Tag: sleep

Expert Advice to Sleep Well

This post provides insights into chronic insomnia, a condition characterized by persistent sleep difficulties affecting daytime function. It emphasizes identifying underlying medical issues and prioritizes lifestyle changes, or sleep hygiene, as initial treatment. Cognitive behavioral therapy for insomnia (CBT-I) is highlighted as an effective intervention, with online options available for convenience.

updated December 9, 2025

person sleeping on a couch
Sometimes getting a good night’s sleep can be a challenge.

 

(Affiliate links are used in this post.It costs nothing extra to shop through these links and this blog may earn a small commission, which funds its existence. )

What is Chronic Insomnia ?

Most of us have trouble sleeping occasionally, but if you persistently have difficulty with sleep, you may have a medical condition associated with sleep disturbances. These include

  • sleep apnea
  • restless legs syndrome
  • depression and/or anxiety
  • post-traumatic stress disorder

Some people have true chronic insomnia, meaning persistent sleep difficulty alone. There are various criteria to diagnose chronic insomnia but in general include

  • difficulty falling or staying asleep
  • at least 3 nights per week for at least 1-3 months
  • with impairment of daytime function, such as fatigue/sleepiness, poor concentration, irritability, school or work dysfunction

How is chronic insomnia managed ? 

First step in treatment of chronic insomnia as well as occasional difficulty sleeping  is identifying and treating any underlying medical issues that might contribute to poor sleep. In addition to the ones mentioned above these include

  • pain, of all kinds
  • heartburn (gastroesophageal reflux)
  • congestive heart failure
  • lung diseases like asthma  causes nighttime breathing difficulty
  • menopausal night sweats

Sleep specialists recommend non-drug management of chronic insomnia and reserve sleep medications for more resistant cases. 

 

Sleep Practices for Restful Nights

In this post I review options to improve our sleep. Daylight Saving Time can disrupt sleep, akin to jet lag. Chronic insomnia involves difficulty sleeping regularly, potentially linked to medical conditions. Treatment begins with addressing underlying issues and adopting sleep hygiene practices, such as exercise and routine. Cognitive Behavioral Therapy for Insomnia (CBT-I) is effective…

Keep reading

 

Sleep Hygiene Management

Experts recommend sleep hygiene , basically lifestyle changes, as the initial treatment.

For optimal sleep you should

  • Engage in regular exercise- moderate intensity , tai chi , yoga and low-impact aerobic exercise
  • Avoid evening large meals
  • Limit caffeine, tobacco and alcohol
  • Use the bedroom only to sleep and for sex
  • Maintain a regular bedtime-awake schedule
  • Avoid daytime naps
  • Avoid distracting stimuli at bedtime-watching television, using electronic devices, talking on the phone
  • Stay in bed only while sleep

How to dim the Lights

The light from electronic devices- clocks, thermostats, televisions, monitors-can disturb your sleep even after you turn off  your phone and tablets. This light can be blocked by stick on light blocking covers than can block out the majority of it.

Light from my clock made it hard for me to fall asleep before I discovered these products. With them I fall asleep easier, and can fall back asleep if I wake up.

Maintaining a regular schedule helps to set or reset your  sleep/wake cycle. So go to bed at the same time every night and wake up at the same time every morning.

However, if you can’t  sleep, rather than lie in bed awake, you should get up, do a non-stimulating activity, then return to bed when sleepy.

woman typing on a laptop keyboard.
Using a computer, laptop, or tablet before going to bed can impair sleep.

If you have persistent sleep loss, consider more intensive therapy by a professional.

Cognitive behavior therapy for insomnia , CBT-I , significantly improves chronic insomnia and daytime functioning and is recommended as first line therapy.

CBT-I combines cognitive therapy with sleep restriction, relaxation training and stimulus control.

Treatment typically requires 5-8 sessions conducted by a health professional trained in its use. Patients need to participate by keeping a sleep diary and writing down daily thoughts in a journal, while continuing with the sleep hygiene practices mentioned above.

person writing in a spiral notebook
Writing thoughts in a journal is often encouraged in cognitive behavioral therapy. (photo from the Lightstock.com collection)

Insomnia sufferers can also get help from an online web-based CBT-I, Sleep Healthy Using the Internet , SHUTi.

One study found 70% of those participating improved their sleep, compared with 43% who received education only.  If you  can’t find a trained therapist or don’t have time for office based therapy, this may be a good option.

 

 

 

SleepPhone by Acoustic Sheep

A physician, Dr. Wei-Shin Lai had trouble falling asleep after being awakened at night by calls from the ER. Her husband suggested listening to relaxing music to help her fall asleep.

She designed a comfortable headphone for her own use, and eventually started a company to make and sell them . You can try her SleepPhone  made by her company AcousticSheep.

Manage Stress, Learn to Relax

If you have occasional trouble sleeping due to stress,  relaxation techniques can help you.  Techniques include  meditation, yoga, imagery, abdominal breathing and muscle relaxation techniques . These can reduce tension and anxious thoughts that inhibit sleep onset and maintenance.

5 Steps to Manage Stress and Strain

This post reflects on the need for coping mechanisms for life’s stressors, sharing five essential steps to manage stress and strain. These steps include maintaining a routine, seeking social support, focusing on the positive, staying active, and nurturing one’s inner self.

Keep reading

 

 

The truth about alcohol and sleep

Think alcohol will help you sleep better ? Read this advice from a psychiatrist, Dr. Melissa Welby.

Everything You Need top Know About Sleep Apnea

Curious about sleep apnea? Dr. Deborah Burton offers this review of another common sleep problem.

Exploring the HEART of Health

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7 Overused Medications

What 7 drugs are overused? Find out here.

This week I discuss  7 groups of medications that are overused. This, and the next post about drugs which are underused, has many links; you may want to bookmark for future review.

medication capsules
Sometimes we need medication, but sometimes we don’t.

I call these drugs overused.  However, I do not mean

  • That you should never take  them
  • That you should quit using them
  • That your doctor should not prescribe them
  • That you should quit taking them if your doctor prescribed them
  • That they are bad or dangerous drugs

We should think more about when, why and how to use these drugs.

By drugs and medications, I consider any substance we put into our bodies to treat or prevent a disease or symptom, whether prescribed or over-the-counter (OTC), synthetic or “natural”. I’m not considering foods,nor any substance that is illegal or mostly recreational in this discussion.

I picked classes of drugs that I am most familiar with as a family physician so excluded highly specialized medications like cancer chemotherapy, cardiovascular drugs, anti-rheumatics and neurological drugs.  

I based my assessment on my professional experience as well as medical literature and the opinions of other physicians. As always, your best source of information about the right drugs for your conditions is your personal physician.

Antibiotics

Every infectious disease expert says we use  too many antibiotics unnecessarily-but we keep doing it. Doctors and patients share the responsibility of using antibiotics appropriately.

Reasons to avoid antibiotics

They don’t help most of the things we use them for, namely respiratory infections which are usually caused by viruses.

They add to the cost of medical care.

They frequently cause side effects; they are one of the top four causes of adverse drug reactions that lead to ER visits and hospital admission.

They can change the balance of the good bacteria that live in our bodies, the microbiome.

Here is a previous post about the use and misuse of antibiotics for respiratory infections, the most common culprit in the inappropriate antibiotic battle.

How to navigate the antibiotic highway

Opioid pain medication

These are the drugs that comprise the current opiate epidemic. Like antibiotics, they are a frequent cause for ER visits and admissions for adverse reactions.  Unlike antibiotics, they can create physical and mental dependency and addiction, and can be fatal in overdose which is happening more often. The New York Times reports 

Some of the overdose deaths are accidental, especially in children, but in adolescents and adults are too often intentional.

Used properly, opiates relieve severe pain due to cancer, trauma,and  surgery, but doctors and patients should consider other alternatives for less severe pain first, especially if it is a long term condition.

Dr. Sanjay Gupta, CNN medical correspondent, suggests doctors and patients work together to achieve pain relief without the risk of addiction.

“But most simply, we as doctors need to engage our patients and discuss treatment with them, whether its short term opioids or alternatives like physical and occupational therapy. We need to help set realistic expectations for our patients: Living entirely pain free is not always possible. As doctors, we need to have follow-up conversations with our patients to see how treatment is going. If we better understand our patients, we can provide better treatment and help develop pain strategies that are effective and safe.”

Talk to your doctor if you believe your use of opiate pain medication has become a problem.

Doctors must lead us out of our opioid abuse epidemic

 

lying woman with palm full of pills
Deaths from accidental and intentional opioid overdoses are skyrocketing.

Anti-inflammatory drugs

These are the  non-steroid anti-inflammatory drugs, referred to as NSAIDs. This includes generic ibuprofen and naproxen, available in both otc and prescription strengths. ( Brand names include Motrin, Advil and Aleve.) There are other NSAIDs but these are most frequently used.

When these drugs first hit the market, we were excited to have effective drugs for people with joint pain from  arthritis. Then we recognized they also worked well for headaches, menstrual pain, and other  forms of muscle and joint pain.

Now they seem to have become the go-to drugs for almost any discomfort or symptom, with people taking multiple doses daily (often exceeding the recommended dose) without medical supervision. 

 

Although usually well tolerated, they do pose risk to the kidney, heart and liver, especially in people who already have disorders of those organs. And they can cause stomach ulcers with bleeding in anyone.

Acetaminophen

The name Tylenol has become synonymous with the drug acetaminophen, although there are other brands and generic versions. Sometimes abbreviated APAP, this drug relieves pain and reduces fever, and is used frequently by adults who also give it to their children. It does not carry the risk of stomach ulcers as do the NSAIDs. However, it also can cause harm to the liver and kidney.

understand your OTC pain reliever options better 

Sleeping medications

Many people have trouble falling asleep, staying asleep, or getting a restful sleep and turn to medications, both prescription and non-prescription for help.

Sleep specialists avoid the routine use of sleeping medications, due to lack of effectiveness long term and potential side effects and risks. They recommend altering conditions related to sleep such as bedtime, sleeping arrangements, temperature and activities, often called sleep hygiene, or mind-body interventions like meditation, hypnosis, yoga, tai chi and music.

Sleeping pills for insomnia 

person sleeping on a couch
Sometimes getting a good night’s sleep can be a challenge.

Rescue inhalers for asthma

People use quick acting or rescue inhalers for asthma or COPD symptoms. The inhalers usually relieve symptoms promptly and if they aren’t, people may believe the inhaler “isn’t working”.

Instead, it may mean that the lungs aren’t “working” to full capacity  and need more aggressive treatment. Continuing to use the inhaler repeatedly with little or no relief can be dangerous and lead to respiratory failure. Instead, you need to seek medical attention at a  clinic or hospital emergency room.

Vitamins,  minerals and other supplements

People spend $37 billion annually on vitamins,  minerals  and other supplements with little to no  proof that they prevent or treat anything. Most nutrition scientists teach that appropriate eating will supply our requirements for vitamins and minerals.

Vitamins and/or minerals are recommended in some medical situations, including-

  • Pregnancy and nursing
  • People with intestinal disorders who absorb nutrients poorly
  • People with restricted diets for any reason
  • People with or at high risk of macular degeneration, a cause of blindness

Most adults don’t need dietary supplements 

7 medications I call underused.

 

Exploring the HEART of Health

Thank you for reading this post. I strive to make them worth your time.

I share information and inspiration that sparks transformation in your body, mind, and spirit.

You can follow this blog in two easy ways. One is to put your email address into the box below.

Another way is to follow me on Facebook, where I share new posts, timely topics, photos, and an occasional cartoon.

Watercress Words by Dr. Aletha

Dr. Aletha