Getting a Good Night’s Sleep: Insomnia a Major Health Issue

. October 1, 2016.
sleepinsomnia

When we get older, sleeping well becomes challenging. The National Institutes of Health (NIH) estimates that 50 percent of seniors have difficulty sleeping well. Approximately 30 percent of adults in the United States sleep less than seven hours. According to Dr. Colleen Carney 10 percent of adults have chronic insomnia.

The Centers for Disease Control (CDC) has found that adult Ohioans get less sleep than people in 39 other states. Less than 62.1 percent of us get seven or more hours of sleep per 24 hours.

According to Dr. Gregg D. Jacobs, a Behavioral Sleep Medicine Specialist at the University of Massachusetts Medical School, sleeping pills are not very effective. According to Dr. Jacobs, sleeping pills “only increase total sleep time, and reduce the time it takes to fall asleep, by about 10 minutes.” Sleep medications also come with significant side effects, especially for those over 60. Side effects include interference with memory and learning, dependency, risk of overdose, and possible dementia and depression.

Deirdre Conroy, Ph.D., the Clinical Director, University of Michigan Behavioral Sleep Medicine Clinic, suggests that if someone does not sleep well, his first priority should be to consider whether physiological or psychological factors might be causing a problem.  For example, if there is snoring, or a bed partner sees pauses in breathing during sleep, an overnight sleep study should be considered.  If a urination problem is discovered, or a breathing problem such as sleep apnea, different treatments can be prescribed.

According to Dr. Conroy worrying, sadness and depression can also interfere with sleep. People who are experiencing these conditions should speak to a psychologist.

If an individual has tried tthese strategies without success, it may be time to move on to a therapist who focuses on insomnia. One of the techniques the therapist may have you consider is Cognitive Behavioral Therapy for Insomnia (CBTI). Dr. Conroy indicates that CBTI is a multi-session approach to insomnia that includes behavioral and cognitive/thinking techniques combined with education to improve the quality and regularity of sleep.  CBTI is now recommended as the first-line treatment for insomnia by the American College of Physicians. Research also suggests that the improvements in sleep after CBTI are more durable after 2 years compared to medication. 

If you have sleep issues here are some simple things you can do increase the likelihood of a good night’s sleep:

  • Do not consume caffeine 4 to 6 hours before bed
  • Do not consume alcohol 3 hours before bed
  • Make sure your bedroom is dark, quiet and at a comfortable cool temperature
  • Remove electronic devices from the bedroom, except for clock if you need an alarm, face the clock away from you.
  • Get plenty of exercise, but not right before bed
  • Do not nap during the day
  • Calm mental activity & stressors an hour before bed

Components of CBTI include:

  • Keeping a sleep diary
  • Sleep Restriction Therapy in which you initially cut back on the time in bed.
  • Stimulus Control Instructions which involves investigating sleep habits that may be interfering with sleep.
  • Challenging sleep beliefs that are counterproductive.

If you cannot locate a CBTI therapist or you would like to try CBTI yourself, consider this online program by Harvard Women’s Health Watch, http://www.cbtforinsomnia.com/

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