Insomnia takes many forms and some people have it only short term and don’t need a health practitioner for assistance. There are many over the counter and herbal remedies for simple insomnia and in most cases it passes by itself. For millions of others, though, Insomnia is a serious disorder. How do you know when it’s time to see a doctor? How do you know what kind of doctor? Do you have insurance? Will your insurance cover this kind of care? Are sleep medications expensive and addictive? There are many questions- enough to keep you awake at night!
Some people have trouble falling asleep at night but can sleep fine once they get to sleep. Still, if this happens night after night you can still end up sleep-deprived, especially if you have to be at school or work at a very set time. Other people go to sleep all right but wake often in the night or wake too early and are unable to go back to sleep. They still don’t feel rested. It is true that some individuals truly don’t need as much sleep as others. If you don’t go to sleep until late and get up early, but function find on a daily basis and have for a long time, you may have nothing to be concerned about. Most of us need six to nine hours of sleep on a consistent basis for optimal mental and physical health.
If you’ve had trouble with insomnia for more than a month, if your daily activities are significantly affected, if you are falling asleep at the wheel of your car or just generally don’t feel right in addition to sleep issues, you need to see a doctor. The causes of insomnia can be extremely varied and only a medical professional can help with a total diagnosis and even then it may take sleep studies and some time to resolve. This article is not intended to be a substitute for a consultation with a medical professional so please take what you read here as a guideline and do see your doctor if you have serious sleep issues.
Most people are aware that there are some simple things that can cause insomnia and basic ways to avoid it, but if you haven’t tried them and you don’t feel you have a serious medical problem, you could start there. You can find all sorts of information on these basics in books and on the Internet, but in general you want to avoid caffeine and other stimulants such as guarana and some antidepressants or other medications if taken too late at night. Insomnia can be brought on by too little activity during the day or too much napping, and it can also be caused by too much activity or exercise close to bedtime. Some over the counter remedies such as Valerian or chamomile tea may be of help, but it is never a bad idea to ask a doctor for an opinion on these things. Over the counter sleep aids that are marketed as “sleeping pills” are typically actually just ordinary antihistamines like the ones you buy for allergies. These can be helpful for an occasional sleepless night, but should be avoided for long periods of time. They can cause damage to your liver and stomach when taken over the long term. Another “natural” remedy that health stores sell is melatonin and it is true that this chemical is produced in the body naturally and can help you sleep. Be warned, though, taking melatonin in tablet form can elevate these levels too much and cause very vivid dreams or even nightmares. There are prescription medications that help regulate your natural melatonin that help some people and these could be better choices. One of the worst choices you can make for regular sleep assistance is alcohol. While it is true that it may help you sleep, it can also make you wake up to empty your bladder. If used in smaller quantities it can wear off and leave you unable to sleep. In heavier quantities you may sleep fine but can develop serious health problems and substance abuse issues.
Sleep disorders can be caused by many physical problems that you already understand or can be pinpointed by paying attention or even journaling. Insomnia can be caused by anxiety, depression, psychological disturbance, brain-chemistry issues, hyperactivity, or grief. If you feel fairly certain that your sleep problems began when you had symptoms like these, you may want to consider starting out by seeing a psychology or psychiatry professional and/or going to a sleep-disorder center. (Centers like this can also be excellent for those with physically-induced insomnia.)
Consider physical causes for insomnia. When you have trouble sleeping, do you also have pain? Do you feel restless and need to move around quite a bit? Do you have to get up to go to the restroom often? If you have a partner who sleeps near you, ask them questions about what they observe when you are sleeping. Do they see you snoring or breathing normally and then snorting suddenly? Also, do you often awake suddenly feeling breathless and gasping? With all of these kinds of symptoms you could have a medical condition that is treatable and can range from simple to serious. Go to an M.D. or Internal Medicine specialist and tell them about any joint or back pain, restlessness, bladder or bowel issues, snoring or other forms of sleep apnea. Particularly with a sleep apnea condition where you literally stop breathing at night, a potentially dangerous condition exists and you need to see a medical professional right away.
If you just aren’t sure why you have insomnia but it is an ongoing issue for you that results in regular impairment of your ability to go about daily functions, go ahead and make an appointment with your regular family doctor. This is a good place to start when you aren’t sure and your doctor can probably help you determine more about the causes of your sleep issues. They may recommend a good center that specializes in sleep disturbance where you can get long-term assistance.
Sometimes the difficult part can find finding a doctor that is understanding and helpful regarding insomnia. Some doctors will automatically write you prescriptions for multiple refills of sedatives and sleeping pills that can be addictive and cause extreme grogginess in the morning. Even if one doctor prescribes it, you may want to get a second opinion if you realize you are being told to take prescription sleeping aids regularly over a long period of time. On the other hand, some doctors have the opposite reaction and assume that you are faking insomnia in order to get sedative prescriptions or will just tell you to drink a glass of warm milk and get over it. When you really have a problem with insomnia and you encounter a doctor like this, find another doctor. Ask friends for recommendations. If you’ve chosen to see a psychologist they are more likely to recommend a non-medication-based therapeutic approach and this can be good for some people. A psychiatrist is again more likely to prescribe medication, but can be very helpful if your insomnia is related to a specific mental illness or brain-chemistry issue. Whether you choose to see a medical doctor, go to a sleep disorder clinic, or a mental health professional – find someone you are comfortable with.
If you do not have health insurance and live in the United States, this can be quite problematic. Some health insurance companies will also refuse to pay for insomnia treatment. Many of the newer sleep medications are very expensive out-of-pocket and the doctors themselves can be quite expensive too. If a psychologist wants to see you once a week at eighty-dollars an hour this can be quite a chunk of your budget. If you have no insurance or if your insurance does not cover you, there are a few approaches to consider. First, you may want to think about whether you qualify for any special programs such as veteran’s assistance, Medicaid, or Medicare. There are websites about all of these that can help you find out. if you haven’t tried the suggestions recommended above for natural and over the counter assistance, you may try those short term. If you must see a doctor and you do not have insurance, you can find the right doctor who can find a way to help you. Some compassionate doctors will arrange to prescribe sleep medications for you for the worst nights and supplement your supply with samples of the expensive medication. Other doctors will be willing to prescribe low doses of inexpensive anti-anxiety medication that can be excellent for inducing sleep and very cheap even out-of-pocket, but these are quite addictive if you take them too often. If you become addicted to them, they can then cause more insomnia, so use this approach only if you have no choice and do so under a sympathetic doctor’s care. Clinics that have nurse practitioners can also sometimes prescribe these same things and offer other help, but you may be able to see the nurse practitioner most of the time (instead of an M.D.) and this can sometimes be less expensive.
Insomnia can be managed and it may take a combination of natural, medical, and mental-health approaches. The main thing to remember is that you should seek help for chronic insomnia. There are ways around discrimination among doctors and bad (or lacking) health insurance companies. Don’t give up on seeking help, and hopefully, get some good sleep!
