Dear CareNav Nurse Elaine,
Lately, I just can’t seem to sleep. I have tried over the counter sleeping pills, but I still wake up in the middle of the night, and they just make me groggy in the morning. I saw an ad for a sleeping pill that claims to leave no “hangover”, so I called my primary care doctor for a prescription. But she wants me to come in for a visit. I don’t understand how this can help, and I feel like my doctor just wants to fill the schedule. My insurance has a large deductible, and I don’t see this as necessary. What do you think?
According to the American Academy of Sleep Medicine, you are in good company. About 1/3 of American adults struggle to fall asleep or stay asleep at some point in their lives, and 10% have chronic problems. This not only causes fatigue, but it can also interfere with quality of life. Both short-term and long-term sleep deprivation cause problems with concentration and mood. It can also worsen health problems like high blood pressure, gastric reflux or worsening sugar control in diabetics, and it increases the risk of heart attack and stroke. Unfortunately, a lot of people do not recognize the importance of sleep health. So you are right to want to get more sleep. The question is how?
Sleeping pills can be helpful, especially for things that cause short term sleep disruption, like travel, illness or a family crisis but they are also a double-edged sword; they can rob you of deep sleep that is so important to helping you function at your best. And they can actually worsen some underlying health conditions and mask others. So they are best prescribed after a medical evaluation.
When helping someone to better sleep health, your primary care will be looking for treatable conditions that disrupt sleep, like sleep apnea (blocked breathing), abnormal nighttime leg movements, lung and heart conditions and thyroid disorders. She will also review any medications you already take (over the counter or prescribed) that might be interfering with your sleep and/or might interact with sleeping pills. She will also help you think through factors in your environment and diet that rob people of sleep like caffeine, nicotine, alcohol, late meals and snoring bed partners.
To get the most out of your visit, keep a sleep diary in advance to give your provider a full picture of your sleep problem. Record the time you go to bed, get up in the night and wake up in the morning. Include information about things in your diet that can affect sleep like caffeine and alcohol. And in the meantime, use these tips to increase the chances of getting a good night’s sleep:
1. Keep a regular schedule, including sleep times and meals.
2. Avoid caffeine after noon and alcohol in the evening.
3. Avoid napping, but if you do, make it early and short, no more than 30-45 minutes.
4. Save the bed for sleeping. Avoid using your computer or watching television.
Wishing you best of luck and a good night’s sleep!
CareNav Nurse Elaine
Nurse Elaine is a part of the CareNav community. CareNav is a network of experienced nurses available for one-on-one virtual consultations to empower and facilitate the healthcare experience of patients, caregivers, and their families. You can visit us here.