Insomnia

Tossing and turning during the night or having trouble falling asleep can make you sleepy and grouchy during the day. You may have tried some things to help your insomnia that haven't worked. The good news is that there are many treatments to help you sleep better. But first it helps to know the reason why you don't sleep well. If you have a medical problem, such as chronic pain, or an emotional problem, such as stress or depression, treating that problem may help you sleep better.

Treatment options for insomnia

Treatment options include behavior and lifestyle changes, medicines, and complementary medicines.

Behavior and lifestyle changes

Getting ready for bed means more than turning down the sheets. Sleep experts know that there are many things that affect how well you sleep. Behavior and lifestyle changes improve overall sleep quality and the time it takes to fall asleep—without the side effects of sleep medicines. Perhaps most important, these improvements last over time.

To improve your sleep, here are some things you can try:

• Relaxation exercises,such as progressive muscle relaxation, may help you if you lie in bed with your mind racing. Try these relaxation exercises:

  Breathing exercises for relaxation

  Doing guided imagery to relax

  Doing meditation

  Doing progressive muscle relaxation

  Relaxing your mind and body

• Positive thinking with cognitive-behavioral therapy. Positive thinking, or healthy thinking, is a way to help you stay well or cope with a health problem by changing how you think. Cognitive-behavioral therapy is a type of counseling that can help you understand why you have sleep problems and can show you how to deal with them. Cognitive-behavioral therapy helps reduce interrupted sleep over time.
• Lifestyle changes are simple things you can do that may help you sleep better. These include changing your sleep area or schedule, watching what and when you eat and drink, and being more active. It's also important to keep regular bedtimes and wake times—7 days a week—and to try to avoid taking naps during the day. For more information, see:

  Insomnia: Improving your sleep.

  Sleep: Helping your children—and yourself—sleep well

Medicines

In some cases, taking sleeping pills for a short time helps you get some rest, while behavior and lifestyle changes can help you over the long term. Doctors recommend taking sleep medicines only now and then or only for a short time. They are not the first choice for treating chronic insomnia.

This advice about medicines applies to everyone, but especially to older adults. This is because while anyone can become dependent on sleep medicines, these medicines can affect how well older people think during and after long-term use.²

Many sleep medicines cause side effects, such as low blood pressure, anxiety, and nausea. These medicines also may become less effective when your body gets used to them and may cause withdrawal symptoms when you stop using them.

Sleep medicines include:

• Prescription sleep medicines, such as eszopiclone (Lunesta), ramelteon (Rozerem), zaleplon (Sonata), and zolpidem (Ambien). They are the first-choice medicines for short-term insomnia.³
• Benzodiazepines, such as diazepam (such as Valium), lorazepam (Ativan), and quazepam (Doral). These medicines help you fall asleep or stay asleep. You need a prescription for these medicines.
• Antidepressants that have a calming or sedative effect. These can be used to help you sleep.
• Antihistamines. Typically used for allergies, these can provide short-term relief of sleeplessness.
• Nonprescription medicines for sleep. These can help, but they also can cause side effects, such as drowsiness the next day. Over time, sleeping pills may not work as well as they did when you first started using them.

To help you decide if you should use sleeping pills to treat insomnia, see:

Insomnia: Should I take sleeping pills?

Complementary medicine

Other treatments for insomnia may include complementary and alternative medicines. Two of the most popular alternative medicines are:

• Valerian, an herbal sleep remedy. Valerian appears to be safe, and it may improve sleep when taken for a week or two.⁴
• Melatonin, a hormone produced by the brain. You can also buy it as a supplement. Melatonin has also been used to treat jet lag and poor sleep from working the night shift.

Don't rely on alcohol

Some people use alcohol to help them sleep, but that's not a good idea. At first, drinking alcohol may make you sleepy and help you fall asleep. But when you drink alcohol, you are more likely to wake up later in the night and have a hard time falling back asleep. This can leave you feeling tired the next day.

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