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Woman lying in bed suffering from insomnia
Difficulty falling asleep, waking up frequently during the night, and waking up feeling unrefreshed are common signs of insomnia. More than 60 million adults in the US face this challenge every year. If you’ve tried counting sheep, reading a boring book, or changing your routine to eliminate afternoon naps, you’re not alone. Despite these well-intentioned efforts, 10-36% of Americans continue to struggle with insomnia. Sleep problems often go unreported in medical settings, accounting for only 0.42% of office visits. This underlines the need for more awareness and proactive discussions about sleep health. Seeking professional advice and exploring tailored solutions can lead to more restful nights and a better overall sense of well-being.
If you have sleep problems, it is important to let your doctor know, as they may not address it otherwise. Your medical provider may have you complete the questionnaire Epworth Sleepiness Scale which only takes 2-3 minutes. The ESS helps estimate your likelihood of falling asleep during daily activities, including:
- Sit and read
- Watching television
- Sitting inactive in a public place (e.g. a theater or meeting)
- As a passenger in a car for an hour without a break
- Lie down in the afternoon to rest if conditions permit
- Sit and talk to someone
- Sit quietly after a lunch without alcohol
- Sitting in a car, standing still in traffic for a few minutes
If your sleepiness is due to insomnia or poor sleep, here are three important tips to help you achieve a good night’s sleep.
Behavioral treatment
Before considering sleep medications, it is important to explore behavioral interventions first cognitive behavioral therapy. CBT is widely recognized as the first-line treatment for insomnia and is often more effective than sleeping pills. Unfortunately, many people miss this valuable option and instead turn to sleep medications, which are often unable to address the underlying problems. The main goal of CBT is to reform negative associations with sleep by providing constructive strategies to help individuals create a healthier relationship with sleep.
One of the best ways to improve your sleep is to build a routine. A part of your brain called the suprachiasmatic nucleus regulates your sleep-wake cycle. This core learns when you typically go to sleep and when you wake up, which helps trigger hormone and other changes in your body to ease the transition between sleeping and waking states. As a result, it becomes easier for you to fall asleep and wake up at regular times. By keeping a regular bedtime and wake-up time, you help your body become more disciplined in regulating your sleep-wake cycle.
Establishing consistent bedtime routines signals to your body that it’s time to wind down, which helps create an atmosphere conducive to sleep, making it easier for your body to transition into rest mode. Once your body adjusts to this routine, you will find that falling asleep and waking up become effortless.
Another behavioral approach is stimulus control therapy, which involves going to bed only when you feel sleepy, leaving the bedroom when you can’t fall asleep, and doing simple activities when you can’t sleep. Another behavioral method is sleep restriction therapy, which involves avoiding daytime naps. This increases the chance that you will feel sleepy at bedtime. However, because there are benefits to daytime naps, eliminating them may not be right for everyone.
It is important not to use the bedroom for activities other than sleeping and sexual activity. For example, don’t try to turn your bedroom into an office. If you live in a studio apartment or have limited space where you only have one room, you should reserve the bed for sleeping only.
The ideal room temperature for sleeping is about 65 degrees Fahrenheit. Warmer temperatures can disrupt sleep for some people. If you live in a noisy area, try to keep this to a minimum during bedtime. Additionally, consider light exposure in the evening, especially from smartphones, laptops and other devices. Also avoid consuming alcohol and caffeine before going to bed.
Evaluate for sleep apnea
The behavioral treatments will not solve your problem if you have sleep apnea. At the very least, sleep apnea has an impact 22 million Americans and about 85% of people with sleep apnea don’t know they have it. One of the most obvious hints that you may have sleep apnea is snoring, which affects at least 90 million Americans.
It is important to distinguish between snoring and sleep apnea because they are not the same condition. Individuals who snore may or may not have sleep apnea, and those who have sleep apnea may or may not snore. In addition to snoring, other symptoms of sleep apnea may include bruxism (teeth clenching), neck pain, anxiety, and daytime sleepiness.
If you experience any of these symptoms and have untreated sleep apnea, you may feel excessively sleepy during the day. Sleep apnea can worsen many medical conditions and increase your risk of serious health problems, such as stroke. Therefore, it is essential to diagnose and treat this condition.
If you discuss your concerns with your doctor, you may be referred to a sleep specialist, who may then recommend a sleep study. This study can be performed in a sleep laboratory or in your home.
It is important to understand what keeps you awake at night. With the right diagnosis you can get … [+]
Once a clear diagnosis has been made, you can begin treatment. Some individuals may benefit from a continuous positive airway pressure machine, while others may find relief with a mandibular advancement device, commonly known as a snoring mouthpiece.
Treat underlying medical problems
Many medical conditions can negatively affect your sleep. For example, iron deficiency is known to cause restlessness in the legs, which can keep you and your bed partner awake at night. Iron supplementation may be all you need, although it is also advisable that your provider find out why you had low iron levels in the first place.
Conditions such as lung disease and heart failure can make it difficult to breathe, leading to disturbed sleep. By effectively managing these conditions, you can significantly improve your sleep quality and potentially extend your lifespan.
Neuropathy can disrupt sleep and often causes pain or tingling in the feet, making it difficult to fall asleep or waking you frequently during the night. To address this problem, your healthcare provider will first need to perform tests to determine the underlying cause of the neuropathy. Once the cause has been identified, appropriate treatment can be given.
These are just some of the conditions that can negatively impact your sleep. Your medical provider may discover other diagnoses that need to be addressed as part of the investigation into your sleep problem.
Many factors can contribute to problems getting a good night’s sleep, including anxiety and several underlying medical conditions. If lifestyle changes do not improve your sleep, it is crucial to seek medical advice before considering sleeping pills. Self-medication can mask other problems that can be harmful in the long term. By prioritizing healthy sleep habits and making these intentional changes, you can take the first steps toward a good night’s sleep, allowing you to embrace each new day with renewed energy and focus.