Q: Please Dr I need your help because I can’t sleep at night

A: Sleep problems may show up as difficulty falling asleep, difficulty staying asleep if one wakes up in the night, waking up too early and being unable to fall back asleep or waking up feeling very tired etc. This is called insomnia. These problems may (secondary insomnia) or may not (primary insomnia) be related to other health/disease conditions. Usually this person wakes up extremely tired and feels sleepy during the day. Women over 60 years of age are more prone, people who are stressed and travel long distances across time zones are also more likely to have insomnia.

This can be due to events of sudden onset like work or emotional stress, jet lag after travelling across time zones, medications, late meals, taking a lot of caffeine, alcohol and smoking etc. It can also be of a longer duration when the person finds himself unable to sleep for about 3 nights per week. The causes of the latter include depression and stress that has been going on for some time (divorce, death of a loved one etc). Other causes include medications, anxiety, pain or discomfort etc.

Treating insomnia depends on the cause. Your doctor may provide some counseling in helping you or could give you some drugs to help you relax for a short period of time…so you don’t get dependent on them. He may also want to try some behavioral therapies with you.

Insomnia without underlying medical conditions can be treated with lifestyle modifications like the under-mentioned ones:

• Have a regular sleep routine that allows you (an adult) about 7 to 9 hours of sleep daily. Go for the higher limit, by the way 😀 
• As much as you can, try sticking with a particular sleep schedule so that your body falls into that pattern
• Limit day time napping. Save it all up for the night 
• Limit your intake of fluids before bed to avoid waking up to urinate and being unable to get back to sleep.
• Cultivate good sleep habits (no TVs in room, no work before bed time, a warm bath before bed etc).
• Lay off the caffeine and alcohol before bed time too.
• Regular exercise helps relieve everyday tension but vigorous exercise before bedtime may lead to inability to sleep too.
• Make your room a haven for sleep and clear out all clutter and be sure that you have invested in a good mattress and pillows. It’s a good idea to ventilate the day’s issues before you actually start getting ready for bed, so you can mentally file every issue away in a ‘to-do’ or ‘done’ box ahead of the next day.

Insomnia due to underlying medical condition needs the medical condition to be addressed. In the case of depression, please ensure that you are taking the medications prescribed by your doctor.

I hope this helps. Good night y’all 😀