Addressing the Causes of Insomnia

Q:  What can I do to treat my insomnia?

A:  The inability to sleep well afflicts many of us and saps our ability to fully enjoy and participate in life.

Many suffer insomnia chronically due to their inability to address its root causes, often amplified by chemically induced efforts to stay awake or to facilitate sleep.

Depression is an often overlooked cause of insomnia, if accompanied by appetite disturbances, feelings of worthlessness and hopelessness and an inability to partake of the joys of life (anhedonia). Antidepressants can be used to both facilitate sleep and treat depression, but I am more convinced than ever that counseling is an absolute necessity as well.

Poor sleep hygiene results in sleeplessness for some. Taking daytime naps, exercising close to bedtime, watching TV late into the night, eating within one to two hours of bedtime and irregular sleep/wake schedules make rest hard to come by. To challenge yourself, keep track of your last week's bedtimes and awakening times. If there is no thread of consistency, you have a great place to begin. This is especially important for those of you working second and third shifts.

Caffeine and alcohol are two other often overlooked culprits. A small amount of caffeine in the morning seems reasonable, but continuous ingestion of coffees, colas, teas, chocolates and other beverages places your body at the mercy of this chemical until it is metabolized. For many, a vicious cycle of fatigue-caffeine-insomnia-fatigue prevents them from ever being rested.

Many assume that alcohol is a sleep aid worth considering. Although intoxication will yield unconsciousness, it does not produce healthy or restful sleep and should not be used for this purpose.

Many are fatigued at bedtime but not physically tired. Surprisingly, a modest exercise program will help you sleep better.

The last issue to review is the stress level in your life and your mechanisms of coping. Short-term issues (an unexpected illness, a death in the family, work-related problems) are going to be disruptive and represent the only times when I will prescribe sleeping pills. Long-term problems require a decision to either make permanent changes or develop a plan. Healthy friendships and a spiritual dimension to your life are key to a solution in this area.

"Your Health" provides easy-to-understand information about common health conditions.