If insomnia is not caused by a disease, the main countermeasures are good sleep hygiene and relaxation exercises. Sleep-promoting drugs can serve as a short-term emergency remedy. If the sleep disorder is based on another condition, it is primarily to treat it.
Our 11 most important tips against sleep problems
Treatment machinery limited - behavior is crucial
Measured by the numerical and health relevance of sleep disorders, the therapeutic treatment machinery is relatively clear. There is a good reason for that. For either the sleep disorder is secondary, that is, caused by another disease. Then, as a rule, she disappears again with her successful treatment. Or the sleep disorder is just like that. Then it's all up to you and your behavior. This is actually the case with most chronic diseases, but especially with disturbed sleep.
For a long time, medicine has hardly been interested in sleep. Something has changed in the meantime and sleep medicine centers and sleep laboratories are increasingly establishing themselves in the supply landscape.
The number one therapeutic: sleep hygiene
The most important sleep hygiene measures include regular sleep times, a suitable sleep environment and the avoidance of unfavorable eating habits. For quick check this small questionnaire may serve:
- Am I just going to bed when I'm tired?
- Do I do nothing but sleep there (and sex)?
- Do I leave the bed and do something else as long as I can not fall asleep?
- Do I maintain regular sleeping and getting-up-time?
- Do I sleep during the day?
- Did I move enough during the day?
- Is my sleeping environment dark, calm, not too warm, freshly ventilated?
- Does my bed meet my requirements?
- Do I avoid alcohol, nicotine, caffeine and heavy foods at bedtime?
- Do I think of pleasant things before falling asleep or are there professional, private or health concerns or worries about my sleep disorder?
If you take a nap during the day, this can reduce your nighttime sleep requirements. It may also interfere with your sleep-wake cycle. That is then to be checked. Of course, the list of all relevant questions about sleep hygiene is much longer.
Relaxation procedures and psychotherapy
Relaxation techniques that help improve sleep health include Jacobson progressive muscle relaxation, meditation, yoga, autogenic training, and hypnosis.
In the therapy-based treatment of sleep disorders, "cognitive behavioral therapy" is the gold standard. You learn how to influence your thinking and, for example, relax in bed in the evening.
Among the proven psychotherapeutic techniques include (attention: psychologist language):
- the paradoxical intervention with sleep deprivation
- the thought stop
- "cognitive restructuring" to silence irrational and agonizing thoughts and fears.
Emergency nail: sleeping aid
Sleeping pills are a good choice when it comes to fast and short-term effectiveness. For example, in case of an acute sleep disorder with urgent need for treatment or to interrupt the vicious cycle in chronic sleep disorder. Then psychotherapeutic exercises are less well suited with their rather long-term effect, in addition one must first of all sleep well, in order to be open for it. After the first nights of restful sleep, fatigue and anxiety diminish, and the soil is prepared for behavioral therapy.
Easier sleep disorders are often treatable with herbal medications. Classics include valerian and black cohosh, both of which have a calming effect on sleep. The effect of the black cohosh starts after a long period of regular use. It is therefore not suitable for acute sleep disorders.
The arsenal of synthetic sleep aids is rich but not unproblematic. The addictive potential of benzodiazepines (Valium & Co, usually active ingredients with "zepam" at the end), the most commonly used sleep medication, has spread widely. As so often in medicine and medicines: Used properly, they can help properly, otherwise the damage often outweighs the benefits.
It should not be forgotten and overlooked that sleeping pills can also cause sleep disorders.
Author: Dr. Hubertus Glaser