Insomnia – Part II: Diagnosis and Treatment

Shell Point’s Staff and Consultant Pharmacist, Yaw Adu Sarkodie, Pharm D., was the featured speaker at a recent Health Connections program. In Part I, we shared some of Dr. Adu Sarkodie’s insights about the types and causes of insomnia. Part II focuses on diagnosis and treatment.

While no doubt you know if you’re suffering from insomnia, a professional evaluation is helpful both to determine which type of insomnia it is and to plan the appropriate treatment. Your health care provider should review your personal medical history, determine what medications you are taking, and examine your physical and mental status.  If secondary insomnia is suspected, your doctor may order laboratory tests including drug use, thyroid function, serum chemistry, and cardiopulmonary studies.

There are three goals of insomnia treatment:  to improve quality of sleep by enhancing both initiation and/or maintenance; to remedy secondary or insomnia-related daytime impairment; and to improve patient-specific quality of life.

Non-pharmacological treatment can include lifestyle modification, such as changing work, eating and drinking habits, implementing an exercise routine, removing or avoiding physical or environmental disturbances, or changing medication use. Cognitive behavioral therapy and relaxation techniques may also be useful treatments. You can also implement better “Sleep Hygiene” – practices, habits, and environmental factors that are critically important for sound sleep. They can include lighting, temperature, bedding, meditation and yoga, and music.

Even your diet can affect your sleep hygiene. If insomnia is an issue for you, consider these tips:

  • Do not eat high-fat, high-protein foods before sleep. They are hard to digest and result in trips to bathroom.
  • Steer clear of spicy foods to avoid possible GI discomfort.
  • Try tryptophan-rich foods, such as warm milk, nuts and seeds, bananas, honey, and eggs for evening snacks.
  • Eat cereal, yogurt, crackers, bread, and cheese. Carbohydrate-rich foods complement tryptophan-rich dairy foods.
  • Do not drink close to bedtime, and avoid using alcoholic beverages as sleep aid.
  • Avoid caffeine late in the day and before bedtime because of its stimulant and diuretic effects.

 

Some insomnia sufferers have found success with herbal supplements or homeopathic agents such as  valerian, lavender, passionflower, hops, German chamomile, skullcap, kava, or melatonin, while others try antihistamines like diphenhydramine (Benadryl) and doxylamine (Sominex), or a sedating antihistamine/analgesic combination, such as acetaminophen as in Tylenol-PM or  ibuprofen as in Advil-PM.

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