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 Medical Self-Care: Insomnia 
American Institute for Preventive Medicine ©
Do you ever find yourself wide awake long after you go to bed at night? Well, you're not alone. An estimated 40 million Americans are bothered by insomnia. They either have trouble falling asleep at night, wake up in the middle of the night, or wake up too early and can't get back to sleep. And when they're not asleep, insomniacs worry about whether or not they'll be able to sleep. They are also irritable and feel fatigued during the day.

An occasional sleepless night is nothing to lose sleep over. But, if insomnia bothers you for three weeks or longer, it can be a real medical problem. Some medical problems that lead to insomnia include:

  • Over-activity of the thyroid gland.
  • Heart or lung conditions that cause shortness of breath when lying down.
  • Depression, anxiety disorders.
  • Allergies and early-morning wheezing.
  • Any illness, injury or surgery that causes pain and/or discomfort, such as arthritis, which interrupts sleep.
  • Sexual problems (Example: Impotence).
  • Hot flashes that interrupt sleep.
  • Any disorder (urinary, gastrointestinal or neurological) that makes it necessary to urinate or have a bowel movement during the night.
  • Side effects of certain medications (Examples: Decongestants, cortisone medications).
Other things that lead to insomnia:
  • Emotional stress.
  • Too much noise when falling asleep. This includes a snoring partner.
  • The use of stimulants such as caffeine from coffee, tea or colas, and stay awake pills such as NoDoz.
  • A lack of physical exercise.
  • Lack of a sex partner

Self-Care Tips
Many old-fashioned remedies for sleeplessness work, and work well. Next time you find yourself unable to sleep, try these time-tested cures.
  • Avoid caffeine in all forms after lunchtime. (Coffee, tea, chocolate, colas, and some other soft drinks contain this stimulant, as do certain over-the-counter and prescription medications. Check the labels for content).
  • Avoid long naps during the day. (Naps decrease the quality of nighttime sleep).
  • Avoid more than one or two servings of alcoholic beverages at dinner time and during the rest of the evening. Even though alcohol is a sedative, it can disrupt sleep. Always check with your doctor about using alcohol if you are taking medications.
  • Have food items rich in the amino acid L-tryptophan such as milk, turkey or tuna fish before you go to bed. Eating foods with carbohydrates such as cereal, breads and fruits may help as well. (Do not, however, take L-tryptophan supplements).
  • Take a nice, long, warm bath before bedtime. (This soothes and unwinds tense muscles, leaving you relaxed enough to fall asleep).
  • Read a book or do some repetitive, tedious activity, like needlework. Try not to watch television or listen to the radio. These kinds of distractions may hold your attention and keep you awake.
  • Make your bedroom as comfortable as possible. Create a quiet, dark atmosphere. Use clean, fresh sheets and pillows, and keep the room temperature comfortable (neither too warm nor too cool).
  • Ban worry from the bedroom. Don't allow yourself to rehash the mistakes of the day as you toss and turn. You're off duty now. The idea is to associate your bed with sleep.
  • Develop a regular bedtime routine. Locking or checking doors and windows, brushing your teeth, and reading before you turn in every night primes you for sleep.
  • Count those sheep! Counting slowly is a soothing, hypnotic activity. By picturing repetitive, monotonous images, you may bore yourself to sleep.
  • Try listening to recordings made especially to help promote sleep. Check local bookstores.
  • Don't take over-the-counter sleeping pills or friends' or relatives' sleeping pills. Only take sleep medicine with your doctor's permission.

Questions to Ask

Do you have trouble falling or staying asleep because of any of the following?
  • Pain or discomfort due to illness or injury
  • The need to wake up to use the bathroom
Yes: Call Doctor
Has your sleep been disturbed since you began taking medication of any kind? Yes: Call Doctor
Do you still have trouble sleeping after 3 weeks, with or without self-care tips (see below)? Yes: Call Doctor
Provide Self-Care

Healthy Self: The Guide to Self-Care and Wise Consumerism
© American Institute for Preventive Medicine
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