If insomnia is derailing your sleep, a prescription sleeping pill may not be the best cure. Here are some options to explore:
Practice good "sleep hygiene." This does not mean making sure your bedding is clean! It means following good sleep habits, especially ensuring the bedroom environment is conducive to sleep. Among experts' recommendations: Use the bedroom only for sleep and sex; keep regular sleep and wake times; eliminate afternoon caffeine; banish pets (and snoring partners) from the bedroom; ensure the bedroom is a dark, cool, quiet place; and get computers and TVs out of the sleep environment, because they stimulate the brain and their light tells the body "it's daytime," disrupting the internal clock.
Break the rules when necessary.While experts' common-sense recommendations about sleep hygiene should be the first line of defense against insomnia, selectively breaking them can sometimes help, too. TV isn't recommended, for example, but a DVD or show (make it a boring one) may put some people to sleep. "Listen to experts' rules; don't throw them out," says Gayle Greene, 65, a lifelong insomniac who has learned to cope. But "bend them, make them work for you."
Develop a pre-bed relaxation ritual."Adults need these rituals, too," says Meir Kryger, director of sleep research and education at Gaylord Hospital in Wallingford, Conn. "You'd be amazed at how helpful they can actually be." To develop a nonstimulating evening ritual, you might recall what your parents did when you were young to get you in sleep mode. Or try taking a hot bath or sipping a warm cup of chamomile tea; either will raise your core body temperature, which leads to a drowsy feeling as you cool down, says Lisa Shives, medical director of Northshore Sleep Medicine in Evanston, Ill.
Try not to self-medicate."I personally don't recommend that people just go out and treat themselves with over-the-counter medications," says Kryger. "They never solve the problem; they'll just help you get through." Pharmacies certainly offer lots of sleep remedies. There are antihistamines, like Benadryl, which have a sedative side effect. (The ingredient that causes drowsiness is also found in products like Tylenol PM and Advil PM.) But those medications can induce next-day grogginess-what some patients call "sleep hangovers"-and they can actually have an alerting or a disorienting effect on the elderly, says Shives. Other OTC options include melatonin supplements and valerian extracts, although evidence of the effectiveness of either is slim, a National Institutes of Health insomnia consensus panel concluded in 2005. And, as Shives says of melatonin, valerian, and similar substances, "Nobody's regulating this stuff."
Don't drink to sleep.Sure, sloshing down a little Pinot Noir will put you to sleep, but as the alcohol is metabolized by the body, it fragments sleep, which tends to cause nighttime awakenings and next-day tiredness. "People have the misconception that alcohol helps," says Ralph Downey III, chief of sleep medicine at the Loma Linda University Medical Center in California. "It doesn't."
Create a barrier between work and sleep.You want to have some sort of break from the day's stress before sleep, advises Lawrence Epstein, medical director of Sleep HealthCenters in Boston and coauthor of The Harvard Medical School Guide to a Good Night's Sleep. If you know you're going to bed at 10:30, stop your day at 10:15, or sooner if you can. Shortchanging that break can be a recipe for insomnia. Write down all the things you need to worry about on a piece of paper, and do your best to leave them behind. Whether asleep or awake, there's likely nothing you can do about them until tomorrow, anyway.
Don't "catastrophize." People who can't sleep tend to compound the problem by fretting about the consequences of their sleeplessness, like the possibility that they'll do a bad job at work and get fired. Catastrophizing a sleep problem, however, tends to further engrain it, says Shives. "I try to get [people] to calm down," she says. "But that's kind of like telling a depressed person to perk up."
如果你的睡眠不規律,一張安眠藥的藥方單也許并非最佳良藥。還有以下方法,可供選擇:
保持良好的"睡眠衛生".并不是指保持床上用品干凈!"睡眠衛生"是指養成良好的睡眠習慣,尤其是保證臥室環境有益于睡眠。專家的建議包括:將臥室只用于睡覺和做愛;保持規律的作息時間;在下午杜絕一切咖啡因成分;不要讓寵物(或打鼾的伴侶)留在臥室里;確保臥室黑暗、涼爽、安靜;而且不要在睡眠環境中擺放電腦或電視,因為它們會刺激大腦,而且它們發出的燈光會暗示身體"天亮了",會打亂體內的生物鐘。
必要時,打破規律。專家們有關睡眠衛生的常識性建議應該作為對抗失眠的首要準則,但選擇性地違反其中幾條也會帶來幫助。例如,通常是不推薦看電視的,但一張DVD光碟或秀(比較無聊的那種)也可能以讓人犯困。"聽專家的建議,并接受它們",現年65歲的嘉樂。格林(Gayle Greene)說道,他一生都患有失眠,并已經掌握應對方法。"但可以'改善它們',讓她們為你所用。"
養成睡前放松的習慣。康涅狄格州沃靈福德市的加洛德醫院(Gaylord Hospital)的睡眠研究和教育主任梅爾。克瑞格(Meir Kryger)表示,"成年人也同樣需要這些習慣,你可能會對這些習慣的實際效果大吃一驚。"為了養成非刺激性的晚間習慣,你應該回憶一下小時候你的父母是如何哄你睡覺的。或者嘗試洗一個熱水澡或飲一杯溫柑橘茶;或提高你的體內溫度,而當你體溫降下來的時候,你將會覺得昏昏欲睡,伊利諾斯州艾瓦斯頓的北岸睡眠醫療中心(Northshore Sleep Medicine)的醫療主任麗薩。謝福思(Lisa Shives)這樣說道。
不要嘗試給自己開藥。克瑞格說道,"我個人非常不建議人們簡單地跑到街角醫院,給自己胡亂開藥。這些藥不會解決問題;它們只能短時間內幫助你。"藥房當然會提供許多睡眠治療藥物。它們是一些抗組胺劑(如苯海拉明),具有鎮靜劑一般的副作用。(引起睡意的成分還在其它產品中發現,如Tylenol PM 和Advil PM.)但這些藥物可能導致第二天站立不穩-也就是所謂的"睡眠'宿醉'".謝福思還說道,這些藥物可能導致老年人變得警惕或迷失方向。其它OTC藥物(包括褪黑素補充劑和纈草提取物),國立衛生研究所的失眠共識委員會于2005年得出結論,顯示其效果極為微弱。而且謝福思還提到褪黑素、纈草和相似物質,"沒有人對這些原料加以規定。"
不要為了睡眠飲酒。誠然,飲下一小杯黑比諾會幫助你入睡,但作為酒精,它促進身體的新陳代謝,會讓睡眠變得不連貫,會導致"夜醒"和第二天的乏累。加利福尼亞州的洛馬連達大學醫學中心的睡眠醫學主任,拉爾夫。當尼三世說道,"許多人的思想中有這樣的誤區,覺得酒精可以幫助睡眠,但事實上并非如此。"
在工作和睡眠制造一道屏障。波士頓睡眠健康中心的醫療督導,同時也是哈佛醫學院良好晚間睡眠指南的合著者,勞倫斯。愛普斯頓(Lawrence Epstein)建議,"在睡覺之前,你需要從白天的壓力中解脫出來。如果你計劃在10:30上床就寢,那么在10:15結束一天的活動,或盡可能早地結束。
這樣的休息可以作為治療失眠的藥方。將所有你覺得煩惱的事情寫在一張紙上,盡可能地忘掉它們。不論你是睡是醒,這些煩惱的事情都要等到第二天才能解決。
不要"小題大做".睡眠不好的人容易將這個問題同其它問題加以聯系,擔心失眠的后果,如可能做不好工作,被炒魷魚。謝福斯說道,"將睡眠問題小題大做容易讓問題變得根深蒂固"."我試圖(讓人們)冷靜",她繼續說道,"但這就好像是勸絕望的人振作起來".