Catching ZZZs

Insomnia, which is difficulty falling asleep, maintaining sleep, or experiencing non-restorative sleep, is the most common complaint in general medical practice. Sleep disturbances cause significant distress or impairment in social, occupational, educational, academic, behavioral, and other important areas of functioning.

Signs of sleep deprivation include drowsiness during the day, falling asleep within 5 minutes of lying down, driver fatigue, and caffeine/stimulants that cannot overcome drowsiness. On average, babies need ~20 hours of sleep/day, teens need ~9 hours of sleep/day, and adults need ~8 hours of sleep/day.

One-third of adults experience insomnia, which can be caused by many factors and can either be transient (a few nights), short-term (< 3 months), or chronic (> 3 months). Below are just some factors that can be linked to insomnia:

Situational	Medical	Psychiatric	Pharmacologic
Work/financial stress Interpersonal conflicts Major life events Jet lag, shift work	Cardiovascular (angina, arrhythmias, heart failure) Respiratory (asthma, sleep apnea) Chronic pain Diabetes Hyperthyroidism Gastrointestinal (GERD, Peptic Ulcer Disease) Neurologic (Parkinson’s) Pregnancy	Mood disorders Anxiety disorders Substance abuse	Anticonvulsants Diuretics SSRIs Steroids Stimulants

It is important to identify/correct the underlying cause and implement good sleep hygiene to treat transient and short-term insomnia. Some sleep aids are available over-the-counter as well, but should only be used as needed. 

Ways to Implement Good Sleep Hygiene

Establish regular times to wake up and go to sleep (including weekends) Go to bed only when sleepy: Avoid long periods of wakefulness in bed Use bed only for sleep or intimacy No reading or watching TV in bed Sleep only as much as necessary to feel rested Avoid trying to force sleep and avoid daytime naps Create a comfortable sleep environment Avoid extremes in room temperature Avoid loud noises or illuminated clocks Discontinue or reduce alcohol, caffeine, and/or nicotine Avoid drinking large quantities of liquids in the evening Do something relaxing and enjoyable before bed

Over-the-Counter Sleep Aids

Benadryl (diphenhydramine) Melatonin Valerian Root Magnesium (helps relax and induce sleep) Lavender oil as aromatherapy Gingko Biloba (helps reduce stress and enhance relaxation)

If the above methods mentioned do not improve your insomnia, then talk to your healthcare provider as there may be prescription medications that can help.