Too Stressed to Sleep?

Invite the sandman to return with tips from a sleep specialist

Sleeping woman

People tend to bring their stress to bed — exactly the place it doesn’t belong.

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That’s not a practice that leads to a good night’s sleep, says sleep expert Nancy Foldvary-Schaefer, DO.

Most people with insomnia caused by stress have trouble falling asleep; some have trouble staying asleep or find their sleep unrefreshing. Dr. Foldvary-Schaefer offers tips for dealing with each of these problems.

When you can’t fall asleep

If you have trouble falling asleep, the longer you lie awake in bed, the more aggravated you become. You may soon find yourself “dreading the bed,” seeing it as a battleground rather than a refuge.

The key is to avoid that negative association and develop healthy sleep habits. To fall asleep more easily, try these tips:

  • Plan for “tomorrow” earlier in the day — then close the door on it before night falls. Plotting out the next day well before bedtime might help you push it out of your brain.
  • If you’re not asleep after spending 20 minutes in bed, take your frustrations to another room. Don’t allow yourself to destroy your sleep environment.
  • Develop a pre-sleep ritual, such as enjoying a long bath or cup of caffeine-free herbal tea.
  • Avoid stimulating your body and mind by eating, working or watching TV in bed.

When you can’t stay asleep

If you fall asleep with no problem but have trouble staying asleep or getting restful sleep, an underlying medical condition may be the culprit. Examples include:

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  • Chronic pain
  • Acid reflux
  • Restless legs syndrome
  • Sleep apnea
  • Hormonal changes caused by menopause

If this is the case, you won’t sleep comfortably through the night until the problem is treated by a knowledgeable primary care physician or specialist, Dr. Foldvary-Schaefer says.

Sleep and the aging woman

As women age, and as hormones such as estrogen and progesterone decrease, many sleep disorders increase. Hot flashes, restless legs syndrome and sleep apnea may fragment the once-sound sleep of older women.

Obstructive sleep apnea, which affects about 4 percent of men, afflicts women to a comparable degree around menopause, says Dr. Foldvary-Schaefer. But the symptoms may differ in women.

“Men with sleep apnea tend to snore and stop breathing, which alerts their bed partner to a problem,” Dr. Foldvary-Schaefer says. “Women often have more generalized symptoms such as depression and anxiety, which makes an accurate diagnosis more difficult.”

If poor quality sleep affects your life, ask your primary care physician to take a sleep history and examine your upper airway muscles. If sleep apnea is ruled out, you may benefit from short-term hormone replacement therapy or antidepressants. If sleep apnea is suspected, you may be referred to a sleep disorders center for a comprehensive sleep study.

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Hope — and a reality check

If you develop insomnia because of a stressful situation, the good news is your sleep problems may go away as that situation resolves.

But if your insomnia keeps coming back, a few sessions with a sleep counselor can teach you how to manage your insomnia so that it no longer rules the night.

“You may never sleep eight hours,” Dr. Foldvary-Schaefer cautions, “but you may sleep for six hours — and that can be long enough.”

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