By Neha Vyas, M.D.
It wasn't that long ago when the term insomnia wasn't in my vocabulary. As a medical student, then a resident, and finally a new mother, I was so sleep deprived that I could have fallen asleep standing up. Now as the years pass and I'm faced with the impending concerns of middle age, I can commiserate with the sleep struggles many face.
Insomnia means difficulty falling or staying asleep, or both. Studies show that at any given time, up to a third of the U.S. population experiences a sleep disturbance. Untreated insomnia has been linked to many illnesses and a shortened lifespan. Often, medical issues will interfere with a solid night's sleep. This is true for thyroid disorders; mood disorders, such as depression or anxiety; and sleep apnea, among others. Your doctor will evaluate you for those conditions if your sleep is disrupted.
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Today, many sleep issues are treated by cognitive behavioural therapy, which is a form of talk therapy. These should be explored before medications are discussed. Practicing good sleep habits (or hygiene) is another important aspect. Here are some of the basics of this approach:
First, the bedroom should be used only for sleeping and intimacy. I tell my patients to avoid using their laptops, performing work-related functions or watching television in their bedrooms. In this way, the brain can be hardwired to associate the bedroom with those functions. You also should avoid vigorous exercise and caffeine for at least two hours before bedtime. Watch for hidden sources of caffeine, including some beverages, chocolate and sodas.
The blue light emitted from televisions, smartphones and smart watches has been shown to disrupt our circadian rhythms and keep our natural melatonin from secreting properly. Melatonin allows us to fall asleep. During the day, this isn't a bad thing, but close to bedtime when the surge of melatonin should increase, this artificial light may prevent us from catching those much needed Zs.
Children are more affected by these wavelengths than adults. All sources of blue light near bedtime should be avoided. It's best to have a night-time wind-down activity that limits light and replaces it with soothing thoughts and words. If work requirements prevent you from doing that, your devices may have night settings to help limit your exposure to this light.
Many people find that several minutes of meditation, reflective thinking or prayer is beneficial to induce a good night's sleep.
In addition to sleep hygiene, turn down the thermostat before bedtime. Many people find that colder temperatures induce sleep better than warmer temperatures. It also may be helpful to wear earplugs or light-blocking sleep masks if environmental noise (such as a snoring dog or bed partner) or external light tend to wake you easily. Peaceful sounds, like running a fan at night, produce a gentle rhythmic noise that may lull you to sleep.
If all these measures fail and you find yourself waking up in the middle of the night or early morning, it's best to get up and start your day. Over time your body will become used to the shorter length of sleep and do a better job of associating your bed with sleep.
You should talk to your doctor if you feel that despite all these sleep measures, you would benefit from a medication. Some medications may help, but many have side effects and shouldn't be used for long stretches of time.
A good night's sleep helps combat many of life's stressors and challenges. Don't be shy about bringing up sleep at your next office visit. You'll feel better, and it will likely improve your life.
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