Healthy Outlook

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I see a lot of patients who suffer from insomnia. However, I don't see a lot of patients who come to see me specifically about their insomnia. Instead, they make an appointment for other medical issues and during the course of their office visits, I learn that they're either not able to go to sleep or stay asleep on a regular basis.

It's estimated that up to 40 percent of the population has experienced some degree of insomnia, although most do not discuss it with their physician. That's fine if someone is dealing with the occasional sleepless night, but more persistent insomnia should be addressed.

While insomnia isn't life-threatening, it can be a real drag on a person's quality of life. Lack of sleep can lower people's productivity at work or school, impact their moods, and affect their ability to concentrate. Insomnia can exacerbate other conditions like depression. Driving while sleepy also increases someone's risk of getting into an auto accident.

The underlying causes of insomnia vary. It can be a side-effect of other medical issues such as chronic pain, restless leg syndrome, sleep apnea, frequent urination, respiratory problems, depression or anxiety. Or it could be caused by stress. Certain kinds of medications can interfere with sleep. The things we eat, drink and consume — sugar, caffeine, nicotine and alcohol — can also be contributing factors.

I should point out that medical issues causing sleeplessness — like sleep apnea, frequent urination, restless leg syndrome—have specific, effective treatments available, so seeing a doctor to treat those conditions is important. But most often the best way to treat insomnia itself is by developing good sleeping habits or good "sleep hygiene." Below are some tips for regularly getting a good night's sleep:

• Develop a routine: Doing something familiar and relaxing each night lets your body know it's getting close to bedtime.
• Stick to a schedule: Try to go to bed around the same time each night to keep up a regular sleep-cycle rhythm. Don't nap during the day.
• Only use your bed for sleeping: It's important to get in bed when you're ready to sleep. Don't watch TV, read, look at electronic devices like iPads, or do anything that can stimulate the brain. Your body needs to associate your bed with sleep.
• If you can't fall asleep, get out of bed: Once again, your body needs to associate your bed with sleeping. If you can't sleep, get up and go do something relaxing. Read a boring book. When you're sleepy again, return to bed.
• Don't eat sugar or drink caffeine or alcohol too close to bedtime: All these things can interfere with sleep.

Of course, there are also plenty of prescription and over-the-counter sleep aids. Many of them are very effective, but they are really only good to use as a short-term solution. Many have their own side effects, and some are addictive. Over the long run, developing healthy sleep habits is what will get you through the night.

For readers with smartphones or tablets, I recommend downloading the "CBT-i Coach" app (cognitive behavioral therapy for insomnia). The app assesses your sleep quality, offers tips, and tracks your sleep patterns over time. It's a great app — just don't use it while you're in bed!

Healthy Outlook is written by the professional staff of Contra Costa Health Services, the county health department. Send questions to series coordinator Dr. David Pepper at theairdoctor@gmail.com. For more health information, go to www.cchealth.org.