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Week of 19 September 1997

Vol. I, No. 4

Health Matters

Beating insomnia

Over the past several weeks I have been having trouble sleeping. What can I do to resume my regular schedule?

If you function well during the day, you may not need to change anything at all. According to Sanford Auerbach, M.D., director of the sleep disorders center at Boston Medical Center and assistant professor of neurology and psychiatry at Boston University School of Medicine, the main purpose of sleep is to help us perform well when we're awake. Some people sleep only five to six hours a night, others need eight or nine, he says.

If you have difficulty staying awake during the day, then you probably suffer from insomnia, the inability to fall asleep or stay asleep. Transient insomnia usually lasts a few days to several weeks, while chronic insomnia lasts for at least six months. You can take measures to prevent either type of insomnia, but if those measures are ineffective, you may be suffering from some other sleep disorder and should consult a doctor.

Food can contribute to a better night's sleep, so a bedtime snack could be helpful. By contrast, Auerbach says, caffeine and alcohol often disrupt sleep. While sensitivity to caffeine (which is found in many colas, teas, and chocolates, in addition to coffee) varies, people become more susceptible to its effects as they grow older. And while people might think that alcohol promotes sleep because it makes them drowsy, a few hours into sleep the body rebounds, waking the sleeper somewhat, so the second half of the sleeping cycle is of lower quality.

Medications can also alter sleeping patterns. The only way to be sure if your medications interrupt sleep is to check with your doctor. Routine exercise can help you maintain regular sleeping hours.

Insomniacs often have trouble easing their bodies into sleep. According to Auerbach, the key to initiating sleep is to be as relaxed as possible by removing yourself from the outside world and the stresses of the day. First, remove any items that you regularly use for work, such as a computer or fax machine, from your bedroom. Second, learn how your body eases into sleep, which will differ from person to person. (Some people will be sedated by watching television; others may become involved in what they're watching and stay awake.)

Some people simply have difficulty relaxing. But they can learn how to relax if they are patient. Some methods commonly used are meditation, self-hypnosis, and audiotapes that play soothing music.

Finally, Auerbach cautions against using melatonin, a newly popular drug sold in health food stores that allegedly helps users attain a deeper sleep than normal. Since melatonin's effects haven't been investigated carefully, he recommends making behavioral changes before trying it. If you do decide to try it, be sure to inform your doctor.

"Health Matters" is written in cooperation with staff members at the Boston Medical Center. For more information about insomnia or other health matters, contact the Boston Medical Center Health Connection at 800-841-4325.