What to Do About Insomnia
Can't Sleep? Insomnia Types, Causes, and Treatments
Medical Causes continued...
The "pins and needles," "internal itch," or "creeping, crawling sensation" of restless leg syndrome (RLS) also make it quite difficult to fall asleep, especially since those symptoms occur more often when one is sleepy or lying down and are relieved only by vigorously moving the legs. The symptoms of RLS may awaken one out of sleep, forcing the sufferer to walk around to relieve the discomfort.
Most people with RLS also have periodic limb movement disorder (PLMD), repetitive movements of the toe, foot, and sometimes knee and hip during sleep. These movements may cause arousals that lead to non-restorative sleep. Your doctor can prescribe various medications to reduce or eliminate the movements and the associated sleep disturbances (arousals) caused by these disorders. This results in a more sound sleep, one from which you awaken restored and refreshed.
Other illnesses that often have nighttime symptoms that cause awakenings include:
Another reason why communicating symptoms of insomnia to your doctor is so important is the possibility that the treatments for medical conditions themselves may cause or worsen insomnia. Following is a brief list of some classes of drugs that may fall into this category:
- Central nervous system stimulants
- Non-steroidal anti-inflammatory drugs
Back to Sleep
Developing good sleep hygiene is very important for insomnia relief. For example, smoking, drinking, and exercise can affect your sleep dramatically. What you actually do in bed (like reading or watching TV), the temperature of room, noise levels, the timing and amount of fluids you drink, and the food you eat significantly impact insomnia. Exposure to light in the evening (looking at a bright computer screen, turning on the light to go to the bathroom) may alter your circadian rhythms. Poor hygiene alone can generate significant sleep problems.
Treatment for insomnia falls into two basic categories, medication and behavioral strategies for sleep initiation. Doctors tend to use one of three different types of medication for insomnia, including:
- The so-called non-benzodiazepine or "non-valium-like" hypnotics (such as Ambien and Sonata) are designed for insomnia and are often first-line treatment. They are especially effective because they work quickly, do not disrupt your "sleep architecture" or the quality of your sleep.
- When considering underlying depression associated with insomnia, antidepressants are often used because of their sedating side effects.
- Hypnotics (including Restoril, Halcion, and Klonopin) should be used only in selected patients because they are potent medications that greatly impact the quality of sleep and may have severe side effects, including daytime drowsiness and addiction.