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Sleepless Nights

November 02
00:02 2019

By: Dr. Abigail Joseph

Sleepless Nights

“YOU SLEEP LIKE A CAT!” – a phrase my friend Shivannie always messages at 4am. This is because Guyana is 2 hours ahead of Belize, so when she gets ready for work and decides to remember me at 6:00am, I should be sleeping. Instead, there is always a response ping to her sent messages which she would then yell at me via text message to go back to bed.

Insomnia is a sleep disorder where individuals find difficulty: falling asleep, staying asleep or both. Sleep is a very important part of life, whether we choose to accept it or not. Failure to fall asleep or maintain sleep can result in health problems. Persons with insomnia often experience low energy, fatigue, difficulty to concentrate, mood disturbances as well as reduced performance at work or school.

Insomnia can be categorized based on its duration. Acute insomnia is a short term sleep disruption due to circumstances. Most persons at some point in their life experience this, (inability to fall asleep in anticipation of travelling, an exam, upon hearing bad news etc.). Transient insomnia is sleep disruption that lasts less than a month, and then there is Chronic Insomnia which is considered sleep disruption that a person experiences at least three times a week for a duration of 3 months or more. Chronic insomnia may have many causes – from poor sleep patterns, medication, medical conditions, changes in the environment, unhealthy sleeping habits and also work shifts.

Certain medical conditions can make sleeping very difficult, especially those that limit your sleeping positions, or aches and pains such as restless leg syndrome, arthritis or back pain. Psychological issues, anxiety and depression can take a toll on your sleep as well. For some people, when they are unable to sleep they find it comforting to take a smoke, a drink or use another type of substance – drugs may make you feel good in the moment and in your mind it makes you forget your troubles, fall asleep quicker or better than you ever could on your own, but many of these drugs such as alcohol, nicotine and caffeine are stimulants and complicate your sleep pattern – you may fall asleep, but you won’t maintain sleep and when you awake it is harder to return to your sleeping state.

Some people have complicated lives, complicated health and complicated love lives. Some people live in fear of their life. Some mothers stay awake at night worried for their husbands who are away or sons who are on the streets. This anxiety and worry may cause them to be unable to sleep or stay asleep, and any little noise or movement causes them to wake. This pattern of sleep and wake takes its toll on the body as well, and in many cases these scenarios are a way of life and as such impact years and years of sleep. No amount of therapy can help, because the situation continues to exist and it reaches a point where your physician begins to prescribe medications for you to relax.

I think when it comes to sleepless nights, we really need to take time to dedicate to ourselves. We often come to the doctor’s office and want a quick fix. This is a topic I tread lightly around because EVERYONE in my family uses sleeping aids to sleep. No one wants to take the time out to figure out why they can’t sleep. No one wants to try new things. They just want to live their lives and when night comes, swallow pills. Most people are like that. They come into the office and tell you that they are not sleeping and want you to prescribe something to help them sleep, because they know that there are medications that can make that happen for them. I have family member that will tell you straight up – nothing works, I am not addicted, but I need my pills. I remember we were all in a car once and two of my aunts forgot their pills. My cousin popped open her purse and they were all in the back giggling that she was the druggist that had what they needed. Yes, they are all on the same pill. Dependency is not something patients want to talk about when talking about treatment of insomnia. For most patients – to them, in their minds, insomnia is a disease. It interrupts their lifestyle and since there is a quick fix, why change it? But in reality, insomnia is a sleep disorder. One that can improve if time is taken to act upon the factors that are affecting sleep. Of course, there are situations where medical conditions affect your sleep due to pain and other discomforts, but people that live generally busy lives and are stressed due to personal lifestyles should reconsider the comforts of a sleeping pill and take the time to modify the patterns in their lives that influence this.

Not everyone is fortunate enough to get a great rest, but everyone deserves a good rest. If you find that you have difficulty sleeping, falling asleep or maintaining sleep, you may want to focus on modifying a couple factors before actually requesting medication from your attending physician. Limit nap time during the day. This is true especially in the elderly where they would nap in the day time and not remember then complain of being unable to sleep at night. Be conscious of your caffeine intake, limit screen time – lights from your cellphone, tablet or television at night stimulates the brain and can stop you from sleeping.

Avoid watching TV in bed, turn your phone off or avoid sleeping with it. Exercising regularly is a good practice overall but it also burns excess energy and may help you sleep faster. Avoid heavy meals at night time. Make sure your mattress and pillows are comfortable. It’s very difficult to sleep if your bed is not warm, soft and inviting. If you are suffering from insomnia and you’ve already made behavioral and lifestyle changes and your sleep quality has not improved, then it is best to get checked out. Don’t just ask for sleeping pills. Ask your doctor to help you figure what is wrong. Because there was actually a point in your life where everything was fine. Seek to understand what your body is trying to tell you.

Sometimes our issues and problems are rooted so deep that we need someone to talk to. Sometimes we are unable to unwind or don’t know how to, and learning how to adapt is key to survival. Make every effort to improve your quality of life and sleep before adding medications to your life. Medication, especially addictive drugs, should be monitored by your doctor, never be long term and should always be a last resort.

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