In our busy lives, we often cut corners on sleep in order to crowd everything in. One-third of all Americans will experience a sleep disorder, namely insomnia. Insomnia is defined as the inability to fall asleep or remain asleep for an adequate length of time or waking up earlier than desired and being unable to return to sleep.

There are three types of insomnia; short-term (acute), long-term (chronic) and transient. Acute insomnia may last from a day to a couple of months, while chronic insomnia may last a month or longer and can cause significant distress. Transient insomnia can come and go with periods of time when a person may not experience any sleep problems.

A night or two of insomnia may not be much of a problem for some, but if insomnia persists for days and has an impact on the way you feel during the day, you should think about speaking to your doctor.

Some causes of Acute or Transient Insomnia include:

  • Environmental factors like noise, light, or extreme temperatures (hot or cold) that interfere with sleep.

  • Significant life stress (job loss or change, death of a loved one, divorce, moving).
  • Female Hormonal Fluctuations (during menstruation, pregnancy or menopause)
  • Partner’s Sleep Habits. Your partner’s snoring can certainly be a factor in your insomnia.
  • Emotional or physical discomfort.
  • Interferences in your normal sleep schedule (jet lag or switching from a day to night shift).
  • Consuming too much alcohol and caffeine and/or smoking cigarettes before bed.
  • Taking long naps during the day
  • Worrying about whether or not you will fall asleep
  • A poor diet and lack of exercise may also contribute to trouble sleeping.

Some causes of Chronic Insomnia include:

  • Medical disorders, such as chronic fatigue syndrome, asthma, sleep apnea (stop breathing in your sleep), thyroid disorders and chronic pain.

  • Neurologic disorders, like Parkinson disease and other movement disorders, as well as headache syndromes.
  • Depression and anxiety (studies also have shown that insomnia can lead to depression.)
  • Sleep disruption is common with excessive use of stimulants (legal and illegal) and alcohol.
  • For people with HIV, some antiretroviral medications have a side effect which can cause insomnia.

Weight gain

Poor sleep can actually change your metabolism. Insomnia seems to be associated with metabolic changes that can lead to overeating and obesity. Our bodies view sleep deprivation as a state of stress that eventually promotes fat storage.

People who exercise spend more time in deep sleep. While we all know quality sleep keeps us rested and alert for the day ahead, it now seems that sleep might even lead to a healthier metabolism!


Acute insomnia may not require treatment. If your insomnia makes it difficult for you to function during the day because you are sleepy and/or tired, your health care provider may prescribe sleeping pills for a limited time.

Health problems that are the root cause for the chronic insomnia must be addressed first. Your doctor will diagnose your insomnia by evaluating your medical history. He/she may also ask you to keep a sleep diary where you would record your sleeping patterns, your quality of the sleep, your consumption of caffeine and alcohol and the amount of cigarettes you smoke per day. If you have chronic insomnia, your doctor may also recommend a specialist or look into sleeping clinics.

You may want to talk to your doctor about trying natural products and supplements. Over-the-counter medications tend to lose their effectiveness over time and may cause the user to experience a “hangover” the next day. Your doctor may recommend relaxation therapy techniques, or may prescribe sleeping pills, usually only for a short period of time to alleviate your symptoms.

Prescription Medications *

Benzodiazepines, notably temazepam, are commonly prescribed sleep medications. They are addictive and associated with a withdrawal syndrome which can be severe. For treatment of depression, there are antidepressants, such as Zoloft, Prozac and Celexa, and psychotherapy. Unfortunately, some antidepressant medication side effects include insomnia. For anxiety, exercise regularly and avoid caffeine. If that isn’t enough, anti-anxiety drugs like Xanax may help. (* Not all these medications may be available in South Africa – consult your doctor.)

“Sleep is absolutely essential for normal, healthy function and is a sign of a balanced lifestyle…”

Natural or Herbal Remedies

Melatonin is a popular over-the-counter sleep aid because it is a naturally occurring hormone in the human body. Treatment with melatonin has been shown to help patients who are experiencing acute insomnia.

Over-the-counter melatonin is sold at doses much higher than those that naturally occur in the human body. Because of this, most health providers do not recommend melatonin for the treatment of chronic insomnia.

Two of the most popular herbs used for sleep are Valerian Root and Kava Kava. Unfortunately, there is little scientific evidence to support claims that either is effective or safe.

If you are using any natural or herbal remedy, be sure to consult with your health care provider. Some herbal mixes may have adverse affects with your prescription medication and/or health condition.


There are several studies where aromatherapy has been used to alleviate sleeplessness in hospital patients. In one study, some essential oils, including lavender and orange oil, were used in place of sedatives and were found to have positive results. Lavender, specifically, has long been regarded for its calming and relaxing effects.

Tips for a good night sleep:

  • Minimise noise and light by covering your windows or wearing an eye mask.

  • Avoid large meals within two hours of bedtime.
  • Get regular exercise during the day to reduce stress hormones, but avoid anything too strenuous within three to four hours of bedtime.
  • Avoid long naps in the afternoon.
  • Stop working at any task an hour before bedtime to calm mental activity.
  • Avoid discussing emotional issues in bed with your partner.
  • I know this one might be difficult, but consider having pets stay outside of your sleeping area. Having a pet in bed may cause you to wake if the pet moves around on the bed.
  • Make sure your bedroom is well ventilated and a comfortable temperature (The ideal sleeping temperature is between 65 and 72 degrees.) A mild drop in body temperature often induces sleep.
  • Keep your bedroom for sex and sleeping only. If you have trouble sleeping or wake during the night, go into another room and read a book or watch television, listen to relaxing music, and try keep your mind off of work or other daily responsibilities.
  • Avoid nicotine, caffeine and alcohol at least four to six hours before bedtime.
  • Hide illuminated clocks from view to avoid clock-watching.
  • If your mattress hasn’t been turned or rotated in a year, do it now. If it’s older than seven years, it’s time to buy a new one.

Sleep is absolutely essential for normal, healthy function and is a sign of a balanced lifestyle. If you are still having trouble sleeping after trying some of these suggestions, tell your doctor about it. There may be an underlying medical condition that is causing your sleep problem.

By Jennifer Medvin, RN

Jennifer Medvin is a perioperative regist

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