Insomnia: preventative strategies and practical advice

Sleep is extremely important, and most people don't get enough of it. Good, quality sleep affects our mental, emotional and physical health. Scientists believe sleep has a significant role in brain function, especially memory and learning. It maintains our emotional balance and bolsters our immune system.

Research suggests that there is no "right" amount of sleep; it's up to you as an individual to know what leaves you well-rested. However, if you're consistently having trouble falling and staying asleep, you may be suffering from insomnia.

What is insomnia?

Insomnia is the inability to sleep. It's a symptom, not a disease, and in most cases insomnia exists because of underlying causes. Insomnia is a very common condition—more than 90 per cent of North Americans suffer from insomnia at some point in their lives. Insomnia, or lack of quality sleep, may affect sufferers in the following ways:

• Makes it hard to concentrate, and contributes to car and industrial accidents, as well as difficulty in operating heavy machinery

• Affects the ability to think and perform, on the job and at home

• Reduces the ability to fight infections

• Causes fatigue, irritability, forgetfulness and sadness

What causes insomnia?

There are a variety of underlying behavioural and environmental causes that can create insomnia and, in most cases, there are direct, simple steps you can take to regain healthy, quality sleep. Some of the most common causes of insomnia include:

• Caffeine and alcohol consumption
• Napping
• Diet
• Poor sleeping environment
• Stress
• Depression
• Lack of exercise
• Irregular sleeping schedule

Strategies for preventing insomnia

If you are having difficulty falling and/or staying asleep, consider the following tips to prevent the onset of insomnia:

• Cut down on caffeine. Caffeine is a stimulant that speeds up your system. Reduce your overall caffeine consumption (tea, coffee and caffeinated soft drinks), and eliminate it completely four to six hours before you go to bed.

• Quit smoking. Smokers tend to be lighter sleepers because nicotine, like caffeine, is a stimulant.

• Adjust your diet. Avoid late-night snacks and heavy dinners that make your metabolism work overtime and keep you awake. Sweets like chocolate and candy create an imbalance of high- and low-blood sugar levels, which can also disturb your sleep. Combat afternoon drowsiness by trading lunchtime carbohydrates (such as pasta) for lighter, high-protein food (such as fish and eggs).

• Exercise. Physical activity releases stress and produces endorphins, which are natural stimulants that decrease your reliance on other stimulants like caffeine. Even small amounts of regular exercise can be very helpful in making you feel more tired at bedtime. However, avoid extended exercise just before bed.

• Limit alcohol. Alcohol before bed may make you feel sleepy temporarily, but as the alcohol gets metabolized by your system, it disrupts the sequence and duration of your sleep state, in addition to altering the total amount of sleep you get.

• Take a bath. A hot bath before bed is both relaxing and an aid to sleeping. Your body temperature drops as the evening progresses, making you feel sleepy. Taking a hot bath raises your core body temperature. After your bath, the substantial drop in your body temperature promotes deep sleep.

As well as the health considerations above, consider the following behavioural strategies:

• Keep a sleep routine. Maintaining a regular sleeping schedule helps to ensure regular sleeping patterns. Establish a regular bedtime and waking time, and try to stick to it. Also, avoid late-night TV or Internet surfing.

• Nap wisely. Naps can be refreshing, but they can also interrupt your regular sleeping patterns. Nap in the early afternoon, and not in the seven or eight hours before your regular bedtime.

• It’s your bed. Sleep in it. Separate your daily activities from bedtime rituals by establishing your bed as a place for sleeping. Don't read, work, eat or watch TV in bed.

• Sleep in a dark and quiet room. Light and noise can keep you awake. Install room-darkening blinds and wear re-usable earplugs, if necessary.

• Open a window or remove a blanket. Most people sleep better in a cool room.

Night-time strategies for dealing with insomnia

If you've followed all the preventative strategies for dealing with insomnia but are still finding it difficult to fall and/or stay asleep, try the following night-time tips:

• Count sheep. Counting visualized objects is an effective method of calming yourself.

• Try relaxation techniques. While breathing calmly, slowly relax the muscles in your body, beginning with your toes. Gradually move up your body, and release the muscles in your legs, belly, back and chest. Then concentrate on moving from your fingertips up to your shoulders, slowly releasing. Imagine the tension flowing away as you release the muscles in your shoulders and neck. Don't forget your face—flex your mouth and jaw muscles, clench shut your eyes and mouth, and then release, blowing the tension out of your mouth as you release.

• Get up. If you're still unable to sleep, get up. Sit somewhere comfortable and read a book or listen to music until you feel drowsy.

• Have a hot drink. Hot milk and non-caffeinated drinks like camomile tea will help you to fall asleep.

• Put on socks. Research shows that having warm feet helps people to fall asleep. Wear loose-fitting socks that don't cut off your circulation.

Chronic insomnia

If you have none of the above behavioural or environmental underlying causes for insomnia, but continue to experience sleeping difficulties, you may be suffering from what doctors refer to as chronic insomnia, usually the result of medical causes or sleep disorders. Certain medical conditions can cause chronic insomnia. Back and neck injuries, arthritis, or ulcer pain can keep you awake, as can respiratory difficulties caused by asthma, and shortness of breath due to heartburn. Your doctor can help you if a medical condition is robbing you of sleep.

Sleep disorders

In addition, sleep specialists have identified a number of sleep disorders that keep people from getting quality sleep. Sleep disorders include:

• Periodic arm and leg movements. This involves excessive twitching or jerking of the arm and leg muscles during sleep.

• Body clock disturbances (circadian rhythm disturbances). This is a disturbance of sleep timing common to people who perform night shift work, those who travel to different time zones and teenagers. Researchers have found that at some point in late puberty, the sleep-related hormone melatonin is secreted at a different time than it is for adults. This altered timing of the secretion of melatonin changes the circadian rhythms that guide a person's sleep-wake cycle. Teenagers, and others experiencing these disturbances, often need to sleep at unusual hours.

• Sleep apnea. People with this disorder experience pauses (10 seconds or longer) in breathing during sleep. The resulting low oxygen levels cause them to continually wake up. Left untreated, people with sleep apnea may never get into deep, restorative dream sleep.

Remember, if the preventive and night-time strategies for combating insomnia listed above don't work for you, don't give up. Your doctor or a sleep specialist can suggest effective methods for conquering mild or chronic insomnia and sleep disorders.