours before bedtime. Give up smoking.
Establish a regular bedtime, but don't go to bed if you feel wide awake. Use the bedroom for bedroom activities only. Once in bed, use creative imagery and relaxation techniques to keep your mind off unrestful thoughts. Avoid staying in bed for long periods of time while awake, or going to bed because of boredom. If too much time is spent reading or watching TV while in bed, the body becomes accustomed to being awake in bed.
Relax by reading, watching TV, taking a bath, or listening to soothing music before getting to bed.
A snack before bedtime helps many people. Foods such as milk or meat have a natural sleep inducer called L-tryptophan.
Exercise regularly, but not in the last two hours before going to bed. Sex can be a natural sleep inducer and helps some people.
Avoid emotional upset or stressful situations prior to bedtime.
INFANTS
Avoid being readily available to a child during the night; otherwise, the child may become dependent on attention and become sleepless if deprived of it.
CHILDREN
For children who have trouble falling asleep, try to make sure that the child is not disturbed by unnecessary noise. Leaving a radio playing soft music may help cover up disturbing noises.
Avoid sending a child to bed as punishment which can result in poor sleep caused by fear.
Never give a child sleeping medicine without consulting the doctor first. Generally, it is unwise to treat the problem with drugs.
MEDICATION
Medication should be a last resort.
Antihistamines (Sominex, Nytol, and Compoz are all approved by the FDA) are available without a prescription.
Antidepressants such as Elavil require a prescription. Benzodiazepines such as Valium require a prescription. A newer sleeping pill called Ambien also requires a prescription, but is somewhat less addicting than benzodiazepine drugs.
Remember, every drug (over-the-counter or prescription) has potential side effects.
Avoid all sedatives, including the benzodiazepines, during the first 3 months of pregnancy.
Call your health care provider if:
- a sleeping problem becomes persistent and unbearable.
- home treatment has been tried unsuccessfully for three weeks or more.
- if the insomnia is accompanied by other symptoms such as chest pain or shortness of breath.
What to expect at your health care provider's office:
The medical history will be obtained and a physical examination performed.
Medical history questions documenting your symptom in detail may include: - type
- Do you have difficulty falling asleep or staying asleep (insomnia)?
- Do you awaken from sleep not feeling rested?
- Is there difficulty initiating sleep?
- Do you awaken many times at night?
- time pattern
- Is the problem persistent?
- For how long?
- Did the problem seem to be resolving after changing your work shift pattern?
- aggravating factors
- Did it begin after stopping the use of alcohol at bedtime?
- Did it begin after stopping the use of a hypnotic (sleeping pill)?
- What medications do you take?
- Is there any excessive stress or anxiety?
- sleep schedule
- How much do you normally sleep? What hours?
- associated complaints
- Does it occur in response to reminders of a traumatic event?
- Does it occur around the time you ingest some form of a stimulant substance?
- Does it occur around the time you use a hypnotic medication?
- Are you associating the bedroom with insomnia?
- Do you worry excessively about sleep?
- Are there also breath holding spells or times of snoring?
- What other symptoms are also present?
Diagnostic tests that may be performed include: After seeing your health care provider:
If a diagnosis was made by your health care provider related to sleeping difficulty, you may want to note that diagnosis in your personal medical record.
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