I usually can’t get to sleep before three in the morning every night. I’ve tried prescriptions, but they didn’t work. I take pm pills to help fall asleep every night and it doesn’t work either. What can I do to get better sleep?
Doctors Answers (6)
Practicing good sleep hygiene is often a first step to sleeping better at night. This might include general suggestions such as keeping a regular sleep schedule, avoiding stimulants such as caffeine or nicotine for several hours before bed, creating a quiet, cool, dark sleeping environment, protecting the last hour before sleep for a relaxing, restful activity, and avoiding use of electronics before bed. However, trouble sleeping can also be caused by a sleep disorder such as insomnia, disorders related to the body’s internal body clock (i.e. circadian rhythm), or obstructive sleep apnea, to name a few. Medical disorders, psychiatric disorders, or medications can also impact sleep. Thus, if general measures fail to improve sleep, individuals should seek the advice of their doctor.
The first thing is to make sure that the your bedroom is conducive for sleeping, and that the TV and lights are both off in the bedroom. Some people find that soft, low background music helps them sleep: but make sure the radio turns off automatically about one hour into your sleep. Avoid alcohol and other stimulants before going to sleep. Another idea is to enter the bedroom every night around the same time, while allowing enough time to sleep around 7 to 8 hours each night. I also recommend taking Melatonin 3mg nightly at 7pm. In some people their sleep-wake cycle is not in tune with the night-day cycle, and Melatonin has been shown to help reset people's sleep-wake cycle. Melatonin is a natural product and may be purchased from any health food store. Finally some people are constant thinkers and worry about everything. For those who suffer from such an affliction, I recommend becoming "an observer" of" their thoughts, and NOT to respond to their thoughts and play the "what if" mind game. I advise "turning in" to one's breathing patterns and focusing on each breathe. This takes practice but repeated efforts with such a technique can be life changing and lead to refreshing sleep. Hopefully one of these ideas will help you sleep better.
Many factors play into poorly sustained sleep. If you have a chronic primary insomnia then a visit to a sleep specialist to evaluate and treat you is certainly warranted. You could also look at your overall health and get a check up and review medications you may be taking that may lead to insomnia. Having a fixed bed time and rise time 7 days per week could help sync up your circadian rhythm to ensure a better nights sleep. Cutting out caffeine and alcohol and using relaxation techniques are also both ways to help consolidate your sleep. Excercise is good for your sleep cycle just not to close to your bedtime (no less than 3 hours before a night's sleep).
The range of sleep disorders that can contribute to that is broad. Ranging from insomnia, clock disturbances, mood disorder etc. It is best to start with sleep hygiene and if that does not help to consult with a sleep physician.
Unfortunately, there is no simple answer. A physician, possibly one who specializes in sleep medicine, should be consulted. A review of the history (how long has this been an issue?), if allowed to do so would you sleep until noon?, are you on medications for anything?, is there stress or anxiety? These are but of the few areas which need to be reviewed. Medication designed to help with sleep and relaxation therapy (cognitive behavioral therapy) is often helpful as well. Most over the counter agents which put you to sleep have an adverse effect on stages of sleep.
Late bedtimes can be a vexing problem. Sometimes they are a sign of sleep-onset insomnia (difficulty falling asleep). However, they may be indicative of other sleep disorders such as delayed sleep phase syndrome (DSPS). DSPS is characterized by late bedtime and late rise time, essentially showing a temporal "shift" of the sleep period to a later time of the night. The shift is thought to be a reflection of the internal biological clock, which results in the delayed sleep phase. Many people with DSPS do not respond will to traditional sleep aids, but might be helped by specific forms of behavioral therapy that help to return one's sleep period to an appropriate and desired time. Treatment with bright light, administered at optimal times of day, scheduling of meal times and activity, and the use of melatonin all may be helpful in the treatment of DSPS. Of course, consulting with your primary care doctor or a board certified sleep specialist is the best place to start to define our sleep problem and determine the appropriate treatment.