When You Can’t Sleep

Insomnia, that is, the inability to fall asleep and stay asleep at appropriate times is a very common problem. I venture to say that nearly every person has had some degree of sleeplessness at one time or another. I am not talking about the restlessness of anticipation, such as just before holidays, big trips, or other special events. I am talking about when there is nothing particularly on your mind, either good or bad, and you just can’t sleep.

The basic reasons underlying sleeplessness are the subject of a great amount of study these days. Sometimes there is a clear-cut explanation, such as lack of oxygen during sleep or so-called sleep disordered breathing. Your see that our respiratory center has a lot to do with rate and depth of breathing during sleep, and if your respiratory center is getting mixed messages about how to breathe in case of emphysema, breathing regularity may become disturbed or temporarily interrupted. This will almost always awaken a patient because of the sensation that “something is wrong.”

When these definite abnormalities are found by a physician, specific corrective treatment can be prescribed. Many more patients have sleep disturbances for no known reason. Here is some advice about dealing with this common situation.

First, just recognize that sleeplessness is common and, by itself, is not harmful. Just remember that you will sleep the next day. If things are running through your mind or you are afraid of forgetting something important, turn on the light and make notes of your ideas, thoughts, or concerns. This will break the cycle of “things running through your mind.” It is even good to get up and do natural things that will promote sleepiness, such as reading, taking a warm bath, or drinking some warm milk. Why do these things work? Simply stated, they relax your mind so that natural sleep occurs, and there is a substance in warm milk called tryptophan which makes people sleepy.

I have left sleeping pills to last because they tend to be overused, but in certain situations mild amounts of tranquilizers or short-acting sleeping pills can be prescribed with safety by your doctor. Before relying on sleeping pills, just remember that some degree of insomnia is very common. In fact, that is why I am writing this Newsletter at 2:00 in the morning.

Dr. Thomas Petty, Professor of Medicine University of Colorado Health Sciences Center; Consultant and Faculty at HealthONE Center Denver, CO.