How can I get better sleep if my thoughts keep me up at night?

This question was asked in Dallas, Texas on 08/24/2012.
Well I go to bed thinking about stuff and it's like I can’t get them out of my head. I will take some type of sleeping pill or a drink it will put me to sleep for three hours. But when I wake up to use the restroom I just can't go back asleep. How can I fall asleep better and stay asleep throughout the night?

Doctors Answers (2)

J. Douglas Hudson, MD, DABSM
Answered on: 8/27/2012

A majority of persons who suffer from insomnia admit to their mind "racing" while trying to fall asleep. The thoughts are commonly random and unrelated to issues about work, finances or family life. It seems that these persons have either an excessive amount of neurotransmitter activity such as dopamine or a reduced amount of sleep inducing neurotransmitter activity. Sometimes, we find cortisol levels elevated at night when they should be a low level. Most sleep aides and alcohol are designed to last for 3-4 hours with the assumption that once you get to sleep you will remain asleep until you satisfy your basic need for sleep. Alcohol, of course, can produce a rebound effect when it wears off. We often awaken for a brief period during the night but once the pills wear off or the level in your system is lower than you need to maintain sleep, it is common to have difficulty returning to sleep. There are medications designed for "middle of the night insomnia". It is not uncommon for a sleep specialist to prescribe a medication to stop the mind from racing which often allows a person to fall asleep. If that fails, then a sleeping pill (not over the counter agents which often destroy normal sleep patterns) and if there is middle of the night insomnia, another pill for that. Fortunately, most persons don't need but one of the above but at times more than one is needed. I am assuming that the thoughts you have are normal and you are not hearing voices.

Richard J. Schumann Jr., MD
Answered on: 8/27/2012

It sounds like you have a chronic insomnia per perpetuated by some anxiety or possibly another sleep disorder like sleep apnea. You should see your primary MD for a check up to see if any physiologic changes need investigation. You shouldn't treat yourself with any medication but can take supplements like Melatonin if you have trouble falling asleep as well as investigating som relaxation techniques you can try on your own. You can also see a sleep specialist or a neuropsychologist who specializes in sleep disorders for training in (Cognitive Behavioural Therapy) CBT to help combat this problem.