Managing insomnia

By Kim Jackson


Do you have trouble falling asleep and staying asleep?

It is estimated that approximately 30 per cent of people worldwide suffer from one or more of the symptoms of insomnia— difficulty falling asleep or staying asleep, or waking early.

Insomnia can disturb the sleep cycle and affect the body’s natural circadian rhythm (internal time clock), leading to lack of energy, poor concentration, mood swings and fatigue.

It can be either acute, lasting anywhere between a few days and a few weeks, or it can be chronic, lasting for a month or longer.  There are many reasons why we may experience insomnia but the most common causes are:

  • Medical conditions: cancer, heart disease, Alzheimer’s, Parkinson’s, gastroesphageal reflux, chronic pain.
  • Medications: Some prescription and over-the-counter drugs can affect sleep patterns. Did you know that some allergy medicines, weight loss products and cold medications contain caffeine and other stimulants?
  • Stress, anxiety and depression, worry and stressful living can cause our minds to be overactive.
  • Travel: jet lag, the result of travelling to different time zones, affects our circadian rhythm.
  • Illness: even something as straightforward as a cold can affect our sleeping patterns. Coughing, sneezing and a stuffy head can leave us counting sheep all night.
  • Environmental factors: light, noise and temperature can make it difficult to drift off to sleep and also wake us during the night.
  • Working day and night shifts: like travelling, working shifts can affect our body’s natural time clock.
  • Using electronic devices just before bedtime.
  • Snoring and sleep apnoea: snoring is most annoying for the person lying beside you but sleep apnoea can affect you both. Although snoring is a symptom of sleep apnoea, it is not the only symptom; it is an obstructive sleep disorder which causes you to stop breathing while sleeping.

The long-term effects of insomnia can be debilitating and it is important to find a solution. There are many interventions available to treat insomnia including temporary measures like medication but these can be addictive. Before relying on medication, consider natural ways and lifestyle changes that can improve sleep time and quality:

  • Adopt a regular routine: try to go to sleep at the same time each night and get up at the same time each morning, including weekends.
  • Avoid daytime naps as these can interfere with the body’s natural sleep cycle and our circadian rhythm.
  • Do not use electronic devices or phones before bedtime.  Electronic devices emit a blue light that affects the sleep- inducing hormone melatonin.
  • Avoid nicotine and drinking coffee four hours before bedtime; both are stimulants that can make falling asleep difficult.
  • Limit your alcohol intake. It can interfere with sleep quality and cause waking during the night.
  • Do not eat a heavy meal within three hours before bedtime. However, if you are hungry, a light snack may stop you waking up during the night.
  • Develop a relaxing routine before bedtime. Take a nice warm bath or shower, listen to soothing music or read a book (not on a tablet or phone).
  • If your mind cannot switch off because of worries and tasks, make a list and revisit when you wake up in the morning.
  • Ensure that your bedroom is dark and quiet. If you are disturbed by external noises, consider earplugs or a fan.
  • Do not watch TV in bed; keep bed for sleeping.
  • Exercise can help to relieve anxiety and endorse a feeling of relaxation but experts recommend avoiding exercise late in the evening. Leave at least 3-4 hours between exercising and preparing for bed.
  • Meditation and breathing exercises can help promote relaxation. The following breathing routine has been shown to be very effective: exhale completely; breathe in through your nose for a count of 4; hold your breath for a count of 7; exhale through the mouth for a count of 8. Repeat the process three more times.


(Kim Jackson is a physiotherapist  who specializes in musculoskeletal pain and dysfunction, including back pain and sciatica, stroke and other neuro conditions as well as sports physiotherapy. She works at Bayside Therapy Services in Rodney Bay, St. Lucia.)