Insomnia; Inability to sleep; Dyssomnia; Sleeplessness; Wakefulness
Home Care:
Try modifying your nighttime sleeping habits and other behavior before resorting to drugs to cure insomnia. For example:
Avoid using alcohol in the evening. Avoid caffeine for at least 8 hours before bedtime. Give up smoking, because nicotine is a stimulant.
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.
Take your TV or computer out of your bedroom. Otherwise, your brain becomes used to the stimulation and starts to expect it when you are there. This makes it harder for you to fall asleep.
Relax by reading, taking a bath, or listening to soothing music before getting to bed.
A snack before bedtime helps many people. Foods such as warm milk or turkey have a natural sleep inducer called L-tryptophan.
Exercise regularly, but not in the last two hours before going to bed. Exercise, especially aerobic exercise, has been show to make people fall asleep faster and benefit from deeper and more restful sleep. Sex can be a natural sleep inducer and helps some people.
Avoid emotional upset or stressful situations prior to bedtime.
IN INFANTS AND CHILDREN
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.
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.
Over-the-counter sleep medicines can have side-effects, including a "hangover" effect the next morning.
If these fail, you may want to ask you health care provider to recommend other options.
Avoid all sedatives, including the benzodiazepines, during pregnancy.
Call your health care provider if:
Call your health provider if:
A sleeping problem becomes persistent and unbearable, despite home treatment
A sleeping problem occurs more than 3 nights per week for more than 1 month
In some rare cases, your health care provider may want you to see a sleep medicine specialist who will perform a sleep study (polysomnography)
MEDICATIONS
In most cases, medication will not be necessary. Your health care provider can explore with you the possibility of using prescribed medications if everything else has failed.
Some antidepressants such as Elavil (amitriptyline) can be used at bedtime because they are sedating. They require a prescription. If insomnia is caused by depression, proper treatment of the depression with other appropriate medications or therapy should solve the problem. Benzodiazepines such as Valium (diazepam) or Ativan (lorazepam) are anti-anxiety medications that can also help induce sleep. They must be used with caution because they can be addictive. They too require a prescription.
Newer sleep medicines help reduce the time it takes you to fall asleep. They are less likely to be addictive than benzodiazepines. Two examples are the prescription mediciness Ambien (zolpidem) and Sonata (zaleplon).
WARNING: The FDA has asked manufacturers of sedative-hypnotic sleep medicines to put stronger warning labels on their products so that consumers are more aware of the potential risks. Possible risks while taking such medicines include severe allergic reactions and dangerous sleep-related behaviors, including sleep-driving.
Reviewed By: Daniel Kantor, M.D., Director of the Comprehensive MS Center, Neuroscience Institute, University of Florida Health Science Center, Jacksonville, FL. Review provided by VeriMed Healthcare Network.
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's
accreditation program
is the first of its kind, requiring compliance with 53 standards of quality and accountability, verified by independent audit. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s
editorial process
. A.D.A.M. is also a founding member of Hi-Ethics (www.hiethics.com) and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 1997-2007 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.