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Dr. Samuel Heiks: Approaching Insomnia. Simple tips.

Dr. Heiks is a board certified Family Medicine doctor and lives in  Bluffton, Ohio.

Dear Dr. Heiks: I struggle with insomnia and have tried several different medications. I would prefer to be on no medication. What can I do?
Reader from Bluffton, Ohio

Dear Reader: If you’re like me, sleep affects every aspect of life and so it is important to get enough of it (or at least try). Having a young family, I understand this is often easier said than done. However, simple steps that can be taken to maximize chances for success, especially if removing medication is your goal.

Are there triggers in your daily life that are contributing to poor sleep? Do you go for the large latte or soda in the afternoon? Try decaf green tea instead, which has outstanding health benefits, and contains L-theanine, a calming amino acid that also stimulates cognition.

Are you taking a medication or herbal supplement that may be overly activating?  Many common medications, including asthma medications, decongestants, some antidepressants, or acid blockers may be culprits. Nutritional supplements including SAMe, ginseng and phosphatidylserine may do this as well.

Do you consume processed foods with stimulants such as food colorings and additives, MSG, sodium benzoate, aspartame, dyes and or other substances that excite the brain and make it less apt to doze? Alcohol, while making you sleepy, will not promote restful sleep.

Do you get physical activity in your day? Exercise, especially interval type training, can improve the efficiency of the sleep you do get. Exercising earlier in the day is better. Do it too late and your insomnia may get worse.

Is your room dark? Melatonin is secreted by the pineal gland in the brain, which is stimulated by darkness. Electromagnetic fields have been shown to decrease melatonin levels so remove electrical devices such as cell phones and radios from the bedroom.

Consider starting a “bedtime” ritual that reinforces your body’s natural desire for sleep.  Importantly, go to bed and get up at the same time each morning.

Sometimes a good, old-fashioned hot bath before bed can have a soothing effect. One of my favorites is to take a bath with 2 cups of Epsom salts (magnesium is a natural relaxer), ½ cup baking soda and a few drops of lavender essential oils (decreases the stress hormone cortisol).

If stress is a problem, consider adding a specific brain calming routine such as deep breathing, or progressive muscle relaxation to reduce the tension in your body before going to bed.

Do you snore? Do you kick your legs at night? Are the sheets all over the place when you wake up in the morning? In other words, is something else going on such as sleep apnea, restless legs syndrome or another condition called periodic limb movement disorder?  Talk to your doctor if you suspect these.

Poor sleep and early waking can be symptoms of depression, so be aware of this and seek medical guidance if you suspect it.

Many natural sleep remedies exist. I will try different kinds in different situations. For example, melatonin is best used for resetting the circadian rhythm in people who do shift work. Valerian is a popular herb, but beware, 10 percent have an excitatory reaction. Most natural sleep remedies may take 4-6 weeks to exert their full effect.

The point is to optimize all of the measures we typically refer to as good “sleep hygiene” practices. If your sleep hygiene is terrible, chances are it will be very difficult to remove the medication or to find a natural supplement that works the way you need it to.

This column provides general health information and is not specific advice intended for any particular individual(s). It is not a professional medical opinion or a diagnosis. Always consult your personal health care provider about your concerns. No ongoing relationship of any sort (including but not limited to any form of professional relationship) is implied or offered by Dr. Heiks to people submitting questions.

Please email your question to Dr. Heiks: [email protected]  If your question is selected your identity will remain confidential.