Advice About Insomnia

Drugs
Avoid excessive caffeine, alcohol, nicotine, and hypnotic drugs.

Exercise
Regular early evening aerobic exercise followed by a hot bath or shower is healthy for sleep and the ability to cope with occasional sleep loss.

Wind down
Indulge yourself with at least 30 minutes of relaxing, quiet, pleasureable activity before lights out time.

Sleep timing
Maintain regular sleep and wake times appropriate for the required length of sleep. Optimum sleep period is centred over the low body temperature time which is governed by the body's internal clock - its'' circadian (24 - hour) rhythms. Exposure to strong light upon final morning wakening will stop the rhythms from drifting later. Sleep periods and rhythms that are too early may require strong evening light in addition to exercise to delay sleep to a more convenient time. Avoid daytime napping unless that is a preferred and convenient habit.

BE INFORMED ABOUT SLEEP

Brief nighttime wakenings about every 90 minutes are a normal part of the sleep pattern especially in older individuals.

Sleep perception is inaccurate and sleep time is almost always greater than estimated.

Night worries may be biological driven when awakening out of REM sleep. The primary cause of worry is biological rather than from the object of the worry. The biological arousal should dissipate over 10 - 20 minutes if not reinforced by a focus on the objects of the worrying thoughts.

The judgement of whether or not sleep is adequate depends on quality of daytime functioning. If daytime functioning is good and free of tiredness and sleepiness, sleep should be considered adquate even if it is not the average 7.5 hours.

CONTRIBUTING FACTORS TO INSOMNIA

• Poor sleep hygine and the presence of sleep disruptors eg noise or discomfort
• Stress and anxiety and conditioned emotional responses
• Medical, psychiatric, and physical problems - Affective disorders, arthritis, angina, asthma, chronic pain, restless legs, periodic limb movements, sleep apnea, etc.
• Use of drugs (alcohol, caffeine, nicotine, hypnotics, etc.)
• Circadian rhythm abnormalities (phase delays and phase advance)