Dear Alice,

I have been having a really hard time sleeping at night. I do my best to stay on a regular schedule as best as I can and steer clear of caffeine, but nothing seems to be working. I have considered taking sleeping pills, but haven't for fear of becoming dependent on them for sleep at all times. Do you know how addictive they really are or if there are any other methods I could try? Thanks so much.

Dear Reader,

It can be frustrating when you can’t catch some shut eye! And, you're not alone in your frustration — sleep issues are very common. In fact, about 50 to 70 million Americans have reported having a hard time getting to sleep or staying asleep. These issues are critical to address because sleep plays an essential role in maintaining your health. Using medications to help you sleep may help, but are intended as a temporary, short-term solution. People who rely on these pills for an extended period of time or in too high of a dose may become dependent in as little as a few weeks. More to your question, though, research hasn’t been able to pinpoint at what stage sleeping pill use becomes problematic, since it tends to be dependent upon the circumstance of each individual. With that in mind, sleeping pills don't have to be your next stop on the way to the Land of Nod. There are other strategies to help restless folks the sleep they need (including those that you mentioned: a set sleep schedule and avoiding caffeine). But first, time to get into the nitty gritty on sleep struggles.

There are lots of reasons why some folks just can't fall asleep. Not getting enough sleep or lack of sleep quality may be influenced by poor sleeping habits (a.k.a. sleep hygiene). For many people, the bed has become a multi-purpose recreation area. People work on their computers, watch TV, munch on late night snacks, and catch up on the phone with friends and lovers, all while snuggled deep beneath the covers. This being the case, it's no wonder then that, for some folks, going to bed makes their bodies think 'slumber party' rather than slumber time. What you do during the day (when you're in bed) can also affect your ability to get a good night's rest, such as:

  • Eating or being physically active too close to bedtime
  • Feeling stressed or mentally aroused (e.g., because you watched a frightful film or read an engaging news story before bed)
  • Drinking alcohol or using tobacco
  • Scrolling and clicking on a computer, cell phone, or other personal electronics (the blue light emitted from those screens can send a signal to your brain that it's time to be awake)

Another possible factor in poor sleep is insomnia, the term typically used to describe those who have difficulty falling or staying asleep, or waking up too early. There are many causes of insomnia, some of which may include stress, anxiety, depression, underlying disease, or chronic pain.

So, what can you do to get a quality night of sleep? Per your question, sleeping pills are one option sleepy people may try, but the concern you've expressed may be warranted. Although they're designed to be a short-term fix for sleeping issues, some folks take these drugs for several months or even on a permanent basis. One potential concern associated with frequent use is that if use is suddenly stopped, withdrawal symptoms such as insomnia, restlessness, anxiety, shaking, dizziness, or circulation problems may result. Unfortunately, these symptoms are often similar to the original concerns that the medication was taken to relieve! Moreover, the experience of these symptoms may cause a cycle to occur, where users take more medication at higher dosages, and, in turn, increase the possibility of undesirable side effects.

Though you seemed to have tried a few recommended do-it-yourself (DIY) strategies, there are still some others you might consider trying before turning to sleeping pills. First, it can be worth it to take note of your daily activities to see what patterns seem to correlate with a good night's sleep versus one that's not so good. That way, you can inform changes to your day-to-day doings and see whether you sleep better at night. For example, if you take naps, try to limit yourself to a power nap (less than an hour) before mid-afternoon. Getting your sweat on can help you get to sleep later on, but being active too close to your bedtime might keep you up at night. Reconsidering your nightcap may also be in order; think of a soothing drink such as a cup of warm milk or herbal tea, (e.g., chamomile, lavender, or valerian root) instead of anything containing caffeine, nicotine, or alcohol. You might also try making your bed a source of relaxation (if you haven't already), so that your brain will get the message when it’s time to hit the sack. To re-train your body to think that going to bed means going to sleep, you might consider some of the following recommendations:

  • Go to bed at the same time each night and rise at the same time each morning.
  • Make sure your bedroom is a quiet, dark, and relaxing environment, which is not too hot or too cold.
  • Keep your bed a place for sleeping and sex only (crack open your school books and watch your favorite show elsewhere!).
  • Establish a soothing bedtime routine (e.g., taking a bath, reading for pleasure, or listening to soothing music).
  • Power-down your electronics at least 30 minutes prior to hitting the sack.
  • Avoid large meals, alcohol, nicotine, and caffeine for several hours before bedtime.

Tried these DIYs and still not getting the shut eye you need? Consider making an appointment with a health promotion specialist or your health care provider to see if there are other issues preventing your daily pit stop in dreamland. In any case, taking medications, such as sleep aids, is best done under the advisement of your health care provider. S/he may also advise you on other treatments or refer you to a sleep specialist who can further troubleshoot your bedtime bind.

Sleep tight! 

Alice!

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