I can’t sleep!

Renly Lim
MPharm, PhD, RPh

 

I can’t sleep too 

Most people experience sleeping problems at one time or another. Chronic insomnia, which is difficulty sleeping that has persisted for at least one month, affects as many as one in ten adults. 

 

That’s distressing! Get me a beer (I heard that helps me sleep) 

Sorry to break it to you but having an alcoholic drink to help you sleep is an old wives’ tale. While alcoholic drinks may help you get to sleep initially, it also may end up robbing your sleep and making you feel groggy. When the relaxing effects of alcohol wear off, the withdrawal effects keep you awake. As a result, you may find it even more difficult to get back to sleep. 

 

Should I take sleeping pills then? 

Sleeping pills can be useful to help you sleep only in the short-term, and should only be taken intermittently for at most 3 or 4 days at any one time. The effects of sleeping pills are lost once you stop taking them. Furthermore, sleeping pills can cause side effects such as: 

  • Dizziness and difficulty with coordination leading to falls and fractures 
  • Daytime drowsiness 
  • Memory loss or confusion 
  • Unusual or disturbing dreams 
  • Leaking urine 

 If you are taking sleeping pills regularly, it is possible to stop taking them. This should be done by gradually reducing the dose of sleeping pills to prevent resurgence of sleeping problem (also known as “rebound effects”). Talk to your doctor or pharmacist to find out how you can stop taking sleeping pills.  

 

So, what can I do to sleep better? 

Below are some of the things you can do to help you sleep better: 

THE YES 

  • Establish a routine. Get up and go to bed at the same time each day 
  • Maintain an active lifestyle during the day 
  • Allow yourself some time to wind down in the evening before going to bed 
  • Maintain a cool temperature of between 15 and 20 degrees in your bedroom 
  • Reduce light (preferably pitch-black) and noise in the bedroom 
  • Go to bed only when you feel sleepy 
  • Use the bedroom only for sleep or sexual intercourse 

THE NO 

  • Avoid having naps especially after 3pm 
  • Avoid a large meal, excessive fluid intake, alcohol or caffeine close to bedtime. 
  • Avoid smoking close to bedtime 
  • Avoid watching the television or use a computer close to bedtime 
  • Don’t get worried or frustrated if you can’t fall asleep. Get up and go back when you feel sleepy. 

 

I’ve tried all the methods above but still can’t sleep 

Fret not. There are a number of medicine-free options that have been proven to be effective in improving sleep. 

  • Cognitive therapy provides information on how people perceive sleep and ways to manage sleep problems 
  • Stimulus control helps promote an association between the bed and readiness to sleep 
  • Sleep restriction involves decreasing the time you spend in bed to match the amount of time that you are actually sleeping 

 For more information about these options, talk to your doctor or pharmacist. 

 

And if you’re still reading……. 

 

I wonder how many hours of sleep I need? 

An average adult (unless you are a superhuman) requires approximately 7 to 8 hours of sleep at night to function optimally. However, the amount of sleep that one needs vary from individual to individual. The average number of hours of sleep decreases as we get older.  

  

 You may find that you sleep fewer hours, and that the sleep is ‘less rewarding’ than it used to be, and that’s okay. More importantly, be mindful that worrying about lack of sleep can have a negative effect on your health. Worrying about lack of sleep may affect you more than the lack of sleep itself. As cliché as it sounds, don’t worry be happy. 

 

What’s the take-home message? 

  • Establish a healthy sleep routine. Our body loves routine 
  • Medicine-free treatments are more effective to help your sleeping problems than sleeping pills in the long term 
  • Stopping sleeping pills need to be done gradually. Talk to your doctor or pharmacist about how you can stop taking these pills and switch to effective medicine-free treatments 
  • Worrying about sleep has more negative effects than the lack of sleep itself 
  • Don’t worry, be happy! 

 

 

References 

1) Ohayon MM, Carskadon MA, Guilleminault C, Vitiello MV. Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: developing normative sleep values across the human lifespan. Sleep. 2004 Nov 01;27(7):1255-73. 

2) Sateia MJ, Buysse DJ, Krystal AD, Neubauer DN, Heald JL. Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med. 2017;13(2):307–349. 

3) Royal Australian College of General Practitioners. Prescribing drugs of dependence in general practice, Part B: Benzodiazepines. 2015. Accessed 13 September 2017. Available from: http://www.racgp.org.au/download/Documents/Guidelines/Addictive-drugs/Addictive-drugs-guide-B.pdf. 

4) Veterans’ Medicines Advice and Therapeutics Education Services. The myths and facts about sleep. 2012. Accessed 13 September 2017. Available from: https://www.veteransmates.net.au/VeteransMATES/documents/module_materials/M31_VetBrochure.pdf 

 

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