Doing Everything Right but Still Can't Sleep?

The room is dark, the temperature is right, and you're as relaxed as you can be. If you've done everything in your power but still can't manage a good night's sleep, it's time to get help.

Although we treat it like a medical condition, insomnia is actually a symptom of some other condition. That "other condition" can be any one of many, so finding the right treatment isn't always as simple as you might think. Insomnia may be due to anxiety, depression, sleep apnea, hormonal changes, environmental disturbances, such as external sound or lights, traveling in different time zones or, it may be due to a neurological abnormality that results in a life-long struggle to control an abnormal sleep-wake  cycle. Sleeplessness may also be a symptom of a host of other medical conditions, such as arthritis, gastrointestinal reflux or heart disease.

A good night's sleep always starts with good sleep hygiene-a restful setting and sometimes sleep-inducing activities, such as warm baths and relaxation techniques-but for many people, that's simply not enough. Treating the underlying cause of insomnia may be the only solution.

In the short term, over-the-counter products that contain sedating drugs (the ones that make you drowsy, like diphenhydramine HCL, the antihistamine used in some allergy and cold medications) can help you get to sleep. These medications won't necessarily help you stay asleep, however,  and they come with side effects that may include dry mouth and a hangover-like drowsiness upon waking.

If insomnia is persistent, the best thing to do is speak to your doctor. Your primary care physician may be able to rule out a sleep disorder or other underlying medical condition, prescribe sleeping pills, or give you a referral to a psychiatrist, sleep specialist or sleep clinic, depending on the nature and severity of your sleeping problems. You can also talk to your doctor about alternative treatments that are available without a prescription, such as melatonin supplements. Melatonin is a hormone that, in accurate doses, has been shown to be very effective at helping people fall asleep and stay asleep, according to researchers at the Massachusetts Institute of Technology.

If you are reluctant to take medication, other treatments are available. Bright light therapy can help reset your internal clock. Short-term cognitive behavioral therapy can help change the behavioral or thinking patterns that are keeping you from sleeping and help you replace these negative patterns with behaviors and thoughts that will help promote healthy sleep. For some people, a short-term combination of therapy and medication works best.



American Academy of Sleep Medicine. "Common Treatments." Web. 23 Dec 2010.

Becker, PM. "Treatment of Sleep Dysfunction and Psychiatric Disorders." Current Treatment Options in Neurology. 2006 Sep;8(5):367-75. Web. 23 Dec 2010.

Howland,  RH. "Sleep Interventions for the Treatment of Depression." Journal of Psychosocial Nursing and Mental Health Services. 22 Dec 2010:1-4. Web. 23 Dec 2010.

Massachusetts Institute of Technology. "Rest Easy: MIT Study Confirms Melatonin's Value as a Sleep Aid." 1 Mar 2005. Web. 23 Dec 2010.

University of Maryland Medical Center. "Insomnia." 13 Dec 2009. Web. 23 Dec 2010.