Treatment and Prevention
There are medications that can help you sleep, but they should be avoided
if more conservative measures work.
Try these strategies to help you get to sleep earlier:
- Develop a regular bedtime routine.
- Don't use the bedroom for daytime activities - just for intimacy and sleep.
- Don't consume coffee or chocolate before going to bed.
- Don't go to bed thinking about work or other stressful matters - read a
book for a while if this helps reduce stress.
- Go to bed at the same time every night, even on weekends.
- If you have a back disorder, try lying on your back with a pillow under
your knees.
- Keep the bedroom dark, quiet, and not too warm - white noise devices can
help drown out traffic sounds or a partner's snoring.
- Many people find that warm milk helps them get to sleep.
- Minimize use of medications like diuretics and appetite suppressants - if
you must take them, don't take them before going to bed.
- Taking exercise during the day will help you sleep. Avoid strenuous exercise
late at night.
- Try to cut down on smoking and alcohol, especially in the evening.
Any medication treatment a doctor recommends depends on what's causing the
insomnia. If it appears linked to depression, antidepressants are
more likely to help than hypnotics (prescription sleeping pills). Some
antidepressants cause drowsiness anyway - these are usually the ones given to
people who can't sleep. If pain is keeping you up, a painkiller is a frequent
solution.
Primary insomnia that doesn't respond to conservative treatment can be helped
with hypnotic medications (sometimes called sedatives, minor tranquilizers,
or antianxiety drugs). The commonest hypnotics are the class of medications
called benzodiazepines. These are safer than most, but can still create
dependency (addiction) and tolerance (a reduced effect over time) in a small
minority of users. For this reason doctors don't like to prescribe them for
long periods (more than 21 consecutive days) unless other treatments fail or
it is clear that tolerance is not developing.
If odd working hours disturb your sleep rhythm, the best way to get back
on track is to expose yourself to bright sunshine in the morning. The evidence
shows that this resets the body clock more effectively than the much-hyped hormonal
medication melatonin. Natural light causes the brain to produce melatonin
anyway. Melatonin supplementation hasn't been adequately researched and may
have adverse effects of which we are unaware at this time.