DIFFICULTY SLEEP...

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Depression and inso...

SYMPTOM CHECKER

Don't think Difficulty Sleeping
explains your symptoms?
Find other possible causes of:

Difficulty sleeping

Call your health care provider if

Call your health provider if:

• Your sleeping problem becomes persistent and unbearable, despite home treatment
• Your sleeping problem occurs more than 3 nights per week for more than 1 month
• You have other worrisome symptoms, such as chest pain or shortness of breath

What to expect at your health care provider's office

Your health care provider will do a physical examination. To help better understand your sleeping problems, he or she may ask the following:

• Do you have difficulty falling asleep or staying asleep (insomnia)?
• Do you wake up not feeling rested?
• How often do you wake up at night?
• How long have you had the problem?
• Have you taken any over-the-counter sleeping products?
• What medications do you take?
• Do you take any herbal supplements or alternative remedies?
• Do you drink much coffee or alcohol? Have you recently cut down on your coffee or alcohol?
• Do you have any excessive stress or anxiety?
• How much do you normally sleep? What hours?
• What do you do during the few hours before you go to bed?
• Does your sleep schedule change often? (shift work)
• Do you fall asleep at the wrong times or places?
• Does your sleep schedule change a lot on weekends?
• Do you worry too much about sleep?
• Do you have breath-holding spells, or do you snore?
• Do you have any aches or pains that prevent you from sleeping?

• Psychological tests
• Sleep log record
• Thyroid tests (TSH, T3, T4)

In some rare cases, your health care provider may want you to see a sleep medicine specialist who will perform a sleep study (polysomnography)

MEDICATIONS

Most people don't need medication. Your health care provider can talk to you about using prescribed medications if everything else has failed.

Some antidepressants such as Elavil (amitriptyline) can be used at bedtime because they make you drowsy. They require a prescription. If insomnia is caused by depression, treating the depression with the right medications or therapy should solve the problem.

Benzodiazepines such as Valium (diazepam) or Ativan (lorazepam) are anti-anxiety medications that can also help people sleep. They must be used with caution because they can be addictive. They also require a prescription.

Newer sleep medicines help reduce the time it takes you to fall asleep. They are less likely to be addictive than benzodiazepines. Two examples are the prescription medicines Ambien (zolpidem) and Sonata (zaleplon).

WARNING: The FDA has asked manufacturers of sedative-hypnotic sleep medicines to put stronger warning labels on their products so that consumers are more aware of the potential risks. Possible risks while taking such medicines include severe allergic reactions and dangerous sleep-related behaviors, including sleep-driving.

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