Scleroderma

Difficulty sleeping, also called insomnia, is a common and frustrating problem. If you are not sleeping well at night, it can be difficult to feel well during the daytime. Insomnia makes everything worse; it can lead to fatigue, depression, anxiety, irritability, poor memory and poor concentration. It can also impair the immune system and other bodily functions, leading to medical problems. If people are sleep deprived for several days, they can even develop hallucinations, paranoid thoughts and other kinds of psychoses.

In short, sleep is extremely important and it makes sense to cultivate more restful nights. Fortunately, there are many ways to treat insomnia. Some of these treatments can be tried on your own at home. If you continue to have difficulty, there are other treatments that can be explored with the help of your physician and other health care professionals.

Sleep Hygiene
A good way to begin is to try healthier sleep practices, sometimes called sleep hygiene. Good sleep requires thoughtful preparation. It is not as simple as just climbing into bed and expecting to fall asleep. You need to do some planning. For example, it is important to begin by relaxing or “winding down” several hours before you hope to fall asleep. Do not exercise in the evening. Increasing your heart rate can keep you awake for about four hours. However, light stretching or meditation can be helpful.  A warm bath can also help.

During the early evening, try to avoid any kind of stimulating or stressful activity.  Avoid loud music, violent movies, bright lights, bright video screens, or any kinds of conflicts. If you are thinking of starting a conversation that might lead to an argument, try to reserve that discussion for an upcoming morning or afternoon. If you have kids at home, talk with them about family schedules. Remind them that there are many opportunities to make noise during the daytime. Do everything possible to reserve your evenings for relaxation.

Sleep Schedule
Maintaining a consistent sleep schedule is also important. The brain has a natural clock that is easily disrupted. If you fall asleep or wake up at different times from day to day, you will confuse your brain, and it will not understand when you actually want it to be awake or asleep. This is what happens with jetlag. It can also happen if you take naps. Try to avoid naps. However, if you feel you need to take naps, take them for less than an hour, on schedule, in the early afternoon.

One atypical day can throw off your brain’s clock. The way to reset your clock is to fall asleep and wake up at about the same time every day, give or take an hour, including weekends. Resetting your clock may take about 1-2 weeks of a consistent schedule. It may sound monotonous but it will help you sleep!

Eating and Drinking
Other important factors are anything that you eat, drink or put into your body. It can be helpful to have some food in your stomach, since digestion induces the body to rest. However, too much food can cause acid reflux and regurgitation.  Therefore, try to finish dinner at least two hours before going to bed. Spicy foods or carbonated beverages can also worsen reflux, so it’s a good idea to avoid them in the evening. Some people find that certain foods, such as dairy products or turkey, can help to induce sleep.

Stimulants are a common cause of insomnia. If you drink coffee or tea, a good general rule is not to have any after lunch; most people do not know that the caffeine in your blood can affect your sleep for at least eight hours. If you have caffeine in the afternoon, you may notice that it takes longer to fall asleep. Even if you do seem to fall asleep on time, the caffeine can prevent your brain from falling into the deeper, more restful stages of sleep. Hence, you will feel more tired in the morning.

Alcohol will also affect your sleep. Although alcohol is a depressant and can make you sleepy at first, it will disrupt your sleep throughout the night. You are more likely to wake up during the night and have more shallow sleep.  Alcohol remains a very common cause of insomnia.

Many medications and substances are either stimulating or sedating. It is a good idea to review your medications, and any other herbs or over-the-counter drugs that you take, with your physician. They may be impacting your sleep. During the same discussion, you can also explore if you have any medical conditions that may be causing insomnia.

In short, there are many possible medical causes and many good treatments for them. With good sleep hygiene, and the help of your care team, you should be on your way to more restful nights and better health.

Harland, J. (2012), "Sleepless Nights: How to Help with Insomnia"; Harvard Vanguard Medical Associates