DIFFICULTY SLEEP...

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SYMPTOM CHECKER

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Difficulty sleeping

Common Causes

Sleeplessness in adults may be due to:

• Aging
• Alcoholism or abruptly stopping alcohol after long-term use
• Anxiety
• Bed or bedroom that does not promote sleep
• Depression or major depression
• Diseases, such as an enlarged prostate, cystitis, COPD, arthritis, heartburn, and heart or lung problems
• Exhilaration or excitement
• Grief
• Illicit street drugs, such as amphetamines and cocaine
• Jet lag
• Lack of exposure to bright light or sunlight
• Medications, such as too much thyroid medicine, ephedrine, phenylpropanolamine, theophylline derivatives, and others
• Overactive thyroid
• Restless leg syndrome
• Shift work
• Sleeping too much during the day
• Stimulants taken in the evening, including nicotine, alcohol, caffeine, or food
• Stress and worrying
• Suddenly stopping a medication (such as sleeping pills or sedatives)
• Too much stimulation at bedtime
• Wake-sleep pattern disturbances

IN INFANTS

Most newborn babies wake several times during the night, but by the age of 6 months they usually sleep through the night. At age 1, babies will sleep an average of 16 out of every 24 hours. Two to three hours of this sleep will be during the day.

Sleeplessness in infants may be due to:

• Desire for attention from parents
• Fever or other illness
• Hunger
• Indigestion
• Infantile colic or other digestive problems
• Teething

Home Care

Try changing your nighttime sleeping habits and other behavior before taking drugs for insomnia. For example:

• Avoid emotional upset or stressful situations before bedtime.
• Avoid using alcohol in the evening. Avoid caffeine for at least 8 hours before bedtime. Give up smoking, because nicotine is a stimulant.
• Eat a light snack before bedtime. Foods such as warm milk or turkey contain a natural sleep inducer called L-tryptophan.
• Establish a regular bedtime, but don't go to bed if you feel wide awake.
• Exercise regularly, but not in the last 2 hours before going to bed. Exercise, especially aerobic exercise, has been shown to make people fall asleep faster and get deeper and more restful sleep. Sex can be a natural sleep inducer for some people.
• Relax by reading, taking a bath, or listening to soothing music before going to bed.
• Take your TV or computer out of your bedroom. Otherwise, your brain becomes used to the stimulation and starts to expect it when you are there. This makes it harder for you to fall asleep.
• Use the bedroom for bedroom activities only. Once in bed, use creative imagery and relaxation techniques to keep your mind off unrestful thoughts. Avoid staying in bed for long periods of time while awake, or going to bed because of boredom.

IN INFANTS AND CHILDREN

• Avoid going in to your child's room throughout the night. Otherwise, the child may depend on the attention and become sleepless if you don't offer it.
• Avoid sending your child to bed as punishment, which can make the child afraid and lead to poor sleep.
• For children who have trouble falling asleep, try to make sure that the child is not disturbed by noise. Leaving a radio playing soft music may help cover up disturbing noises.
• Never give a child sleeping medicine without asking the doctor first. It's usually not a good idea to treat the problem with drugs.

MEDICATION

• Avoid all sedatives, including benzodiazepines, during pregnancy.
• Over-the-counter sleep medicines can have side effects, including a "hangover" effect the next morning. If these fail, you may want to ask your health care provider to recommend other options.
• Use medication as a last resort.

Reviewer Info: Christos Ballas, M.D., Attending Psychiatrist, Hospital of the University of Pennsylvania, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed byDavid Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., 02/06/2008