Dr. Eddie ‘I am 70 years and my problem is I cannot sleep. Let me be clear, I am in bed and go off asleep at about 4 in the morning, waking up around 6, getting about 2 hours per night for about 5 nights a week and for about two nights a week I can go to bed getting no sleep. As a result I get restless, agitated, irritable and have significant concentration difficulties. 10 years ago I looked after my elderly mother and was regularly called upon at night to attend to her needs. During this period my sleep became disturbed.
My mother passed away and after this loss I went to her GP seeking help to sleep. My GP prescribed sleeping tablets and I have been on these for 6 year. Now I am at the end of my tether. I don’t believe I have depression or anxiety and I am over the grief and bereavement of the loss of my mum, even though I think about her frequently. I know that I have insomnia, but now I have two main problems insomnia and drug dependency to my sleeping tablets.
Dear Mary ‘Thanks very much for contacting. I remember seeing a wonderful person, Anne, with similar issues a number of years ago. Getting a good night’s sleep is so critical to how we function. Working with her GP Anne was prescribed a reducing dose of her sleeping medication. In addition using CBT (Cognitive Behavioural Therapy) techniques Anne is now having 5 hours sleep a night on average. In fact, in two nights Anne is getting as much sleep as she was getting for the whole week. Finally Anne reported dreaming normally something she hadn’t done for years while on sleeping pills. She also reported no hangover effects. Anne describes feeling refreshed and has a zest for life.
So how did we get there, as I said a reducing dose of medications was prescribed. The GP and local pharmacist agreed that the pharmaceutical properties and impact of the medications for sleep was minimal after 6 years. Sometimes medications can act like a crutch. Now having a crutch is OK. And no good therapist would remove a crutch without replacing it, in the first place. Now I am a firm believer of what gets measured gets done. So it’s important to exactly monitor your sleep and log the number of hours. Then it’s about putting into place good sleep hygiene, that is a routine that prompts sleep. As you are well aware if your sleep is disturbed your life suffers you can be in bad form with the ‘Three F’s’ of your life; Family, Friends & Fools. Sleep is the third part of the health triangle of exercise and healthy eating.
While most people will have occasional disturbances in sleep often caused by temporary stress. However for insomnia two questions need to be answered. If your sleep is disturbed for over one month and if you answer yes to the following questions “Do you experience difficulty sleeping?” or “Do you have difficulty falling or staying asleep?” Then you may be experiencing insomnia.
Indeed insomnia may accompany several sleep, medical, and psychological conditions, and is having persistent difficulty falling asleep and/or staying asleep or having sleep of poor quality. In the first instance a good work-up by your GP is recommended to determine any pre-existing conditions that may be causing insomnia
Below are suggestions for ways to improve sleep that Anne used.
Ways to Improve Sleep
- Go to bed at the same time each day.
- Get up from bed at the same time each day.
- Get regular exercise each day, preferably in the morning. There is good evidence that
regular exercise improves restful sleep. This includes stretching and aerobic exercise.
- Get regular exposure to outdoor or bright lights, especially in the late afternoon.
- Keep the temperature in your bedroom comfortable.
- Keep the bedroom quiet when sleeping.
- Keep the bedroom dark enough to facilitate sleep.
- Use your bed only for sleep and sex.
- Use a relaxation exercise just before going to sleep. e.g.Muscle relaxation, imagery, massage, warm bath, etc.
- Exercise just before going to bed.
- Engage in stimulating activity just before bed, such as playing a competitive game,
watching an exciting program on television or movie, or having an important
discussion with a loved one.
- Have caffeine in the evening (coffee, many teas, chocolate, sodas, etc.) .
- Read or watch television in bed.
- Use alcohol to help you sleep.
- Go to bed too hungry or too full.
- Take daytime naps.
- Don’t command yourself to go to sleep. This only makes your mind and body more alert.
If you lie in bed awake for more than 20-30 minutes, get up, go to a different room do a quiet activity (e.g. non-excitable reading or television), and then return to bed when you feel sleepy. Do this as many times during the night as needed