Is there anything worse than the 3 a.m. wakeup? You get to sleep after a stressful day, only to wake in the middle of the night with your mind racing, unable to get back to sleep. Then you start to stress about being unable to sleep, creating a negative cycle. Or maybe you struggle to fall asleep in the first place, fretting about life stresses and relationships. Sound familiar? You’re not alone. According to the Sleep Foundation, 10 to 15 percent of people experience chronic insomnia, and women are 40 percent more likely to have insomnia than men. The good news is that by working with your doctor, you can manage insomnia with lifestyle changes and medication as needed. Here’s a look at this challenging condition and strategies for managing it.
How Do I Know If I Have Insomnia?
Most of us experience the occasional sleepless night, but if your symptoms persist for weeks or months, you may have chronic insomnia. Some of the signs include:
- Having trouble falling asleep at night or waking up in the middle of the night.
- Waking up too early and not being able to get back to sleep.
- Feeling tired during the day.
- Moodiness or irritability.
What Causes Insomnia?
As many of us know, stress is a big one. As we get older, worries about work, children, aging parents and other concerns can keep us up at night. Mental health conditions like anxiety and depression can also play a significant role, especially in those middle-of-the-night wake-ups. Other factors include:
- Medications, including some antidepressants, blood pressure, cold and allergy products and weight loss medications.
- Sleep disorders, including sleep apnea
- Alcohol, caffeine and tobacco use can interfere with our sleep patterns. Caffeine and nicotine are stimulants and can prevent us from falling asleep. Alcohol is a depressant and may put us to sleep but often causes a middle-of-the-night or early wakeup.
- Heartburn or digestive issues, including discomfort from overeating too late in the day.
Sleep habits and lifestyle choices, including napping and using digital devices before bed. - Lack of exercise.
- Underlying health conditions, including diabetes and obesity.
Irregular schedules caused by work, school or family responsibilities - Hormonal changes in women, including night sweats and hot flashes during menopause and hormones during pregnancy. Women are far more likely to experience insomnia than men.
- Insomnia is also a problem in older adults. As we age, we are more likely to have underlying health conditions, be on regular medications and be less physically active. We also experience shifts in our internal clocks as we age.
When Should I See My Doctor About Insomnia?
If insomnia affects your daily life, it’s time to call your doctor. It can affect your performance at work or school and hurt family relationships and responsibilities. Insomnia can also make existing medical conditions worse. Insomnia can also create a negative cycle with mental health conditions, including anxiety and depression. Finally, it can pose risks when driving or operating equipment. If lack of sleep has started to impact your life, your primary care physician is an excellent first resource.
What Are Treatments For Insomnia?
If you have chronic insomnia, your primary care physician can help. We’ll start with a check-up and review your sleep habits, medications and lifestyle. We can also order a sleep study if we suspect a sleep disorder to help you get answers. Generally, we’ll start with nonmedical treatments and then move to medications as needed. Here are some strategies for preventing and treating insomnia:
- According to the Sleep Foundation, exercise can improve sleep by making it easier to fall asleep and reducing stress that can keep us awake. Exercise can also indirectly impact sleep by helping with underlying conditions like obesity that can negatively affect sleep patterns.
- Meditation and mindfulness practices can help relieve stress and improve sleep patterns. This practice usually involves a mental practice of targeting anxious thoughts while incorporating breathing techniques to enhance relaxation.
- Good sleep habits and changing your sleep patterns, including eliminating naps during the day, avoiding using electronic devices before bed and developing a relaxing bedtime routine and a regular sleep schedule as much as possible.
- Cognitive Behavioral Therapy (CBT) is a mental health practice that can help you address insomnia by managing the thoughts and behaviors that disrupt sleep. It can include relaxation methods and help you address thoughts and behaviors that negatively impact your sleep.
- Spending time outside during the day or getting light therapy can reset your internal clock to make nighttime sleep easier.
- Melatonin supplements imitate your body’s natural sleep hormone and help regulate your sleep cycle. Melatonin is available over the counter. Talk with your doctor before starting supplements.
If other treatments don’t work, your doctor may prescribe medications to help you fall asleep. Familiar names include Lunesta, Ambien, Halcion and Sonata. They all work differently, but most have sedative effects. Many patients get much-needed relief from prescription medications, but they can also have side effects, including daytime sleepiness, and can lead to dependence. Be sure to go over potential side effects with your doctor before deciding.
How Can My Primary Care Doctor Help With Insomnia?
Sleep is at the heart of wellness. It affects so many aspects of our daily lives. When we get good sleep, it improves our mental and physical well-being, productivity and relationships. It can also help us engage in an active lifestyle and improve other medical conditions. For these reasons, assisting patients in achieving healthy sleep is a priority for Dr. Ojha and Norvinia Health. If sleep problems are a wellness challenge for you, let’s talk. Together, we can help you sleep better and feel better.