8 basic sleep hygiene tips to help manage insomnia at home

I am sure that we all know someone who has some degree of insomnia. It has been estimated that over 40 per cent of Canadians have some degree of difficulty falling, staying asleep or experiencing early morning awakenings. It is important to manage insomnia, as poorly controlled insomnia can exacerbate other conditions such as cardiovascular diseases.

Patients with insomnia are often put on some form of medication to help them sleep. A common class of sleep medication is benzodiazepines (for example, lorazepam, diazepam, oxazepam, temazepam, etc.). These medications are attractive to patients because they work fast.

However, these medications carry with them significant risks if used long term. These medications are meant to be used generally for one to two weeks just to help a patient overcome the cause of the sleep disturbance. Long-term risks with benzodiazepines include daytime sedation, cognitive impairment and falls.

It is important to identify if the insomnia is secondary to another condition, such as psychiatric illness or substance abuse, where the insomnia should resolve if the primary condition is managed.

Alcohol is often thought of as a sleep aid, but long-term use has been shown to promote sleep disturbances, thus alcohol should not be used to manage insomnia.

Another common cause of insomnia can be medications such as decongestants, corticosteroids, stimulants, and many more. It is important to consult your pharmacist to identify any potential drug-related causes.

A safer approach to managing insomnia is behavioural therapy. This is now considered first line in the management of insomnia, as it has been shown to be effective and safer than pharmacologic treatments.

Behavioural therapy is essentially an approved method of changing habits and thoughts to treat insomnia.

For more complicated insomnia patients, there is also cognitive behavioral therapy (CBT-I), which combines many different strategies over several weeks. CBT-I strategies can include cognitive therapy, sleep hygiene, stimulus control, sleep restriction and education.

Unfortunately, there are a limited number of practitioners who are skilled at providing this service in Toronto.

Here are some sleep hygiene basics:

1) Maintain a regular consistent sleep schedule;

2) Avoid caffeinated beverages after lunch and alcohol after dinner;

3) Try not to force yourself to sleep;

4) Avoid smoking or nicotine products;

5) Avoid prolonged use of light-emitting screens before bedtime;

6) Decrease stimuli in the bedroom, such as reducing ambient light and turning off electronics;

7) Avoid daytime naps;

8) Exercise regularly.

It is important to note that it often takes successive nights of good sleep hygiene to facilitate sleep. Therefore, if you know someone who has difficulty sleeping, try suggesting one of these behavioural approaches first. If it does come down to medication, regular follow-up appointments with the family physician and pharmacy team is prudent to ensure the medication is used in the safest and most efficacious way.

Full article here.