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’ve been having trouble sleeping lately. Is that normal and what can I do?Answer: Difficulty sleeping is a common problem for people of all ages. Up to one-third of the population experiences occasional difficulty sleeping, and 10 percent have chronic sleep problems. Difficulty sleeping, or insomnia, is defined as not getting enough sleep or having poor-quality sleep. People with insomnia may have difficulty falling asleep or maintaining sleep; they may wake up too early in the morning or get sleep that is not refreshing. Insomnia can lead to fatigue, lack of energy, difficulty concentrating and irritability. It can also contribute to medical problems, such as high blood pressure, depression and obesity.Insomnia can be either acute or chronic. Acute insomnia is when one has difficulty sleeping for one night to several weeks. The cause of acute insomnia is usually obvious, such as stress, anxiety or pain. It can also be caused by sleeping at a time that is inconsistent with the daily biologic rhythm, such as when a person works a night shift and attempts to sleep during the day. To treat acute insomnia, it is important to address the underlying cause.Chronic insomnia refers to difficulty sleeping that occurs at least three nights per week for one month or more. Chronic insomnia can be caused by long-term medical issues and is often the result of a combination of factors. Chronic insomnia can also be caused by specific sleep disorders, such as Restless Legs Syndrome, where one experiences uncomfortable sensations in the legs during sleep; periodic limb movement disorder, in which one has jerky and disruptive leg movements; and obstructive sleep apnea, when excessive snoring causes one to stop breathing and to wake up repeatedly. In these cases, the underlying condition should be identified and treated. When other causes of insomnia are ruled out or fully treated, any remaining difficulty with sleep is called primary insomnia. The cause of primary insomnia is usually not known.The first step to treat primary insomnia is to develop good sleep hygiene. Hygiene is anything that promotes healthy living, and sleep hygiene refers to habits and behaviors that contribute to healthy sleep. To maintain good sleep hygiene, it is important not to go to bed before one is sleepy and to avoid eating, reading or watching TV while in bed. If you go to bed and haven’t fallen asleep within 20 minutes, get out of bed and do something relaxing outside of the bedroom, returning when you are sleepy. It is also important to go to bed at the same time every evening and to get up at the same time every morning, even on weekends. It is best to avoid naps during the day, even if tired. To get a good night’s sleep, one should avoid any caffeine after lunch time, as the effects of caffeine can last eight to 10 hours. It is also best to avoid alcohol, tobacco, eating and exercise within a few hours of going to bed.If establishing good sleep hygiene doesn’t help you sleep, certain medications can help. Melatonin is a natural remedy that can help when your sleep cycle is off, such as in people who work the night shift or people with jet lag. It is not typically sedating so it must be taken for some time, rather than just as needed. Virtually all over-the-counter sleep medications contain diphenhydramine, the active ingredient in Benedryl or other antihistamines. They are typically allergy medications that have the side effect of sedation, so they help with sleep. They can work well, but can be overly sedating and, like most sleep medications, are not designed for nightly use.If these measures don’t work, see your doctor for additional help. He or she can evaluate you for an underlying disorder, such as sleep apnea, or help with prescription medications. Consistent and quality sleep is crucial to good health and well-being, and it is important to take whatever measures are needed to achieve it.Dr. Kent HerbertBoard-Certified Family PhysicianFalcon Family Medicine7641 McLaughlin Rd.Falcon, CO 80831(719) 494-2006(719) 494-8448 faxwww.FalconFamilyMedicine.com
