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Main Line Pediatrics

Are You Sick?

Insomnia

Is this your symptom?

  • Trouble falling asleep
  • Trouble staying asleep (waking up a lot)
  • Waking up too early

Some Basics...

  • Most healthy adults need 8 hours of sleep each night.
  • Some people can do well with as little as 6 hours a night. Other people need 9 or more hours.

Types

Insomnia can be acute (short-term) or chronic (long-term).

  • Acute insomnia lasts less than a week or two. Common causes include caffeine, stress, travel, alcohol, and certain medicines.
  • Chronic insomnia is an ongoing problem that lasts longer than 2 to 3 weeks. It may last months or years. Causes of long-term insomnia include some medical problems, chronic pain, and depression.

Causes - Environmental

  • Eating or exercising just before bedtime
  • Jet lag
  • Napping during the daytime
  • Shift work where a person is working varying shifts or evening/night shifts
  • Too much light or noise in the bedroom
  • Too warm in the bedroom

Causes - Medical

  • Alcohol : Drinking alcohol can make a person feel sleepy. However, it decreases sleep quality. It causes people to wake up in the middle of the night.
  • Breathing problems from any cause (such as asthma, COPD, or heart failure)
  • Caffeine: Caffeine is a stimulant. It is a common cause of insomnia. People who have insomnia should avoid drinking anything with caffeine (such as coffee, colas) after 3 PM (within 6 hours of bedtime).
  • Drug abuse
  • Medicines, over-the-counter: Examples include pseudoephedrine (Sudafed) and diet pills.
  • Medicines, prescription: Examples include theophylline, albuterol (Ventolin), and quinidine.
  • Medicines, psychiatric: This can occur if there is a new drug or recent change in dose. Drugs called SSRIs can cause sleep problems.
  • Nicotine (cigarettes and E-cigarettes)
  • Pain from any cause (such as back pain or knee pain)
  • Restless legs syndrome
  • Sleep apnea

Causes - Emotional and Psychiatric

  • Anxiety
  • Bedtime worrying
  • Depression
  • Mania or hypomania
  • Stressful life events

When to Call for Insomnia

When to Call for Insomnia

Call Doctor or Seek Care Now

  • You feel weak or very sick
  • You think you need to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • You think you need to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • Awakened by jerking leg movements
  • Restless legs feeling and causes insomnia
  • Pain causes insomnia
  • Insomnia interferes with work or school
  • Insomnia lasts more than 7 days
  • Insomnia off and on for weeks or months
  • Daytime sleepiness off and on for weeks or months
  • Loud snoring off and on for weeks or months

Self Care at Home

  • Trouble falling to sleep or staying asleep
  • Questions about jet lag
  • Questions about over-the-counter sleeping pills

Call Doctor or Seek Care Now

  • You feel weak or very sick
  • You think you need to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • You think you need to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • Awakened by jerking leg movements
  • Restless legs feeling and causes insomnia
  • Pain causes insomnia
  • Insomnia interferes with work or school
  • Insomnia lasts more than 7 days
  • Insomnia off and on for weeks or months
  • Daytime sleepiness off and on for weeks or months
  • Loud snoring off and on for weeks or months

Self Care at Home

  • Trouble falling to sleep or staying asleep
  • Questions about jet lag
  • Questions about over-the-counter sleeping pills

Care Advice

  1. What You Should Know:
    • Many people sometimes have trouble sleeping.
    • Here is some care advice that should help.
  2. Tips for Good Sleep - Healthy Habits:
    • Use your bed only for sleeping and sex. Do not use your bed for eating, reading or watching TV.
    • Regular exercise is good for your body and helps you sleep. However, do not exercise right before bedtime.
    • Drink a small glass of warm milk at bedtime.
    • Take a warm bath or shower before bedtime.
    • Try to go to bed at the same time each night. Even more important, get up at the same time each morning.
  3. Tips for Good Sleep - Your Bedroom:
    • Keep bedroom temperature cool, not warm or cold.
    • Keep bedroom quiet and dark.
    • Use a comfortable mattress.
  4. Tips For Good Sleep - When You Can't Fall Asleep:
    • If you can't fall asleep after 30 minutes, get out of bed and do something relaxing.
    • Read a book or listen to some soothing music.
    • When you feel sleepy, go back to bed.
    • Repeat these steps as needed.
  5. Tips For Good Sleep - When Worrying Keeps You Awake:
    • Do not use your bed as a place to worry about your problems.
    • Get up and write down problems or things that you need to do. Reassure yourself that you can look at this list in the morning.
  6. Tips For Good Sleep - What To Avoid:
    • Avoid caffeine within 6 hours of bedtime.
    • Avoid alcohol within 4 hours of bedtime.
    • Avoid nicotine within 2 hours of bedtime (cigarettes and E-cigarettes).
    • Avoid heavy meals just before bedtime. Eating a light snack is OK.
    • Do not drink over 1 glass of liquid at bedtime. If you do you may need to get up to go to the bathroom.
  7. Call Your Doctor If:
    • Sleep problems last more than 2 weeks
    • You think you need to be seen
    • You get worse

Over-the-Counter Sleeping Medicines

  1. OTC Sleeping Pills:
    • Sleeping pills can sometimes be helpful.
    • Sleeping pills can help you fall asleep. However, they may decrease the quality of your sleep. You may feel slightly groggy in the daytime after taking a sleeping pill the night before.
    • Therefore, generally, you should avoid taking sleeping pills.
  2. Warning:
    • Most OTC sleeping pills contain an antihistamine medicine, such as diphenhydramine (Benadryl).
    • Do not drink, drive, or use dangerous machinery while taking them.
    • Do not take these drugs if you have prostate problems.
    • Read the instructions and warnings on the package insert for all medicines you take.
  3. Call Your Doctor If:
    • You have more questions
    • You think you need to be seen
    • You get worse

Jet Lag

  1. What You Should Know:
    • Many people find that crossing time zones disturbs their natural biorhythms. This is called jet lag.
    • Symptoms of jet lag include: trouble sleeping and concentrating, upset stomach, and headaches.
    • Jet lag is usually worse when traveling eastward than when traveling westward.
    • Here is some care advice that should help.
  2. Preventing Jet Lag on Brief Roundtrips: Try to eat and sleep at the same time as you normally would back home.
  3. Preventing Jet Lag - Preparing For Longer Trips:
    • During the couple days before the trip, start moving your meals and sleep time closer to the schedule at your destination.
    • For example, if you are heading east, try to get-up and go to bed earlier.
    • For example, if you are heading west, try to go to bed later and get up later.
  4. Tips For Healthy Air Travel:
    • Drink plenty of water, 6-8 glasses a day.
    • Avoid alcohol and caffeine.
  5. Expected Course:
    • It usually takes one day to adjust for every time zone you cross.
    • For example, 2 time zones require 2 days for your body to adjust.
  6. Call Your Doctor If:
    • You have more questions
    • You think you need to be seen
    • You get worse

And remember, contact your doctor if you develop any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Copyright 2023.

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