Expert Help On How To Manage Insomnia

MAR 10 2014, 10:40 AM ET | MARIA SHRIVER | NBCNews.com

Juggling life’s daily challenges can be stressful enough without the added torment of not being able to get a good night’s sleep.

Kelly Baron PhD, MPH, is an Instructor of Neurology at the Feinberg School of Medicine, Northwestern University, and the founder of its Behavioral Sleep Medicine training program, which was accredited by the American Board of Sleep Medicine. Here, she shares her expert guidance on how to manage insomnia.

Every person knows the frustration of a poor night’s sleep. Although nearly everyone experiences temporary sleep problems during times of stress, for some individuals, insomnia develops into a chronic problem. Chronic insomnia (insomnia lasting over four weeks) is experienced by 40 million Americans.

What Is Insomnia?

• Difficulty falling asleep
• Difficulty staying asleep
• Waking up too early and having difficulty returning to sleep

If you have adequate opportunity for sleep, but you are suffering negative consequences of sleep loss in terms of functioning or quality of life, then you are dealing with insomnia.

How Insomnia Affects Us

Insomnia can impact both your physical and mental health. Here are just some of the symptoms sufferers report:

• Mental and physical fatigue
• Irritable and depressed mood
• Difficulty with concentration
• Strained interpersonal relationships

Recent research has also linked insomnia to the development of health conditions such as high blood pressure and heart attacks.

What To Do

If you are having difficulty sleeping, here are some things that may be helpful.

1. Maintain A Consistent Sleep Schedule

Having an irregular bedtime and wake time can throw off your body’s clock. If you go to bed at 2 a.m. on Saturday and then try to go to bed at 10 p.m. on Sunday, that’s a recipe for sleeplessness. Also, trying to stay in bed to “catch up” after a bad night may make it more difficult to fall asleep the next night.

2. Don’t Go To Bed Too Early

Often people with insomnia think “If it takes me an hour to go to sleep, and I want to be asleep by 10 p.m., then I should go to bed at 9 p.m.” What happens is that people go to bed when they are feeling fatigued but their body is not physiologically ready to sleep, which just gives them extra time to worry.

3. Don’t Stay In Bed If You Can’t Sleep

Lying awake in bed at night just gives you the opportunity to think, plan, stress and worry. You are better off getting up and doing something quiet (e.g. reading, watching TV), then returning to bed when you feel sleepy again. It may not be helpful during that particular night, but over the long run, getting out of bed has been shown to be beneficial in insomnia.

4. Exercise

Exercise is good for sleep! Several scientific studies have shown that exercise improves sleep quality. However, be careful of the time you exercise. For some people, exercising close to bedtime can exacerbate insomnia.

5. Reduce Alcohol And Caffeine

Although alcohol and caffeine are not usually the cause of insomnia, they can impair sleep quality. Limit your overall alcohol and caffeine intake. In particular, alcohol in the two hours before bed impacts sleep. For caffeine, your morning cup of coffee should not negatively affect your sleep quality, but limit caffeine in the afternoon and evening.

6. Don’t Try To Sleep

I know, easier said than done! Sleep is not something you can force on yourself. If you worry about sleep, stare at each passing minute on the clock, you will undermine your goal. Instead, do something calming and quiet until your body feels ready for sleep.

Medications and non-drug treatments, such as Cognitive Behavioral Therapy for Insomnia (CBT-I) are also effective at managing insomnia. CBT-I involves four to six sessions of a treatment focused on changing your thoughts and behaviors about sleep.

Tech To Help You Sleep

There are lots of apps and gadgets out there to monitor your sleep.

• Using a device such as Fitbit or Jawbone Up can help you monitor your sleep wake patterns. Even a simple paper sleep log can help you understand your patterns, such as how much sleep you get each night and the factors that may contribute to a good and poor night’s sleep. Be aware, however, that these devices do not give you advice on managing insomnia.
• If you are looking for an online program, Sleepio and Shuti are online CBT-I programs that have been shown to be effective for treating insomnia.

If you experience insomnia for over four weeks or are concerned about the impact of insomnia on your health and functioning, talk to your physician about available treatment options. There are effective medical and non-medical treatments. You can seek evaluation at an accredited sleep center. Additional information, as well as a list of CBT-I practitioners, available here:

http://www.sleepeducation.com

http://www.behavioralsleep.org