American Medical Association Family Medical Guide - American Medical Association [446]
To treat chronic insomnia, your doctor will diagnose and treat any medical or psychological problems that may be contributing to the disorder. He or she also will try to identify any behaviors, such as excessive napping, that could be making your insomnia worse and suggest ways to reduce or stop them. Your doctor may prescribe a sleep medication, but may instruct you to take it for only a short time to minimize side effects and to reduce the possibility of your becoming dependent on it. The dosage of some of these sleep medications must be gradually reduced as they are discontinued. To avoid problems, make sure you work with your doctor to gradually stop any sleep medication you are taking.
Many doctors recommend treating insomnia with simple behavioral techniques, such as relaxation therapy, which reduces anxiety and tension and helps you sleep more restfully. Sleep restriction is another behavioral technique that benefits some people by allowing only a few hours of sleep each night at first and then gradually increasing sleep time to a more normal span. A third behavioral treatment is called reconditioning, in which a person learns to associate the bed and bedtime only with sleep by not using the bed for any activity other than sleeping or sex.
Jet Lag
Jet lag is characterized by fatigue, sleep disturbances, irritability, and dehydration that occur after long plane flights. Lengthy plane trips disrupt the natural rhythms of the body by exposing them to abrupt time changes. Jet lag is more likely to occur if you are traveling east through several time zones (for example, from the United States to Europe or from Hawaii to the US main-land) because your body finds it harder to adjust to a shorter day than to a longer one.
The following simple measures can help lower your chances of having jet lag:
• Drink a lot of water during the flight; carry a bottle of water with you, and don’t be reluctant to ask flight attendants for water.
• Avoid caffeine because it can keep you awake and cause dehydration.
• Avoid alcohol because it can cause dehydration.
• Try to get a good night’s sleep before your flight.
• Begin to think in terms of your destination’s time zone and plan your meals and sleep accordingly.
No special diets have been proven effective in reducing the effects of jet lag. Some people take the hormone melatonin to induce sleep either on the plane or before going to bed at night when they reach their destination. Melatonin resets the body’s sleep cycle. You can buy melatonin as an over-the-counter supplement. Ask your doctor if he or she recommends taking melatonin to avoid or treat jet lag.
Restless Legs Syndrome
Restless legs syndrome is a neurologic disorder characterized by unpleasant sensations in the legs and, less often, in the arms. Restless legs syndrome is sometimes categorized as a sleep disorder because the symptoms can disrupt normal sleep, making a person feel tired or fatigued during the day. The cause of restless legs syndrome is unknown, although doctors think it may be hereditary. Restless legs syndrome affects people of all ages but is more common and more severe in older people. Younger people with restless legs syndrome are sometimes misdiagnosed with attention deficit hyperactivity disorder (ADHD; see page 730) or incorrectly said to be experiencing “growing pains.”
Symptoms
The sensations associated with restless legs syndrome are most often described as creeping, crawling, pulling,