Sleep disorders: Therapy and self-help

Sleep disorders: Therapy and self-help

The non prescription treatment for insomnia or a sleep disorder depends on the form and cause of the sleep problems. If you sleep badly, you can also do a lot yourself to make your sleep restful again.

Often it is not too difficult to find the reason for restless nights. A changed lifestyle and a healthy sleep hygiene usually bring back a good, sufficient sleep (see below). If there are concrete triggers for persistent sleep disorders, any successful therapy starts with the causes (see the corresponding chapters of this article).

If you try to banish your sleep deprivation in the long term by taking sleeping pills, you may be covering up the responsible health problems. It is therefore important to always consult your doctor, usually your family doctor, if you have persistent sleep disorders. Depending on the diagnosis, he or she will suggest and discuss a suitable treatment method or consult the relevant specialists (see chapter “Sleep disorders – Diagnosis”).

Effective Behavior Therapy

Sleep doctors have made very good experiences with persistent sleep disorders with targeted programmes from cognitive behavioural therapy. Studies have shown these to be at least as successful as treatments with sleeping pills, as they help those affected to change their habits and sleep patterns in the long term and thus find a restful night’s sleep again. Behavioural therapy can also effectively accompany the medical treatment of physical causes. Behavioural therapies are standard for the consequences of stress, burnout syndrome and mental illnesses such as depression and anxiety.

Relaxation techniques are part of many treatment concepts, whether they are for physical or psychological causes. Here every affected person can find the method that suits him most. This can be autogenic training, progressive muscle relaxation or breathing therapy.

Light therapy with special lamps is to be considered only with some disturbances, like for example with stronger Jet Lag problems, disturbances of the sleep awake rhythm or with seasonally conditioned psychological problems such as winter depressions.

Sleeping pills only controlled and for a short time

Always take sleeping pills, including over-the-counter herbal pills, only in consultation with your doctor. Herbal remedies with hops and valerian can sometimes help to facilitate falling asleep and improve sleep in cases of sleep disorders that do not have a pathological physical cause.

Synthetic preparations, so-called hypnotics such as benzodiazepines, are available only on prescription and are only suitable for short-term use (see chapter “Sleep disorders – causes: sleeping pills and other medications”). They often lead to habituation and dependence during prolonged use and often exacerbate sleep problems. Uncontrolled use can lead to other adverse effects, such as increased daytime sleepiness or parasomnias. In addition, sleeping pills have threatening consequences for certain sleep disorders such as sleep apnea or nocturnal movement disorders.

The use of benzodiazepine receptor agonists, including zopiclon and zolpidem, is also limited to short-term treatment. Synthetically produced, retarded melatonin is available in Germany as a prescription drug for people over 55. It is only intended for a controlled, short-term therapy trial if there are no physical, psychological or external causes for the sleep problems.

Antihistamines, drugs for allergies that make you tired, should also be taken only for a short time. Depending on the symptoms, doctors also prescribe certain antidepressants to regulate sleep.

The best sleeping tips

A healthy lifestyle with sufficient physical exercise and a balanced diet, little or no alcohol, no nicotine, a satisfying alternation between tension, activity and relaxation is the basis for restful sleep. This also includes proper sleep hygiene, i.e. measures that ensure calmer nights.

All this is usually easy to say, but for many people it is not always easy to implement. Then a sleep diary often helps to track down the critical points (see also chapter “Life situation, shift work”). Those who are unable to make the necessary changes on their own can usually succeed with a targeted behavioural therapy.

Here are the most important tips for a good night’s sleep

Adhere to fixed times for falling asleep and getting up. This strengthens your sleep-wake rhythm.

Exercise regularly during the day, but don’t do any strenuous sports in the evening. An evening walk, however, is relaxing.

Do not eat too much in the evening. In addition, spicy food can lead to heartburn in the evening, which in turn interrupts sleep. A light snack, on the other hand, helps you fall asleep.

No more coffee, tea, coke or other caffeinated drinks in the late.

Afternoon and evening. Find out for yourself what time you can still drink coffee without having trouble falling asleep.

Avoid alcohol and nicotine. It is best to give up smoking altogether. Since alcohol can disturb sleep considerably, you should also check your habits here. If alcoholic drinks are used at all, they should be used very little and not as a sleeping drink.

Relax before going to bed: no more arguments, no more long television with exciting thrillers, no folders on the bedside table. Take a relaxing bath, read, listen to music, do relaxation exercises. Find your personal sleep ritual. This may include a soothing herbal tea or the famous glass of warm milk.

Create a real sleeping room for yourself: this means that the room is sufficiently dark, quiet and well ventilated and that the temperature does not exceed 18 degrees. A good mattress can help prevent a lot of tension and pain.

Don’t roll around in bed for hours: try breathing and relaxation exercises or stand up and distract yourself. Do not lie down again for some time. Calm yourself, because it does not harm your health immediately if you sleep less or less. Serenity helps more than worry.

 

Stephen S. Davidson

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