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<< Previous   of   Next >>   ADVERTISEMENT   Related Stories • You have to sink a lot lower to embarrass NBC 1/15/08   CONTACT THE HERALD Melanie Munk, Features Editor munk@heraldnet.com   Published: Tuesday, January 15, 2008 Nondrug treatments help with insomnia By Elizabeth Smoots, Herald Columnist Amy is a 38-year-old receptionist who has trouble falling asleep and staying asleep. The symptoms have plagued her for eight years and have gotten worse since she took a higher-stress position a year ago. Amy goes to bed at 9:30 p.m. but takes up to two hours to fall asleep. She wakes up once or twice during the night and has difficulty going back to sleep. Averaging four hours of sleep at night leaves her feeling fatigued during the day. The cause of Amy's sleep problems? It's insomnia, a condition that affects up to 20 percent of adults. The disorder occurs most frequently in women, older adults and people with chronic medical or mental-health disorders. To provide the latest advice about nondrug treatments for insomnia, I've enlisted help from Dr. James Herdegen, the medical director of the sleep science center at the University of Illinois in Chicago. What is insomnia? Insomnia is the most common sleep problem in America. A Gallup poll found that 95 percent of adults experience symptoms of the condition at some point in their lives. Difficulty falling asleep or staying asleep, or waking up not feeling refreshed, are essential to a diagnosis of insomnia. The symptoms are not produced by another medical, mental or sleep disorder and must significantly impair your ability to function. Symptoms of the condition may last only a few nights (acute), persist longer than a month (chronic) or occur intermittently. The exact cause of insomnia is unknown. Stress and worry, schedule changes, painful conditions and other health problems can trigger the condition. So can a number of medications, including those used for asthma, allergies, colds, depression, high blood pressure, heart or thyroid disease and seizures. Nondrug treatments No matter the cause, a lack of adequate sleep can result in distressing difficulties. Fatigue, depression, concentration problems, illness and accidental injury are more likely to occur among sleep-deprived people. See your doctor if you suffer from insomnia. Though medications are often tried, changes in behavior and lifestyle are often equally effective and better tolerated in the long run. Herdegen recommends these nondrug therapies for the treatment of insomnia: Stimulus control: "Try to associate the bedroom with sleeping," Herdegen said. "Take all those other activities out of the bedroom and reassociate the bed with sleep." His list of no-no's include eating, watching television, using your laptop computer or making phone calls in the bedroom. Sleep restriction: Go to bed when you're sleepy and get out of bed when you're awake. Studies indicate that limiting your time in bed to the hours you're actually asleep results in more consolidated and efficient sleep. Other points: Arise at the same time each morning regardless of the amount of sleep you got the previous night. And avoid daytime napping. Relaxation training: "Bedtime is a common time to worry," Herdegen said. He suggests writing your thoughts down on paper before going to bed. Establishing a one-hour period to unwind before bedtime is also beneficial. So are meditation, guided imagery, biofeedback or relaxation exercises. Cognitive therapy: This counseling technique aims to change faulty attitudes and beliefs about insomnia. It can also help you set realistic goals and learn healthier ways of dealing with insufficient sleep. Sleep hygiene practices: Finish exercising at least four hours before bedtime. Avoid alcohol and stimulants around bedtime. Bathe one to two hours before shut-eye instead of immediately beforehand. And keep the bedroom quiet, dark and comfortable. Pleasant dreams ... For more information: National Sleep Foundation, www.sleepfoundation.org. Contact Dr. Elizabeth Smoots, a board-certified family physician and fellow of the American Academy of Family Physicians, at doctor@practicalprevention.com. Her columns are not intended as a substitute for medical advice or treatment. Before adhering to any recommendations in this column consult your health care provider. © 2008 Elizabeth S. Smoots

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