I went to my family physician for a routine physical last week. I hadn’t had one in a while, so I decided to get the exam and requisitions for the usual blood work.
This doctor is one whose opinions I respect. But I never hesitate to speak up when information I have leads me to question those opinions. One topic we’ve had discussions about is insomnia and sleeping pills.
When people write in with lots of questions about insomnia, I’ll often recommend seeing a sleep specialist or a sleep therapist who can provide cognitive behavioral therapy for insomnia (CBT-I).
But finding sleep specialists and sleep therapists can be tricky. Here’s why you might want to consult one and how to locate the right provider.
People come here looking for solutions to sleep problems. Some read about sleep restriction, a drug-free insomnia treatment, and decide to try it on their own. It’s not rocket science: insomnia sufferers who follow the guidelines often improve their sleep. It’s empowering to succeed.
But self-treatment is not the right approach for everyone. Sometimes insomnia is complicated by another disorder, or what looks like insomnia is actually something else. In both cases, the best thing to do is to have yourself evaluated by a sleep specialist ASAP.
Keisha was wondering whether to have a sleep study.
“I asked my doctor to give me something for my insomnia,” she wrote, “but he wants me to have a sleep study first. He thinks I might have sleep apnea. I don’t think I do. I don’t snore (as far as I know). I wake up a lot at night but I’m not short of breath or gasping for air.
“Besides, how could I get any sleep at all with those wires attached to my head! You say sleep studies aren’t helpful for people with insomnia. So what’s your opinion here? Should I have a sleep study or will it just be a waste of my time?”
Nothing ruins the night more than an overactive bladder. If you’re lucky you’ll fall right back to sleep when you return to bed. But getting back in the groove is not always easy. Sometimes your mind latches onto a problem and you lie awake for hours.
Here’s how to reduce the urge to go at night and get a better night’s rest.
If you haven’t had a sleep study, you may wonder if spending the night at a sleep clinic might help the doctor understand your problem and how to fix it. Polysomnography, or PSG, is the test conducted at the clinic. New guidelines from the American Board of Internal Medicine (ABIM) clarify when PSG is useful in cases of chronic insomnia and when it isn’t. Here’s a summary and explanation of the guidelines.
Do you take medication for a chronic health condition? That drug may be disturbing your sleep.
Working with a doctor to adjust the dose or time you take it—or replace it with a similar drug that does not stimulate the central nervous system—may be all you need to hold insomnia at bay.
Which drugs can interfere with sleep? Here are a few most widely prescribed.
Some people tell me marijuana helps them sleep. Just last week a friend from college—I’ll call her Marcia–mentioned she’d tried it and was happy with the result.
Marcia’s insomnia came in the middle of the night. She’d wake up at 3 and was rarely able to get back to sleep. Ambien helped for a while. Then her doctor refused to renew her prescription, so Marcia made an appointment with a sleep therapist and went through CBT for insomnia . . . to no avail. She continued to wake up in the darkest hours. As a last resort she tried marijuana.
“Just two puffs” at bedtime enabled her to sleep uninterruptedly until 5 or 5:30 a.m. This was a surprise and a relief. But the bigger surprise came when she quit the marijuana and continued to sleep through the night.