Insomnia

Dr Ryen, please help. I’ve tried everything for insomnia, but most nights I just lay there for hours trying to fall asleep. Then the next day I’m a zombie and can barely keep my eyes open. I have to take a nap just to function! I don’t want to take pills - either over the counter or prescription - so what can I do to help me fall asleep when I want to?

- Chantelle, Tulsa, OK

Hi Chantelle. I feel your pain. During the long night shifts of medical school my sleep pattern was a wreck. My schedule was so completely backwards that I couldn't even fall asleep on my days off! Medication can certainly help reestablish a normal circadian rhythm, but if you're keen to avoid that, your best bet is to improve your "sleep hygiene". Do your best to make good sleep habits and avoid bad ones, such as:

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• keep a consistent schedule for bedtime and wake-up, even on the weekends; avoid daytime naps

• avoid screens an hour prior to bed

• don't use your bed for anything other than sleep and intimacy

• get the TV out of your bedroom!

• avoid exercise, big meals, and caffeine in the hours leading up to bedtime

• exercise regularly during the day

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There are lots of other tips and tricks available online. However, insomnia is a complicated issue. Various medical/psychiatric conditions can interfere with normal sleep - longstanding anxiety is a common culprit. If your sleep doesn't improve with some basic interventions, see your doctor for a full assessment. Most of my patients with chronic insomnia have underlying issues that often require medications or some other intervention before they finally get a good night's rest. 

Sweet dreams!

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