A: Sleep problems are incredibly frustrating. But you are certainly not alone — 35 percent of U.S. adults, particularly women and the elderly, experience them every year. Your difficulty with falling and staying asleep fits the definition of insomnia, and I imagine you are also experiencing daytime consequences such as irritability, memory problems, poorer work performance or depression. Although medications offer quick relief and are commonly prescribed for insomnia, they are associated with multiple side effects and may only work in the short term. The good news is that insomnia can be reversed, often without drugs.
To overcome your insomnia and start sleeping again, your first step should be to see your physician to rule out any medical causes (such as menopause, restless leg syndrome, sleep apnea or cardiac problems). As insomnia is commonly caused by depression, anxiety disorders or substance abuse, you should rule these out too, and, if necessary, seek the appropriate treatment. Once you're sure these things aren't behind your sleepless nights, try these techniques:
• Change your sleep "rituals." After repeated experiences with insomnia, you have probably learned to worry before bedtime and to associate the bedroom with frustration rather than restful sleep. You may go to bed earlier than necessary, trying to build in extra time to fall asleep. These reactions are understandable, though they may actually contribute to your insomnia rather than help alleviate it. Here are a few strategies you can practice now to change your sleep rituals, taken from cognitive-behavioral therapy (CBT), an approach that has been shown to help the majority of patients suffering from insomnia:
• Limit the activities you perform in bed only to sleep and sex — this means no watching TV in the bedroom — and spend only as much time in bed as you plan to sleep.
• Keep a consistent sleep schedule, even on weekends and after a poor night's sleep.
• Avoid daytime napping and stay away from alcohol, caffeine and physical exercise within four hours of bedtime.
• When you find yourself unable to fall asleep for more than 20 minutes, do not lie in bed struggling. Instead, leave the bedroom, engage in a quiet, soothing activity (not watching TV or Web surfing) and return to your bed after 20 to 30 minutes.
• Relax. Insomnia is often associated with anxiety, so you will probably benefit from learning different ways to relax at bedtime and maintaining a soothing bedtime routine, such as having herbal tea and reading 30 minutes before hitting the hay. I also recommend practicing some form of deep breathing or relaxation training. It is best to practice multiple times per day at first — including before bedtime — to teach your body and mind to relax quickly. Any deep-breathing CD should work, though I particularly like Jon Kabat-Zinn's guided meditations.
• Stop trying so hard to sleep. It may sound counterintuitive, but instead of saying to yourself, "I must fall asleep soon or else ...," try allowing yourself to not fall asleep. Make it your goal to simply "rest" the entire night. Don't check the clock, and avoid calculating how many hours you have left until you need to get up.
If none of these techniques work, you might consider seeing a cognitive-behavioral therapist. Go to www.academyofct.org to find one in your area.
Rene D. Zweig, Ph.D., is a certified cognitive therapist and a clinical psychologist at the American Institute for Cognitive Therapy. Learn more about her here.
This article is intended for general informational purposes only and not as a substitute for treatment. Health-related content within LifetimeTV.com should not be treated as a substitute for professional medical advice, examination, diagnosis or treatment. Lifetime Entertainment Services and its medical consultants are not responsible or liable for any diagnosis made by a user based on the content of the LifetimeTV.com website. Consult a qualified health-care provider if you are in any way concerned about your health.
