Sleeplessness
How to know if you need a doctor's help
If it's hard to remember your last good night's sleep, it may be time to talk to a doctor about treatment for sleeplessness. You may be among the millions of Americans who suffer from sleep difficulties. If so, or if you know someone who is, read on.
This article will provide an overview of sleeplessness (also known as insomnia), as well as guidelines for knowing when to see a doctor... and what type of doctor to see.
There are 3 "degrees" of sleeplessness:
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Occasional difficulty sleeping (also known as "transient" insomnia, lasting a few nights) is something that most people experience from time to time. Usually this is a reaction to a disruption in your regular schedule or to stress.
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Short-term insomnia lasts from a few days to a few weeks. Common causes include going through a life change (i.e., divorce or job loss),concerns about health, money worries, or experiencing the psychological stress of bereavement.
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Chronic or long-term sleeplessness is an ongoing condition that lasts for more than a few weeks. For some people, this may continue for months or even years. This type of insomnia may be caused by living in a noisy environment, working a night shift, chronic drug or alcohol use,or certain medical conditions. In some people, difficulty sleeping is related to emotional distress such as depression.
The key to deciding whether or when to seek medical help for insomnia is how chronic your problem is. "You should seek help," says Dr. Allan Pack, Medical Director of the National Sleep Foundation, "if your sleeplessness has been long lasting."
Another clue is if you're not getting relief after following the basic rules of good "sleep hygiene" . These were outlined in the introductory issue of this newsletter, and are briefly reviewed below:
- Go to bed and get up at the same time every day.
- Get regular exercise.
- Use your bed primarily for sleeping, so you will associate being in bed with going to sleep.
- Invest in a good bed.
- Deal with your worries before you go to bed.
- Don't go to bed on a full stomach.
- Aim for quality sleep. A few hours of that are better than more hours of tossing and turning.
- Develop a pre-sleep relaxation routine.
- Don't go to bed until you're tired enough to fall asleep.
Here are some more serious signals that warn you it's time to get some help:
- It's difficult for you to stay awake during the day.
- You're having trouble performing at your job.
- You're having trouble concentrating, becoming forgetful, or feeling disoriented.
- You've had an accident or near-accident caused by drowsiness.
Since insomnia may be a symptom of certain medical conditions, the first person to consult is your family doctor. He or she can evaluate your overall health and rule these out as causes. However, Dr. Pack cautions that internists may not have had specialized training in treating sleep problems. Your doctor should take a detailed history to uncover the underlying cause of your sleeplessness...not just prescribe something to give you short-term relief.
If you think that stress, anxiety or depression are factors in your sleeplessness, consulting a stress-management specialist, psychotherapist or other mental health professional may be advised. "There's a real relationship between insomnia and depression, as well as anxiety disorders," says Dr. Pack.
Under certain circumstances, you may be referred to a specialized sleep disorder center. These would include:
- If you are falling asleep inappropriately during the day.
- If sleep fails to refresh you.
- If you've tried everything previously outlined in the article and nothing has worked.
Sleep disorder specialists caution that you should not suffer needlessly, and should seek help quickly. That's because the longer you wait, the more difficult your sleeplessness may be to treat.
For more information about sleeplessness, contact the National Sleep Foundation, 1367 Connecticut Avenue, NW, Suite 200, Washington, DC 20036. Or you can find information on the Internet at http://www.sleepnet.com, a Web page devoted to sleep issues that has listings of sleep disorder centers and referrals to other Web sites devoted to sleep-related issues.
Recommended reading: No More Sleepless Nights, by Peter Hauri Ph.D. and Shirley Linde Ph.D. (John Wiley and Sons, $14.95). Authored by the Director of the Insomnia Research and Treatment Program at the Mayo Clinic, this book outlines a practical self-help program to help you diagnose and treat your sleeplessness problem.
