Sleeping Problems

What is it?

Most adults need 7 – 9 hours of sleep/night. Those that are well rested feel alert and do not feel a need to nap. Problems sleeping can originate from several sources:

Sleep apnea – this disorder causes a person to stop breathing in his or her sleep for short periods.

It is often associated with loud snoring.
The most frequent cause in college students is enlarged tonsils and adenoids.
Being over weight also can be a cause.

Nightmares - everyone has a nightmare once in a while. However, some people have them frequently, making them want to avoid falling asleep.

Nightmares may be triggered by certain medications, drugs, alcohol or sleep deprivation.

Periodic limb movement and restless legs syndrome – people with either of these disorders find their sleep disturbed by movements of their legs.

These movements are generally involuntary twitches or jerks.
Frequently those with periodic limb movement do not realize that they moved. It’s their bed partner that notices it.
Some people with restless leg syndrome feel tingling, burning, cramping or itching that is only relieved with movement.

Circadian rhythm disorders – we all have circadian rhythms that refer to our “internal body clocks” and regulate our 24 hour cycle of biologic processes, such as when we sleep or eat.

The circadian rhythm of college students is frequently different from that of “working adults”. This why some students are much more productive during the middle of the night.
You may need to adjust your schedule to be a better fit with your circadian rhythm. At other times, you may need to make small incremental adjustments in your routines to get your circadian rhythm on a schedule that meets your scholastic needs.

Insomnia – This is the sleeping disorder that causes most people to seek care. This is a condition in which you have trouble falling and/or staying asleep. This is where we will focus our attention.

Insomnia may be primary, meaning there is no other known cause, or secondary, meaning it is because of something else such as medication or alcohol.
It has lasted at least 1 month.
Chronic insomnia is a serious problem that can affect your safety, performance in school/work and/or your mood.

Signs and Symptoms

Difficulty falling or staying asleep
Daytime sleepiness/feeling fatigued all the time
Loud snoring; especially if accompanied by periods without breathing
Difficulty concentrating/memory problems
Depression or irritability
Morning headaches

Causes

Stress and anxiety – sometimes we are unable to turn our brain off to allow us to sleep. We may be thinking about our concerns with school, work, finances, relationships, or whatever.
Depression – with depression we may either sleep too little or too much.
Stimulants – some medications, including some antidepressants, decongestants, steroids, and weight loss medications, may worsen symptoms.
Changes in your environment or schedule – just changing from your home environment to living in the resident hall or apartment with other people can affect your sleep.
Medical conditions that cause chronic pain
Ingestion of alcohol before going to bed – although we may fall asleep initially after ingesting large amounts of alcohol, it causes us to wake frequently and have difficulty falling back to sleep.
Eating too much before going to bed – this can cause reflux and disturb our sleep.

Treatment/Recommendations

Keep a sleep diary: what time went to bed, how long to fall asleep, what time awoke, number of hours slept, how alert feel in the morning
Go to bed at the same time every night.

If you are unable to sleep after about 15 minutes, get up and occupy your time.
Do not take day time naps.

Follow a routine that helps you to unwind and relax before bed

Avoid exercise, games, etc that energizes you before bed
Don’t exercise within 2 hours of going to bed.

Make your bedroom sleep friendly

Room should be dark (no TVs, computer screens, etc) and quiet.
Be sure you have comfortable bedding and temperature.
Use your bed only for sleep or sex. Do not watch TV in bed.

Avoid caffeinated beverages after dinner. Drink water, juices, herbal teas, etc.

Avoid energy drinks, such as Red Bull, after dinner.
Avoid large meals within 2 hours of bedtime.

You may want to use the Counseling Center to improve your relaxation techniques and/or deal with any underlying anxiety and/or depression.
Medications – these may be over-the-counter or prescription.

Over-the-counter:

Many people try different OTC meds such as Benedryl (also found in Tylenol PM, Sominex, etc).
Others use OTC herbal medications such as Melatonin or Valerian Root.

Prescription: There are a number of prescription meds that can be used such as Ambien, Lunesta, Sonata and Rozerem.

These are good for short term use since they may have the potential to cause rebound insomnia.
You will need an appointment with your provider to discuss any of these.