In one of my favorite books, One Hundred Years of Solitude, written by Gabriel Garcia Marquez, a plague strikes the mythical South American village of Macondo. It is no ordinary plague, however.
It is the plague of insomnia, and it infects every man, woman, and child in the village. At first the villagers are happy to have the extra time on their hands, but soon, lack of sleep begins to cause memory loss, and a global amnesia grips this village of insomniacs. Out of necessity, the villagers begin labeling everything in pen and ink.
The cow wears a placard stating, "This is a cow. She must be milked every morning so that she will produce milk, and the milk must be boiled in order to be mixed with coffee to make coffee and milk." Then, after five years, the plague disappears as mysteriously as it arrived, and the villagers of Macondo can go back to sleep.
While there certainly is no such plague of insomnia, there may as well be. It is estimated that 60 million American suffer from insomnia, and I have no difficulty believing this number because, every day in my practice, I see patients who suffer from it. While it is normal to have difficulty sleeping from time to time, chronic insomnia is defined by a lack of sleep, that occurs on a regular basis, often for no apparent reason.
How much sleep do you really need? While some people can get by on four or five hours, and others need nine or 10, most people require seven or eight hours per night.
Inability to get a good night's sleep, on a regular basis, is harmful to your health physical and mental. Sleep deprivation is cumulative, and it can cause irritability, fatigue, memory loss, and concentration difficulties. It can worsen the severity of chronic diseases such as hypertension and diabetes; and people with chronic insomnia are more likely than others to develop psychiatric problems such as depression and anxiety disorders. In addition, insufficient sleep can also lead to serious or fatal car accidents.
So what can be done about insomnia?
The first thing I tell my patients with insomnia is to practice good sleep hygiene:
Stick to a schedule. Keep a consistent bed time and wake time.
Limit your time in bed, and reserve the bed for sleeping. If you can't sleep, and want to read a book or watch TV, get up and sit in a chair, or go in the other room.
Avoid forcing sleep. The harder you try, the more awake you'll become. Get up and read until you become drowsy.
Avoid caffeine after lunch.
Avoid alcohol and nicotine (that means no "night caps").
Exercise regularly for at least twenty minutes, preferably 4 to 5 hours before bedtime.
Avoid or limit naps.
Do not go to bed hungry. Have a light snack, but avoid heavy meals before bedtime.
Relax. Take a warm bath or sip an herbal tea before going to bed.
Talk to your doctor to make sure you're not on any medication that could cause or worsen insomnia
If you are following these behavioral techniques, and you still can't sleep, you should talk to your doctor or herbalist about sleep aids. According to my Karyn, my herbalist friend, the appropriate herbal concoction would depend on the individual, and his/her underlying medical problems, but several herbs can be helpful-chamomile, valerian, passionflower to name a few.
For some people, the sedating antihistamine Benadryl works quite well. Other medications that are used for sleep include Trazodone, Nortriptylline, Seroquel, Ambien.
Good sleep is a necessity. It is a building block in the foundation of good health. Talk to your doctor if you are having difficulties.
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