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Back behind the wheel: Insomnia: Why can’t I fall asleep?

Many of my patients complain about having a hard time sleeping while on the road....

Dr. Christopher Singh

Dr. Christopher Singh

Many of my patients complain about having a hard time sleeping while on the road.

This causes them to feel exhausted, increases their pain sensitivity and often puts them in a bad mood. In this month’s article I am going to discuss the topic of insomnia: what it is, its causes and treatments as well as some simple hints that help promote a good night’s sleep.

Insomnia is defined as a sleep disorder which is characterized by difficulty falling asleep, waking up often during the night and having trouble going back to sleep, waking up too early in the morning and unrestful sleep. It is not unusual for people to have trouble sleeping from time to time. However, if you feel that you do not get enough sleep or satisfying sleep, you may have insomnia.

Insomnia is quiet common. For example, about 60 million Americans each year suffer from insomnia which can lead to serious sleep deficits and problems.

Insomnia tends to increase with age and affects about 40 per cent of women and 30 per cent of men. One of the general misconceptions about sleep is that there is a general number of hours required for everyone. However, insomnia is not defined by the number of hours you sleep every night as the amount of sleep a person needs varies from person to person. While most people require between seven and eight hours of sleep, some people function fine with less and some need more.

You know you are getting enough sleep if you do not feel sleepy during the day. The amount of sleep you need stays the same throughout adulthood. However, sleep patterns may change with age. For instance, older people may sleep less at night and take naps during the day.

There are two main types of insomnia which are called primary and secondary insomnia. Primary insomnia means that the person is having sleep problems that are not directly related to any other health condition. Secondary insomnia means the person is having sleep problems due to something else, such as a pre-existing health condition like depression, cancer, asthma and pain.

The duration that a person experiences insomnia can also vary significantly. Insomnia can be short-term (called acute insomnia), or long-term (called chronic insomnia).

Acute insomnia can last from one night to a few weeks. It is often caused by physical or emotional discomfort, and can be related to a single specific event. Some common causes of acute insomnia include: significant life stress; environmental factors like noise; light or extreme temperatures; and changes in normal sleep schedule like jet lag or shift work.

Chronic insomnia is when a person has insomnia at least three nights a week for one month or longer. There are many causes of this condition which include depression, chronic stress, and pain or discomfort at night.

How is insomnia diagnosed? Your doctor will ask you a series of questions about your sleep habits, any medication your take, and the amount of caffeine and alcohol you drink. Other questions may include how long you’ve been having trouble sleeping, if you have any physical pain such as arthritis, and if you snore. Your doctor will also enquire about events or problems in your life that may be upsetting you and making it hard for you to sleep. It is common for doctors to interview your bed partner about the quantity and quality of your sleep. In some cases, you may be referred to a sleep centre for special tests.

Once your doctor has diagnosed you with insomnia, he or she can begin to treat you. Acute or short-term insomnia may not require treatment at all as it often resolves itself. However, if your insomnia is effecting your day-to-day functioning, your doctor may prescribe sleeping pills for a limited time.

The rapid onset, short-acting medications now available avoid many of the earlier problems like continuing effects of drowsiness or grogginess the following day but, some of these medications may be less effective after several weeks of nightly use. Side effects of sleeping pills and over-the-counter sleep medication can be a problem and should be used with caution.

The first step to treating chronic insomnia is to treat any underlying conditions or health problems that are causing the insomnia. If your insomnia continues, your doctor may suggest behavioural therapy or medication. Behavioural approaches to treatment focus on modifying behaviors that may worsen insomnia and learning new behaviors that promote good sleep.

Good sleep habits can help you get a good night’s sleep. Here are a few hints that you can try tonight:

* Try to go to sleep at the same time each night and get up at the same time each morning.

* Try not to take naps during the day.

* Avoid caffeine, nicotine and alcohol late in the day. Caffeine and nicotine are stimulants and can keep you from falling asleep.

* Get regular exercise but do not exercise within a few hours to bedtime.

* Follow a routine to help you relax and wind down before sleep, such as reading a book, listening to music or taking a bath.

* Try eating a light snack before going to bed, but do not eat too much. A glass of warm milk or some cheese and crackers may be all you need.

* If you can’t fall asleep and do not feel drowsy, get up and read or do something that is not overly exerting.

Until next month, drive safe!

– Dr. Christopher Singh, B. Kin., D.C., runs Trans Canada Chiropractic at 230 Truck Stop in Woodstock, Ont. He can be reached at 888-252-7327, or email

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