By Bassam Hashem, MD
Most of us have experienced a night of poor sleep. Difficulty falling asleep or staying asleep could persist and start affecting your quality of life and health. So how do you know when you have a long-term problem that is unlikely to resolve itself naturally?
Insomnia is the most common sleep problem. Poor sleep causes difficulty in functioning during the daytime and affects job performance. Insomnia is associated with an increased risk of cardiovascular diseases and often is associated with depression and anxiety. You should not ignore insomnia, as it will become worse over time and will make sleep management more challenging.
It is best to see a physician about insomnia when the problem persists over a period of weeks, when it affects your quality of life, and when you start to worry about your sleep. The earlier you report the problem to your primary care physician or a sleep specialist, the sooner you can get back to normal sleep.
Insomnia has multiple factors
Difficulty sleeping usually is the result of multiple factors. Poor sleep habits and worry about sleep are the most common factors. The most important goal of the physician in managing your sleep is to figure out why you are not sleeping well.
It is common to have transient insomnia over a few nights because of a short-term illness or stress related to work, personal or social issues. In some people the insomnia persists and gets worse over time, mainly because they try to treat insomnia on their own and they worry about their inability to sleep.
The sleep environment also affects sleep. The most common environmental factors that disturb sleep are noise or light, a partner’s snoring or restless sleep, and pets.
Insomnia could be related to psychiatric problems such as depression and anxiety, physical illnesses such as pain, and medications or stimulants such as caffeine or nicotine.
Chronic medical diseases often are associated with chronic insomnia. Insomnia might result from other sleep disorders such as sleep apnea, shift-work related sleep disorder and restless legs. A physician can determine the cause of your insomnia and whether you have another sleep disorder.
Evaluating and treating insomnia
When you see a physician about your sleep, you will be asked about your physical and mental health, lifestyle, work, habits, diet and medications. You may be asked to keep a record of sleep time for two weeks in order to evaluate your sleep pattern. In certain cases you will need a sleep study at a sleep center.
A comprehensive evaluation of insomnia is the key to successful treatment. Addressing and treating the underlying causes of insomnia are essential in the management of this problem.
The initial treatment for insomnia is behavioral therapy, during which the physician will help you recognize the factors that are affecting your sleep and learn how to practice good sleep habits. You can achieve better sleep by keeping the bedroom cool, quiet and dark; by using it only for sleep; and by removing the television, clock, electronic devices, work papers and restless pets from the bedroom.
In addition, you will sleep better if you limit caffeinated beverages to small quantities in the morning, avoid alcohol in the evening, exercise regularly, take a walk in the daylight rather than a nap during the day, and be sure to avoid napping in the evening. Allow at least one hour to unwind before bedtime. Maintain a regular sleep schedule and avoid staying in bed very long without sleep.
Minimizing frustration and worries about sleep will help you sleep. Cognitive therapy helps you to deal with your anxiety and worry about sleep. A behavioral sleep therapist can provide behavioral cognitive therapy for insomnia.
Avoid using over-the-counter sleep aids without consulting your physician. Your physician might consider prescribing medication in conjunction with cognitive behavioral therapy, and would weigh the benefit against the risk.
People commonly use alcohol for sleep, but this is a big mistake because alcohol interferes with sleep later in the night and affects your sleep quality, making the insomnia worse in the long term.
Treating insomnia takes time. Your physician can help you manage your sleep problem, but you have to actively participate and change your habits. Sleep is a natural process that cannot be forced.
Ultimately, the goal of sleep management is to help you maintain good health and well-being. You need to sleep well to live well.
Bassam Hashem, MD is a ProHealth Medical Group physician specializing in pulmonary disease, critical care medicine and sleep medicine. He is board-certified in all three specialties and sees patients at the ProHealth Sleep Center in Delafield, ProHealth Medical Group clinic in Pewaukee, ProHealth Waukesha Memorial Hospital and ProHealth Oconomowoc Memorial Hospital.
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For more than a century, ProHealth Care has been the health care leader in Waukesha County and surrounding areas, providing outstanding care across a full spectrum of services. The people of ProHealth Care strive to continuously improve the health and well-being of the community by combining skill, compassion and innovation. The ProHealth family includes ProHealth Waukesha Memorial Hospital, ProHealth Oconomowoc Memorial Hospital, ProHealth Rehabilitation Hospital of Wisconsin, ProHealth Medical Group, the UW Cancer Center at ProHealth Care, Moreland Surgery Center, ProHealth AngelsGrace Hospice, ProHealth Home Care, ProHealth West Wood Health & Fitness Center and ProHealth Regency Senior Communities. Learn more at ProHealthCare.org.