In his monthly column, Dr. Kent Herbert answers your questions related to health care matters. Simply submit your question to stefaniw@newfalconherald.com. It’s your chance to ask the doc.Question: I have a hard time sleeping and feel tired during the day. What can I do about this?Answer: The inability to fall asleep, or difficulty in staying asleep, is called insomnia. Some people with insomnia think they are getting a good night’s sleep, but wake up feeling unrefreshed. Forty-eight percent of Americans have insomnia occasionally, and 22 percent experience insomnia almost every night. Insomnia is more common in women than men and is more likely to occur in people over age 65.Insomnia can directly contribute to other heath issues, such as heart disease and diabetes, as well as reduced productivity during the day. It can decrease one’s quality of life. People with chronic insomnia are four times more likely to suffer from depression than those who consistently get a good night’s sleep. In the United States, it is estimated that $14 billion is spent annually on sleep-related health costs, including visits to doctors, medications and medical tests. In addition, another $14 billion is lost in reduced work productivity and missed work.Many factors can lead to insomnia, including stress, anxiety and depression. Uncontrolled pain can also cause depression. Certain medications, such as hormones, blood pressure medications and cold medications can cause poor sleep, as can caffeine. A poor sleep environment, such as excessive noise or light, can affect sleep. In addition, people who have another sleep disorder, such as sleep apnea or restless leg syndrome, are more likely to have insomnia as well.If you suffer from insomnia, it is important to evaluate these factors and work to eliminate them. It is essential to try to reduce stress and anxiety, and if this can’t be done, it is important to seek medical or psychological help. Nighttime pain can often be controlled with a simple analgesic such as acetaminophen or ibuprofen. It is important to look at the side effects of any medications that you are taking to see if insomnia is listed. If so, talk to your doctor about the possibility of changing it. Finally, caffeine should be avoided; its action lasts longer than many people realize. Most sleep experts recommend eliminating any caffeine, even that in soft drinks, after noon to avoid insomnia.In addition to these factors, a good sleep environment should be created to promote sleep. Doctors call this your “sleep hygiene.” This includes eliminating any unnecessary light, noise or other distractions. Avoid watching television or eating in bed. Reading before bed can promote sleep, but active work, such as doing reports or working on the computer, can disrupt it. It is important to keep the same sleep schedule on weekends as during the week and to set a reasonable bedtime. Sleepytime teas can promote sleep and are OK to use, but it is important to choose one that is decaffeinated. Over-the-counter products such as Tylenol PM are fine to use occasionally but may lead to over sedation or a “hangover” effect, or morning drowsiness.If you have tried these things and still have a hard time sleeping, see your doctor. Medications can be effective to help you sleep if nonmedical treatments have been tried and failed and if the lack of sleep is causing problems with daily activities or other medical issues. Prescription sleep medications do have risks, including addiction and behavioral problems, so they need to be closely monitored by your doctor. Never try someone else’s prescription sleep medication without first consulting your doctor, as not all are appropriate for everyone.If you have other sleep-related symptoms, such as loud snoring or frequent leg movements, it is also important to discuss this with your doctor. These can indicate the presence of another sleep disorder, such as sleep apnea, that needs to be treated differently. Doctors will often order a sleep study – a medical test where your sleep is monitored overnight in a sleep lab – to further evaluate your sleep. These can give you a tremendous amount of information about your sleep and often lead to nonpharmaceutical treatments.Sleep is extremely important to your body’s natural functioning. A lack of sleep can lead to other medical issues and a poor quality of life and should be addressed. This can often be done by correcting the issues discussed above; but, if not, see your doctor for help.Dr. Kent HerbertBoard-Certified Family PhysicianFalcon Family Medicine7641 McLaughlin RoadFalcon, CO 80831(719) 494-2006(719) 494-8448 faxwww.FalconFamilyMedicine.com
