Overcoming InsomniaDo you have a problem with insomnia? The Health Check 3-3, “Are You Getting Your Zs?”, may offer some insight. Here are some suggestions for overcoming insomnia:

•Recognizethatsleepcannotbeforced.You cannot will yourself to sleep or to stay asleep. You can only set the stage for sleep by putting yourself in a relaxed frame of mind and letting nature take its course.

•Gotobedonlywhenyouaresleepy.Don’t try to sleep if you are wide-eyed and full of energy. Let yourself wind down before hitting the pillow.

•Developaregularsleeproutine. Establish a bedtime routine that allows your mind and body to get into a sleep mode before retiring. Read, watch TV, or engage in some relaxing activity for an hour or so before bed. Go to bed about the same time every night and rise about the same time each morning.

•Makethebedacueforsleeping.Consider limiting other activities in bed, such as eating, talking on the phone, or watching TV.

•Getupifyoucan’tsleep.If you don’t fall asleep within 10 to 20 minutes, get out of bed and go to another room. Restore a state of relaxation by reading, meditating, or listening to calming music. Return to bed when you feel relaxed.

•Avoiddaytimenaps. Napping can throw off your natural body clock, making it more difficult to fall asleep the following night.

•Don’ttakeyourproblemstobed.Bedtime is not the time to try to solve your problems or organize your life. Think about tomorrow, tomorrow.

•Takeamindtrip.Mental fantasy is an excellent means of letting your thoughts slip away from consciousness, leading to sleep. Take a nightly mental excursion into some fantasy domain space—travel, a fantastic adventure, knights in shining armor—wherever your mind takes you. Or you might try picturing pleasant mental imagery, such as lying on sun-drenched sand at the beach or walking through a beautiful, green meadow on a clear spring day. Let your mind wander. (It won’t go far.)

•Exerciseregularly.Regular exercise can help relieve daily stress and reduce muscle tension, which can help you relax when you retire at night. But don’t exercise immediately before bedtime, because it temporarily increases your body’s level of arousal.

•Limitcaffeinatedbeveragestothemorning.Caffeine is the stimulant found in coffee and tea (and in chocolate!). It can remain active for up to 10 hours. Tobacco also contains a stimulant that can keep you awake—nicotine.

•Challengeexaggeratedfears. You need not be a sleep expert to realize that convincing yourself the day will be ruined unless you get to sleep right now may increase, rather than decrease, bedtime tension. However, we often exaggerate the problems that will befall us if we do not sleep. The following table shows some beliefs that increase bedtime tension and some alternatives.

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Beliefs That Increase Bedtime Tension and Alternatives

BELIEFS THAT CONTRIBUTE TO INSOMNIA BY INCREASING TENSION ALTERNATIVE BELIEFS

If I don’t get to sleep, I’ll feel wrecked tomorrow.

Not necessarily. If I’m tired, I can go to bed early tomorrow night.

It’s unhealthy for me not to get more sleep.

Not necessarily. Some people do very well on only a few hours of sleep.

I’ll wreck my sleeping schedule for the whole week if I don’t get to sleep very soon.

Not at all. If I’m tired, I’ll just go to bed a bit earlier. I’ll get up about the same time with no problem.

If I don’t get to sleep, I won’t be able to concentrate on that big test/conference tomorrow.

Possibly, but my fears may be exaggerated. I may just as well relax or get up and do something enjoyable for a while.

Should You Take Sleeping Pills? Sleep medications (“sleeping pills”) are tranquilizing or sleep-inducing drugs that cause feelings of drowsiness. Although they can help combat insomnia, they should only be used for a limited time and under a physician’s direction. Long-term use can lead to physiological and psychological dependence. Sleep medications also tend to suppress rapid-eye-movement sleep—called REMsleep—so-named because the eyes dart rapidly under the lids. REM sleep is the stage associated with dreaming. Lack of REM sleep can interfere with the natural restorative functions of sleep. When sleep medications are discontinued after protracted use, they can lead to rebound insomnia, meaning insomnia that is worse than it was before. Tapering off rather than withdrawing cold turkey may reduce the potential for rebound insomnia.

Another problem with sleep medications is tolerance, the tendency for drugs to lose their effectiveness with regular usage, so that larger doses are needed to achieve the same effect. Regular use, especially with increasing doses, can lead to physiological dependence (addiction). High doses can also be dangerous, especially if they are combined with other drugs, such as alcohol. Regular users can also become psychologically dependent on sleep medications. They reach for a pill rather than finding more effective ways of coping with the stress in their lives. At best, sleep medications provide a temporary respite from sleeplessness in times of stress.

You should also avoid using alcohol to combat insomnia. Alcohol slows down your central nervous system, which may make you feel sleepy. However, alcohol use, especially in higher dosages, interferes with normal sleep patterns and can leave you feeling less refreshed upon awakening.

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