Control insomnia by identifying true underlying problem

Q:  After a bad ear infection about two years ago I experienced sleep problems.  Now I only sleep for  about 4 hours, then awaken and sometimes can’t fall back asleep for hours.  The ear problem also caused me occasional anxiety but I’m making progress on that.  A checkup with my doctor showed no problems, and I’m otherwise in good shape.  My primary doctor gave me the usual sleep hygiene tips and offered sleep medications.  But I worry about taking drugs, do they cure insomnia or just mask it?  Also would I see an ear or sleep specialist to treat this?

A:  The true underlying cause is really key to pin down in your situation.  The real reason for your sleep problems now may not necessarily be related to the ear situation two years ago.

If your ear is healed, and you are otherwise normal, you may simply have a case of primary insomnia.  If you do, rest assured it’s very common.  This seems to be what your doctor is suggesting.

Your problem may be as simple as allowing too much time for sleep, which is contributing to your maintenance issue. For instance, if you only need 8 hours of sleep but are in bed for 10, waking up in the middle of the night is understandable.  In fact, middle of the night wake-ups were much more common in previous generations before electric lights, when people often spent 10 or more hours in bed.

However, before using drugs or going to expensive specialists, you might try some simple behavioral methods for better sleep, such as those suggested by your doctor.  Especially important is a consistent sleep schedule so you only allow as much time in bed as you actually need for sleep.  Doing something this simple may be all you need to improve your sleep.

If that doesn’t do the trick, then check out a good comprehensive CBT-based sleep training program.  This enables you to go beyond sleep hygiene to address all of the usual problems that prevent or interfere with good sleep, including anxiety, which is a potent fuel that perpetuates insomnia.

You might be surprised to learn the majority of insomnia is actually caused by some non-medical combination of bad sleep habits and excessive worry about the idea of sleep.  Drugs that artificially force sleep are unable to address these non-medical underlying problems.  That’s why many experts take the position that sleeping pills can actually do more harm than good, because they tend to reinforce the idea that the solution to your problem is external and resides out of your self-control.

If you have primary insomnia, your problem is not necessarily medical, it’s more behavioral.  In that case, it is within your control to fix this permanently without drugs, and without risking the significant side-effects of drugs.

Explore posts in the same categories: Health, Insomnia, sleep

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