Not Sleeping Well? Here’s Where to Start

Not sleeping well? Do an assessment of your life circumstances first. What’s on your mind when your head hit the pillow at night? Is it the same issue or a number of different concerns? What’s keeping you from resolving these issues? If you were to resolve them, how would your life be different? This is the “between the ears” part of assessing the causes of your sleeplessness.

cant_sleepNext, consider possible physical causes. Is sleep apnea a problem; how about restless legs? Pain? Then, are you taking any medications that may be keeping you awake? Remember, caffeine is a drug and the nasal decongestant you may be taking for a sinus or allergy condition often contains drug components that promote wakefulness.

When contemplating a sleep aid for the management of insomnia, the most important issues to consider are (1) what do you want the drug to do and (2) for how long. Insomnia is often transient and may improve within a matter of days. For example, if you’ve experienced a recent loss, you may want to consider an over-the counter agent that will help you manage your difficulty sleeping for only a few days. Benadryl or melatonin may very well be sufficient. If, on the other hand, your sleep difficulties are chronic, ruling out the aforementioned possible medical causes in consultation with your primary care physician is imperative.

If the decision is for you to try a prescription sleep aid, you need to know: drugs such as Ambien or Lunesta will typically help you get to sleep; they have a poor track record however, at keeping you asleep. And then there’s the issue of how long you intend to take them. Tolerance develops, meaning you eventually may need to take more to obtain the desired results, creating a cycle of dependence.

Whether insomnia emanates from what’s going on in your head or what’s happening within your body, there will be limitations to what any drug can do for you.

If you’re able, the most efficacious remedies are behavioral, brisk walking and yoga are a couple of excellent choices. Both help improve body and mind, which is as good as it gets when it comes to better sleep.

Joseph Wegmann, R.Ph., LCSW is a licensed clinical pharmacist and a clinical social worker with more than thirty years of experience in the field of psychopharmacology. His diverse professional background in psychopharmacology and counseling affords him a unique perspective on medication management issues. In addition to consulting with numerous psychiatric facilities, he has presented psychopharmacology seminars to thousands of clinicians in 46 states.

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