Insomnia: How to Get a Good Night's Sleep

By Alan Peterson, M.D.

What is Insomnia?

People who have insomnia may not be able to fall asleep. They may wake up at night and not be able to fall back asleep, or they may wake up too early in the morning.

Many things can cause insomnia, such as stress, too much caffeine, depression, changes in work shifts, and pain from medical problems.

Is Insomnia a Serious Problem?

Insomnia is generally not a serious health problem. But it can make you feel tired, depressed, and grumpy. It can also make it hard to concentrate during the day. It could be serious if you fall asleep driving or using other machinery because you couldn’t sleep the night before!

How Much Sleep Do I Need?

Most adults need about 7-8 hours of sleep each night. You are getting enough sleep if you don’t feel tired during the day. The amount of sleep you need stays about the same throughout adulthood. But sleep patterns may change with age. Older people may sleep less at night and take naps during the day.

What Can My Doctor Do to Find Out Why I'm Not Sleeping?

Your doctor will ask you and your bed partner about your sleep habits (such as when you go to bed and when you wake up). Tell your doctor about any medicine you take, and when and how much caffeine and alcohol you drink. Your doctor also may ask if you smoke.

Other questions may include how long you’ve been having trouble sleeping, if you have any pain, and if you snore. Your doctor may also ask about problems in your life that may be upsetting you and making it hard for you to sleep.

If the cause of your insomnia is not clear, your doctor may want you to keep a sleep diary. The diary will help you keep track of when you go to bed, how long you lie in bed before falling asleep, how often you wake up during the night, when you get up in the morning and how well you sleep.

How Is Insomnia Treated?

Treating insomnia can be easy. Once the problem that is causing the insomnia is taken care of, the insomnia usually goes away. The key is to find out what is causing the insomnia. Just making a few changes in their sleep habits helps many people.

What Can I Do to Improve My Sleep Habits?

Here are some things you can do to help you sleep better:

• Go to bed and wake up at the same time, including weekends, even if you didn’t get enough sleep. This will help train your body to sleep at night.
• Get into a bedtime routine. Do the same things every night before you go to sleep. For example, take a warm bath and then read for ten minutes every night before going to bed. Soon these things will help make you sleepy.
• Use the bedroom only for sleeping or having sex. Don’t eat, talk on the telephone, or watch television while you are in bed.
• Make sure your bedroom is quiet and dark. If noise is a problem, use a fan to cover the noise or use earplugs. If you must sleep during the day, hang dark blinds over the windows or wear an eye mask.
• If you are still awake after trying to fall asleep for 30 minutes, get up and go to another room. Sit quietly for about 20 minutes, and then go back to bed. Do this as many times as you need to until you can fall asleep.

Will Sleeping Pills Help?

Sleeping pills can help some people, but they are not a “cure.” Sleeping pills should only be used for a few days. Using them longer can make your insomnia come back. Sleeping pills can be dangerous for people with certain health problems. Talk to your doctor before you take any medicine to help you sleep.

Tips to Help You Sleep

• Avoid or limit the use of caffeine (such as coffee, tea, sodas, chocolate), cold medicines, alcohol and tobacco.
• Exercise more often, but not within a few hours before going to bed.
• Learn to reduce or manage stress in your life.
• Don’t lie in bed worrying. Set aside another time just for worrying. For example, spend 30 minutes after dinner writing down what’s worrying you and what you can do about it.
• Try eating a light snack before going to bed, unless you have medical conditions that would be made worse by eating before lying down (like reflux, some diabetes, or those that are overweight). Don’t eat too much. A glass of warm milk or some cheese and crackers may be all that you need. Remember: If you have high cholesterol, hypertension, or blood sugar problems, those must be taken into account.
• Don’t nap during the day if it seems to make your insomnia worse (or do it only for a brief period).