Insomnia: Not For the Faint of Heart

By Carol Duff, MSN, BA, RN – April 8, 2019

Insomnia: Don’t Be a Victim

by Carol Duff MSN, BA, RN

Insomnia can be both a symptom and a disease. Insomnia may be a sign that you have another disease (obstructive sleep apnea or depression) and if that is the case you may need to, after trying the following hints to improve the ease of getting to and staying asleep, seek the help of your healthcare provider.  More than one third of adults do not get the recommended seven hours of sleep per night.  This amount of sleep is needed to insure good health.  Enough sleep may be very difficult to get and there can be many reasons why this is so.

With the increased use of computers, tablets, smart phones, televisions, etc., we are exposed to something called “blue-light.”  This type of light suppresses melatonin which is the important hormone to help you sleep.  Your brain naturally makes melatonin in the pineal gland which is located deep in the brain.  There are glasses that block that blue light and are available for purchase.  You can wear these in the evening in preparation for sleep.  Otherwise, it is recommended that you turn off your electronics at least one hour before bedtime. Also, your computer or tablet or device may had a mode to set for night-time viewing and this would limit the blue light the monitor will emit. Check the settings and see if you can find something called “night light.”  If you enable this function it will begin at around 8:00 p.m.

For women, Insomnia may be caused by decreasing estrogen (female hormone) levels in post-menopausal women. Decreased estrogen can cause hot flashes that may occur during the night.  If you sleep with a partner who has hot flashes, you could have different amount of covers for each side of the bed.  Sheets and pajamas that wick away moisture are helpful.  A handy fan for quick cool downs would also be a potential life saver.

If you are retired from your job or wherever you had to get to everyday, and have no set time to be up in the morning, you may tend to just go to bed whenever since you will not be hostage to the alarm clock the next morning.  You should still stick to a rather set time for going to bed to help your body to make that melatonin.  A specific time to go to bed should also continue on the weekends for those of you who would like to sleep in on days you are not working.

Most of us use caffeine which is of course a stimulant. Some of us think that we need an intake of caffeine to get started on daily activities. Caffeine of course comes with teas and coffees, but is also in chocolate, carbonated drinks, and of course, energy drinks.  Everyone has a different time in which his or her body metabolizes the caffeine, so you may find that you must limit your espresso sipping to before noon.  Add ice tea to the list of caffeinated products.

Typically, your bed should be used for sleep or to have sex.  Keep the relaxing activities such as reading, working on cross-words, etc. to other areas of your home.  Your mind can associate your bed with activities other than sleeping…I know this sounds strange, but it would be worth a try…

We can find ourselves drifting off to sleep while watching TV, listening to music, or just simply sitting down after moving around all day. We naturally have a time of day when we feel sleepy, other than at night time.  Our circadian rhythm can make us sleepy tired in the afternoon at about 3 to 5.  It is so tempting to lay down and rest your eyes and drift off for a few minutes which can turn into one or two hours.  Resist sleeping during the day if you want to be able to sleep at nighttime.   If you consistently feel low on energy at this time of day, schedule a walk or activity to keep you stimulated.  Also, there is a tendency to become sleepy after eating and that is because your blood supply has partially abandoned your brain to help your stomach digest your meal.  If you sleep at any other time of the day before bed time your brain will think you have had sleep and will not be as receptive to night time sleep.

Going to your bedroom, thinking this will encourage you to become sleepy, is not a workable concept.  You go to bed, lay there, your mind is racing, you cannot fall asleep. When you do not feel like you can get to sleep, go to another room and do something relaxing, remembering to not use blue-light producers or if that is the only form of entertainment you have, to use blocking glasses while you have your relaxing activity.

Your sleep can be interrupted by the time of day or evening that you take your medications.  Taking a blood pressure lowering med, that will act as a diuretic and cause you to get rid of fluids, i.e. go to the bathroom during the night, will wake you up out of necessity, but still you have been awakened. Other medications can cause sedation or be stimulants, so take according to when you want to be sedated or energized.  Your healthcare provider can help you with the best time to take your medications.

A moderate amount of alcohol intake can be relaxing and since it is really a depressant can send you to sleep, but there can be a rebound affect which can cause you to sleep lighter and eventually be more easily aroused as the night progresses. The second/later portion of your period of sleep can be disrupted. Also, alcohol will suppress the hormone (antidiuretic hormone)that your body makes to keep your urine from containing too much water. Obviously suppressing this hormone will send you to the bathroom more frequently.  It is best to drink alcohol no sooner than three hours before you go to bed.

You may be having trouble sleeping because you are anxious about something (s) that are happening to you or you fear may be going to happen. We all live a busy life and worries are often a part of our life.  The pressures of anxiety may wear you down so much that you will fall a sleep immediately but then wake up and your brain will start speeding up and, well, real sleep will be hard to get back to.  If you have a lot of anxieties, you will need to address the root causes for these. There is Cognitive Behavioral Therapy (CBT-1) for insomnia.

For those of you who have pets who may sleep on the bed or in your bedroom, you all know how the dog or cat getting onto or off of the bed can shake the bed and awaken you. Sounds of shaking collars with tags on them, ears flapping with head shaking, little sounds made by a dog when it is dreaming because it is not having insomnia, and the big one of all time, the cat getting ready to vomit. Seriously, they should make an alarm clock ring out of that sound since it will get you out of bed quicker than just about anything short of someone yelling “fire.”  You might need to keep pets out of the bedroom for the seven hours that you should be sleeping. I know it will be upsetting for your pets, you, or all of you, but you could give it a try to see if separation at night will help you to stay asleep.

Insomnia will be a disruption to your life, can affect your health, and is best dealt with as soon as possible.  If you are a victim (yes, you are a victim) of insomnia, try some of these tricks/suggestions for a few weeks.  If you are still experiencing insomnia, it is best to consult your healthcare provider for additional help and suggestions.  Hopefully you will eventually be able to sleep “tight” as the old saying goes.  “Sleep tight, don’t let the bedbugs bite.”  Bedbugs are a topic for another time……..Carol

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