There’s no magic pill for insomnia, but habits can make or break your slumber.
“Sleep that knits up the raveled sleave of care . . .”
As far back as Shakespeare, humans have understood the restorative powers of sleep. When your rest is disrupted by insomnia, you need a multifaceted solution that addresses your mind, body, and lifestyle. Sleeping pills are no longer considered a long-term solution. That’s according to Alberto Ramos, M.D., a neurologist specializing in sleep medicine at the University of Miami Health System.
Dr. Ramos places sleep disturbances into three categories:
- inability to fall asleep
- multiple nighttime awakenings
- waking earlier than desired
Short-term insomnia lasts up to three months; chronic insomniacs toss and turn at least three times a week for three months or more.
Causes of sleep issues
Triggers include anxiety, stress, pain, mood disorders, and certain medications. Some people are predisposed to restlessness, meaning their brain cannot shut off when it should. Excessive daytime drowsiness, sore throat, morning headache, snoring, or waking up gasping for breath may point to obstructive sleep apnea. A potentially serious condition, it happens when your throat muscles relax and block your airway during sleep. Overindulging in caffeine or alcohol, too much screen time and irregular bed times also affect your ability to rest.
Common misconceptions about insomnia
To clear the cobwebs from your head and insomnia from your bed, it helps to dispel some myths.
“Many people mistakenly think they can catch up on sleep by going to bed earlier, but the data shows that insomnia worsens the longer you stay in bed. Many also believe they need eight hours of sleep, but there’s great variation in sleep need, depending on age. Between 6.5 and 9 hours is normal for most adults,” says Dr. Ramos.
A misunderstanding among older adults is thinking they need less sleep.
“Sleep gets lighter as you age, but you need the same amount. If you slept seven hours a night in your 40s, you need that much as older person,” Dr. Ramos explains.
Insomnia’s toll on health is gradual.
You may become so accustomed to fatigue, it becomes your new normal. Or, you rely on sleep aids to get your rest, so the quality of your slumber is not what it should be.
“If you experience sleep problems for a month, see your family doctor. If it persists for three or more months, see a sleep specialist,” says Dr. Ramos.
He recommends keeping a sleep diary before seeing a specialist. In it, you record caffeine and alcohol use, sleep and wake times and other behaviors. Fitness wearables that record habits also help. A diary and consultation with a specialist may reveal enough information so that an overnight sleep study is not necessary.
How do you treat insomnia?
Treatment approaches vary, depending on the cause. To provide relief, Dr. Ramos may suggest short-term an FDA-approved sleep medicine, but only for short-term use.
“Sleep medications can have serious side effects, especially in older patients and females, who tend to metabolize differently.” He also cautions against over-the-counter medications and herbal supplements.
“Herbals are effective, but there’s less quality control,” Dr. Ramos explains. If you have sleep apnea, your doctor may recommend lifestyle changes or medical devices to alleviate the problem.
Cognitive Behavioral Therapy for Insomnia (CBT-I) is a safe, nondrug treatment that modifies habits and beliefs that contribute to insomnia. Patients commit to consistent wake and bed times, no naps, and stimulation control – restricting caffeine, alcohol, and screen time. Relaxation training and improving the sleep environment are also considered.
If you find yourself awake for more than 30 minutes during the night, CBT-I requires getting up to read or engaging in another quiet activity until you feel drowsy. Then and only then do you return to bed. Otherwise, your brain associates your bed with wakefulness.
“CBT-I requires a six-to-eight week commitment to changing your habits,” Dr. Ramos says.
Ask any insomniac – if a treatment results in sound, restful sleep, it is well worth the effort.