"Most people will have some insomnia at some point during their lives," said Dr. Michael Abene, assistant professor of neurology and neurophysiology at Baylor College of Medicine. "It can be due to stress, something more serious like depression, or other medical problems such as cardiac disease or chronic pain. It can even be worsened by exposure to the bright screen of a computer before bed."
If an expert determines that a psychiatric condition or medical problem is not the culprit, Abene, also the medical director of the BCM Neurophysiology Sleep Disorders Clinic and Sleep Lab at St. Luke's Hospital, suggests the following remedies in addition to logging off well before bedtime:
Develop a regular pre-bedtime routine 30 to 60 minutes before going to bed, such as brushing your teeth and doing some light reading.
Establish a regular bedtime and wake time -- weekends included.
Reduce your caffeine intake. Even small amounts in the morning can adversely affect sleep.
Make your bedroom conducive to sleep. Buy a comfortable mattress, and keep the room dark and at a comfortable temperature.
Try to keep kids and pets from waking you up at night.
Think positive -- don't go to sleep stressed.
Don't use the computer at least one to two hours before bedtime.
Insomnia is by far the most common sleeping disorder. The American Academy of Sleep estimates that 30 percent of adults experience symptoms of insomnia and 10 percent are at risk for chronic insomnia.
BCM's sleep clinic uses cognitive behavioral therapy instead of medication to treat insomnia. CBT, a form of psychotherapy, aims to identify and modify thoughts and behaviors that may be causing the insomnia. It has been shown to be more effective than medication in the long run with fewer side effects.
Dr. Mary Rose, assistant professor of medicine in the section of pulmonary and critical care medicine at BCM, uses CBT to treat her insomnia patients, many of whom have tried other options to no avail. If chronic insomnia is suspected, she suggests seeing a sleep specialist with a background in behavioral sleep disorders.
Sleep CBT consists of the following:
Stimulus control therapy, in which patients do not go to bed until they are markedly sleepy. If they wake up in the middle of the night, they should get out of bed and do something sleep-inducing like reading a dull book.
Sleep restriction therapy, in which sleep is condensed into a relatively short time frame to increase sleep efficiency. Time spent in bed rises as sleep efficiency improves.
Sleep hygiene, as in establishing a regular bed time, exercising four to five hours before sleep, and avoiding caffeine and alcohol.
Cognitive therapy, which treats sleep-related stressors.
Relaxation therapy, which incorporates techniques such as stretching, to relieve tension.
"People with chronic insomnia will have been going to bed and tossing and turning for many years, and over time they can develop a very negative feeling about going to bed," said Abene. "The problem then becomes the anticipation of going to bed and having insomnia rather than the insomnia itself."