Thoughts about Insomnia

10 Tips to Beat Insomnia

If you are suffering from insomnia, there are many steps you can take to change behaviors and lifestyle to help you get to sleep. Here are some tips for beating insomnia.

  1. Wake up at the same time each day. It is tempting to sleep late on weekends, especially if you have had poor sleep during the week. However, if you suffer from insomnia you should get up at the same time every day in order to train your body to wake at a consistent time.
  2. Eliminate alcohol and stimulants like nicotine and caffeine. The effects of caffeine can last for several hours, perhaps up to 24 hours, so the chances of it affecting sleep are significant. Caffeine may not only cause difficulty initiating sleep, but may also cause frequent awakenings. Alcohol may have a sedative effect for the first few hours following consumption, but it can then lead to frequent arousals and a non-restful night's sleep. If you are on medications that act as stimulants, such as decongestants or asthma inhalers, ask your doctor when they should best be taken to help minimize any affect on sleep.
  3. Limit naps. While napping seems like a proper way to catch up on missed sleep, it is not always so. It is important to establish and maintain a regular sleep pattern and train oneself to associate sleep with cues like darkness and a consistent bedtime. Napping can affect the quality of nighttime sleep.
  4. Exercise regularly. Regular exercise can improve sleep quality and duration. However, exercising immediately before bedtime can have a stimulant effect on the body and should be avoided. Try to finish exercising at least three hours before you plan to retire for the night.
  5. Limit activities in bed. The bed is for sleeping and having sex and that's it. If you suffer from insomnia, do not balance the checkbook, study, or make phone calls, for example, while in bed or even in the bedroom, and avoid watching television or listening to the radio. All these activities can increase alertness and make it difficult to fall asleep.
  6. Do not eat or drink right before going to bed. Eating a late dinner or snacking before going to bed can activate the digestive system and keep you up. If you suffer from gastroesophageal reflux (GERD) or heartburn, it is even more important to avoid eating and drinking right before bed since this can make your symptoms worse. In addition, drinking a lot of fluids prior to bed can overwhelm the bladder, requiring frequent visits to the bathroom that disturb your sleep.
  7. Make your sleeping environment comfortable. Temperature, lighting, and noise should be controlled to make the bedroom conducive to falling (and staying) asleep. Your bed should feel comfortable and if you have a pet that sleeps in the room with you, consider having the pet sleep somewhere else if it tends to make noise in the night.
  8. Get all your worrying over with before you go to bed. If you find you lay in bed thinking about tomorrow, consider setting aside a period of time -- perhaps after dinner -- to review the day and to make plans for the next day. The goal is to avoid doing these things while trying to fall asleep. It is also useful to make a list of, say, work-related tasks for the next day before leaving work. That, at least, eliminates one set of concerns.
  9. Reduce stress. There are a number of relaxation therapies and stress reduction methods you may want to try to relax the mind and the body before going to bed. Examples include progressive muscle relaxation (perhaps with audio tapes), deep breathing techniques, imagery, meditation, and biofeedback.
  10. Consider participating in cognitive therapy. Cognitive therapy helps some people with insomnia identify and correct inappropriate thoughts and beliefs that may contribute to insomnia. In addition, cognitive therapy can give you the proper information about sleep norms, age-related sleep changes, and help set reasonable sleep goals, among other things.

In some cases, doctors will prescribe drugs for the treatment of insomnia. All insomnia medications should be taken shortly before bed. Do not attempt to drive or perform other activities that require concentration after taking an insomnia drug because it will make you sleepy. Medications should be used in combination with good sleep practices.

Here are some medications that can be used to treat insomnia

  • Antidepressants : Some antidepressant drugs, such as trazodone (Desyrel), are very good at treating sleeplessness and anxiety.
  • Benzodiazepines: These older sleeping pills -- emazepam (Restoril), triazolam (Halcion), and others -- may be useful when you want an insomnia medication that stays in the system longer. For instance, they have been effectively used to treat sleep problems such as sleepwalking and night terrors. But these drugs may cause you to feel sleepy during the day and can also cause dependence, meaning you may always need to be on the drug to be able to sleep.
  • Doxepine ( Silenor ): This sleep drug is approved for use in people who have trouble staying asleep. Silenor may help with sleep maintenance by blocking histamine receptors. Do not take this drug unless you are able to get a full 7 or 8 hours of sleep. 
  • Eszopiclone ( Lunesta ): Lunesta also helps you fall asleep quickly, and studies show people sleep an average of 7 to 8 hours. Don't take Lunesta unless you are able to get a full night's sleep as it could cause grogginess. Because of the risk of impairment the next day, the FDA recommends the starting dose of Lunesta be no more than 1 milligram.
  • Ramelteon ( Rozerem ): This sleep medication works differently than the others. It works by targeting the sleep-wake cycle, not by depressing the central nervous system. It is prescribed for people who have trouble falling asleep. Rozerem can be prescribed for long-term use, and the drug has shown no evidence of abuse or dependence.
  • Suvorexant (Belsomra). It works by blocking a hormone that promotes wakefulness and causes insomnia. It is approved by the FDA to treat people that have insomnia due to an inability to fall asleep or to stay asleep. The drug may cause you to feel sleepy the following day.
  • Zaleplon ( Sonata ): Of all the newer sleeping pills, Sonata stays active in the body for the shortest amount of time. That means you can try to fall asleep on your own. Then, if you're still staring at the clock at 2 a.m., you can take it without feeling drowsy in the morning. But if you tend to wake during the night, this might not be the best choice for you.
  • Zolpidem ( Ambien , Edluar, Intermezzo): These medicines work well at helping you get to sleep, but some people tend to wake up in the middle of the night. Zolpidem is now available in an extended release version, Ambien CR. This may help you go to sleep and stay asleep longer. The FDA warns that you should not drive or do anything that requires you to be alert the day after taking Ambien CR because it stays in the body a long time. You should not take zolpidem unless you are able to get a full night's sleep -- at least 7 to 8 hours. The FDA has approved a prescription oral spray called Zolpimist, which contains zolpidem, for the short-term treatment of insomnia brought on by trouble falling asleep.
  • Over-the-counter sleep aids: Most of these sleeping pills are antihistamines. There is no proof that they work well for insomnia, and they can cause some drowsiness the next day. They're safe enough to be sold without a prescription. But if you're taking other drugs that also contain antihistamines -- like cold or allergy medications -- you could inadvertently take too much.

In 2007, the FDA issued warnings for prescription sleep drugs, alerting patients that they can cause rare allergic reactions and complex sleep-related behaviors, including "sleep driving." In 2013, the FDA also warned people that taking sleeping medication at night can impair their ability to drive or be fully alert -- even the next day.