Copyright (c) 2010 Dr. Arshia Alec Shirzadi

Millions of Americans toss and turn at night, unable to get a good night’s refreshing sleep, suffering from insomnia. Some can’t get to sleep, some keep waking up in the middle of the night and others consistently wake up early in the morning. If you are one of the unfortunate ones, you probably suffer from the mixture of all of the above.

Insomnia can — and often does — lead to more than just some minor crankiness in the morning following a poor night’s sleep. Poor sleep can affect your overall health. In fact the American Cancer Society surveyed more than one million American’s and found that those of us who sleep fewer than six hours a night had higher mortality rates than those who got a full seven hours of blissful slumber. (Interestingly, the survey also found that those who regularly got more than eight hours of sleep also had higher mortality rates; if you sleep more than 8.5 hours a night, your mortality rate rises by 15 percent.)

It may give you some small comfort, but you’re not alone as you toss and turn: the U.S. Department of Health and Human Services in 2007 reported that about 64 million Americans experience insomnia each year.

Each of us has some insomnia some of the time. We all have days (nights) where worries, stress and/or illness of us or those we love keep us awake at night.

Real trouble arises when you have what is known as chronic insomnia. This is the kind of insomnia that lasts for more than six months, possibly even for years. Chronic insomnia can be caused by variety of psychiatric or medical illnesses. In women in particular hormonal shifts can cause drastic sleep disturbances. But sometimes chronic insomnia comes about of its own accord.

If you suffer from insomnia, your first line of defense is to ensure that the place you sleep is cool, dark and quiet. Use this space — usually your bedroom — for sleeping and sex only. Don’t watch television or read in bed. Avoid caffeine for several hours before bedtime. Try not to get stressed in the two hours before bedtime. While exercise overall can help you get a good night’s sleep, exercise as late as two or three hours before bedtime actually can make it difficult to fall asleep.

If you still have trouble falling or staying asleep, a visit with your health care provider is in order. I urge you to forgo taking over-the-counter sleep aids until you’ve met with your physician. He or she may recommend over-the-counter sleep aids such as the supplement melatonin, over the counter antihistamines or a prescription medication such as one of the many available benzodiazepines or other hypnotic agents such as Ambien or Lunesta. Precautions should be taken with sleep aids as some have been known to cause unwanted side effects such as nighttime eating and/or sleep walking. In addition, prescription sleep aids are not to be used for long periods of time.

As a psychiatrist, I often see insomnia that is as a result of mood, anxiety or substance use disorder.  Once the underlying illness is treated, then sleep would improve drastically also. So if you are having trouble sleeping despite having good sleep hygiene, then it might be time to discuss this with your physician as there are treatments available but you have to be willing to ask for it.

—————————————————-
Dr. Arshia Alec Shirzadi is a Harvard Medical School educated; board certified adult psychiatrist, psychotherapist, and psychopharmacologist. His vast clinical and research expertise also includes substance abuse, addictions and co-occurring disorders. Dr. Shirzadi is presently in private practice in Newport Beach, CA. For more information please visit http://www.dralec.com

I am now starting to ween myself off the xanax slowly. I am now trying lunesta, this was my second night taking it and it didnt really work well only 4 hrs sleep (if that). I was looking for opinions… should i keep on the lunesta and drugs, or try to go it drug free?

What has best helped everyone. I soon will be seeing a sleep therapist, but would like to hear your expeirences and what has worked best for other fellow insomniacs?

The best solution for insomnia is to try and find the cause of your insomnia. Causes of insomnia can include, anxiety, stress, withdrawal reactions or adverse reactions to medications or alcohol. It can also have medical causes eg thyroid. In your case from what I am reading it just seems anxiety related where you didn’t sleep for one night and then got worried about it and it triggered off an worry about not sleeping that is now causing you not to be able to sleep.

Unfortunately these sleep aids cause rapid tolerance development and people find they stop working after a few weeks or months of regular use. If you are trying to wean yourself off xanax you should join this withdrawal support group if you are having difficulty http://www.non-benzodiazepines.org.uk/
Lunesta works the same way on the brain as xanax. It is technically a nonbenzodiazepine but it is just molecularly different from benzodiazepines like xanax but it still works on benzodiazepine receptors.
You better be careful your body doesn’t become dependent/addicted to these drugs or else you will never be able to sleep without sleep aids. Long term use of sleep aids often leads to a worsening of sleep quality as well with desruption of REM stage sleep. A natural sleep is better than a drug induced sleep.
You should seek counselling or CBT to overcome the anxiety related to your sleeping.

mark f