Insomnia Medical Therapies
Insomnia from shift changes
- Behavioral therapy has been useful in modifying the insomnia and symptoms of sleep deprivation in shift workers.
- A person should shift their schedules forward in a clockwise direction, from days to evening, then evenings to night shift, and allow sufficient time to adapt (at least one week) between shift changes.
- Bright light is a potent stimulus to circadian rhythm. Bright light is being examined as a rhythm synchronizer.
- Shift workers should stress the importance of good sleep habits with regular bedtime and awakening.
- Supplemental naps may be necessary to ensure work time alertness.
- Discuss the use of naps with a doctor.
- Some people promote using short-acting sedatives in the first few days following a shift change, but not everyone agrees.
Insomnia from Acute Stresses
- Stress may be positive or negative, and concerns about sleep may vary. Many stressors will go away with support and reassurance.
- Education about the importance of good sleep habits is also helpful.
- Some people may need short-term treatment with medications. A doctor will often work toward the lowest effective dose with a short-acting sedative to achieve proper sleep.
General recommendations for prevention of insomnia include the following:
- Work to improve your sleep habits.
- Learn to relax. Self-hypnosis, biofeedback and relaxation breathing are often helpful.
- Control your environment. Avoid light, noise, and excessive temperatures. Use the bed only to sleep and avoid using it for reading and watching TV. Sexual activity is an exception.
- Establish a bedtime routine. Have a fixed wake time.
- Avoid large meals, excessive fluid intake, and strenuous exercise before bedtime and reduce the use of stimulants including caffeine and nicotine.
- If you do not fall asleep within 20 to 30 minutes, try a relaxing activity such as listening to soothing music or reading.
- Limit daytime naps to less than 15 minutes unless directed by your doctor.
- It is generally preferable to avoid naps whenever possible to help consolidate your night's sleep.
- There are certain sleep disorders, however, that will benefit from naps. Discuss this issue with your doctor.
Recovery from insomnia can vary.
- If you have insomnia caused by jet lag, your symptoms will generally clear up within a few days.
- If you are depressed and have had insomnia for many months, it is unlikely that your symptoms will go away on their own. You may need further evaluation and treatment.
- Your outcome will also depend on coexisting medical conditions, which may include congestive heart failure, chronic obstructive pulmonary disease (COPD), and chronic pain syndromes.
Medically reviewed by Peter O’Connor, MD; American Board of Otolaryngology with subspecialty in Sleep Medicine
REFERENCES: eMedicine.com. Insomnia.
FDA.gov. Medication Guide Intermezzo. <http://www.accessdata.fda.gov/drugsatfda_docs/label/2011/022328s000mg.pdf>
Medically Reviewed by a Doctor on 5/25/2016
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