I Need Something for Sleep

It is hard to not encounter an advertisement if your eyes are open; there are so many in so many places. Pills and supplements are offered for every problem. What a simple solution, and how easy it is for them to make some money! But is it the best solution? Getting poor sleep is a problem. You have less energy, you can’t think as well, your performance at work suffers, you make mistakes, you are forgetful.

What are the causes of poor sleep and what is the best way to help?

Noise: get away from it; mask it with music or ocean sounds; block it with doors, windows, earplugs.

Withdrawal from chemicals such as coffee, cigarettes, drugs, alcohol: be done with these. If you can’t stop coffee, start limiting yourself to coffee in the mornings only, since as you age, the caffeine effects last longer. See if decaf gives you the thrill without the night alertness.

Not relaxing: avoid a stressful book, TV show, thoughts. Allow only peaceful thoughts in your brain at bedtime.

Gotta pee: Sometimes we think that the desire to urinate is driving the problem. Even if this isn’t the problem it is associated. When we have trouble sleeping or are bored, we feel the desire to urinate frequently. Check your body when this happens and see if the desire is the main reason for poor sleep, or the less important reason. Stopping water and fluids 2-4 hours before bedtime is helpful for many. Cutting down salt helps too since the body wants to get rid of the excess.

Darkness is helpful. Maybe trying a sleeping mask if the lights need to be on while you are trying to sleep.
Lack of exercise: Sweating 15-30 minutes, or more, a day or more will help you become physically tired.

Being too cold or hot: this is a problem. I was way too hot in Haiti, but I fell asleep eventually, trying to ignore the problem. Try to adjust your body temperature with more or less pajamas, sheets, blankets, windows, fan, air conditioner.

Medications causing naps, or daytime naps. Discuss with your medical provider if the medication is causing sleepiness. Being bored causes us to nap. Try to vary your activities if that is the case. When you feel sleepy, take a walk, or do some brief exercises, get a glass of water. If you sleep in the daytime, then your “sleep debt” is partially paid so there is less physical desire to sleep at the normal bedtime. So avoid any naps longer than about 20 minutes.

Poorly treated diseases can cause sleep problems. Please see your health care provider.

Sleep apnea: where a person stops breathing at night or wakes up choking.

Gastroesophageal Reflux Disease (GERD): when a person lies down and the stomach acid sloshes up into the esophagus (food pipe) and burns.

Hiatal Hernia: where the stomach his partly in the chest and they have similar problems as GERD.

Asthma , other lung problems or heart problems so that they have shortness of breath at night when lying down.

Pain anywhere makes sleeping very hard.

Congestion makes it hard to breathe through your nose.

Worry or anxiety can cause your brain to work too much and it can’t rest.

Treatment: Treating the cause is the best treatment.

Sometimes the most difficult problem to treat is worry. You can try different techniques to relax. Scan your body with your mind and find tense muscles. Make them relax. If there still is trouble, tense groups of muscles and then relax them; start with your feet, then your calves, on up to your forehead.

Distraction is helpful. Imagine a peaceful place and let a story develop, follow it.
Going to bed at the same time night after night and getting up at the same time is very good for your inner clock. Don’t sleep in too much.

A sexual activity is also helpful. But saying, “Honey I need to use you as a sleeping aide.” doesn’t sound very romantic.
Pills are a last resort since they can put a bandage on and hide an important problem.

Without a prescription, many pills are available. Most of these are antihistamines which treat allergies but cause drowsiness in some people. The drowsiness can last longer than you would like, and the dullness of mind even longer—even if you don’t realize you are duller.

With a prescription, most of the pills are in the Valium class, the benzodiazepines or BZDs. These and the antihistamines cause an unnatural sleep and you don’t cycle through the stages of sleep naturally, so you may not be completely refreshed once you wake up. The BZDs, like narcotics, cause tolerance, so that the same dose may be less and less effective over time and if you stop abruptly, you may have withdrawal. The withdrawal can cause the opposite of sleepiness, agitation, and can cause seizures. We try to use the shorter acting ones to minimize this problem, but sleeping pill dependency is very common. It is not good to be dependent on chemicals.

Natural products can be helpful, such as melatonin which has had some positive research results. The problem is that, since it is a “food” and not a drug, the FDA doesn’t require quality control. The amount of melatonin on the label may be quite different from what is in the capsule.

Conclusion: Analyze why you are having trouble sleeping and treat the cause. See you health care provider if needed. Rest well.