Behavioral changes can help with sleep disorders


Q. I have insomnia. I can’t go to sleep, and I can’t seem to get up in the mornings. I’m so tired throughout the day that I have trouble concentrating. I’ve tried medications, but then I feel like I have a hangover when I wake up. Do you have any suggestions?

A. You are not alone. Sleep disorders affect more than 70 million people in the United States each year or one-third of the population. Insomnia, or the difficulty falling asleep or staying asleep, is by far the most common disorder.

If you are not getting enough sleep at night, you will likely feel fatigued the next day and become impaired in your work function. You may be feeling irritable and become quick to anger. Additionally, people with insomnia are three times more likely to report depression, anxiety, and work-related difficulties.

There are several potential causes for insomnia. Stressful situations related to job or family matters, an increase in caffeine or nicotine use, or even potential positive events can cause sleeplessness. Also, heavy meals or alcohol consumption in the evening are other potential contributing factors to interrupted sleep.

Changing your bedtime behaviors may help you to relax. Do not do anything that will cause you to become either physically or mentally over-stimulated within at least an hour before bedtime. Such activities can include exercising, playing computer games, or watching certain television programs or movies. Although exercising should help you sleep better, be certain that you limit it to earlier in the day.

Most sleep experts recommend that you use the bedroom for sleeping. Do not watch television or bring your laptop to bed. Researchers find that reading before bedtime, keeping the same sleep schedule throughout the week, and having a snack containing carbohydrates often promotes sleep.

I suggest you research some behavioral techniques for insomnia prevention such as relaxation training and visual imagery. You can consult a psychotherapist or you can find many resources on-line to help you. I suggest that you start with helpguide.org, which has an excellent section on insomnia and suggestions for relaxation techniques.

Q. I’ve had trouble sleeping, so I’ve been having three drinks an hour or two before I go to bed. Now I’m getting 7 hours of sleep, but I still feel tired. Why is that?

A. Researchers now know that alcohol before sleeping can interfere with the quality of your sleep more than caffeine. Many studies suggest avoiding any alcohol for at least two hours before bedtime. Other studies show that even a moderate amount of alcohol consumed six hours before bedtime can increase wakefulness during the night.

To fully understand the problem that alcohol causes with sleep it is necessary to understand the sleep cycle. During the night, people go through two alternating types of sleep, Slow Wave Sleep (SWS) and Rapid Eye Movement (REM). Episodes of REM occur about every 90 minutes and last from 5 to 30 minutes. In REM sleep, one’s heart rate, breathing, and blood pressure are similar to being awake. Alcohol interferes with the REM cycle, so you’ve probably noticed that you fall asleep quickly, but awaken several times during the night. When people are deprived of REM sleep, they often feel fatigued, groggy, and lack concentration the next day.

Drinking alcohol before bed is helping you fall asleep, but you are not getting quality sleep throughout the night. Consult your physician about your insomnia and be certain that there is no underlying physical cause for your problem. There are medications and behavioral techniques that you can use which are safer and will provide you with better sleep.

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Nancy Ryburn holds a doctorate degree in psychology from Yeshiva University in New York City where she maintained a private practice. She now teaches psychology at Southeast Arkansas College. Email your questions to drnryburn@gmail.com. The questions will not be answered personally, but could appear in a future column. There

will be no identifying information and all emails remain confidential.