Insomnia #2-How to talk to your doctor about insomnia

Handy list of questions for insomnia

Lunar Eclipse 2015 blogphoto

Discussing insomnia with your physician  is an important decision. Doing some analysis of the situation will not only help you resolve the situation, but will help your physician work with you more effectively.  

Here are a few questions to consider before going in to see your physician:  

How long have you had sleep issues?

If this started just a few nights ago, likely there is a cause the patient can pin down themselves.  If it has been over a month, we’ll need to dig a little deeper. If it’s been over 6 months, likely you will be diagnosed with insomnia but we still need more details.  

Do you have trouble falling asleep? Or do you wake up after a few hours?

There are different types of insomnia. Having some awareness of if rather your issue is trouble with initiating sleep, waking up frequently, or waking up very early.  You may want to consider keeping track of your sleep with a sleep journal. It can be a cell phone app, information from your activity tracker, or just a list of bedtimes and waking times.

Are you a shift worker?

Naturally, if your work requires you to work overnight, or change scheduled frequently, we’ll need to discuss how this affects you.  

What’s your medical history?

Are you diabetic?  Do you have a condition that’s causing pain?  Are you prone to depression?

Almost any medical condition can disrupt sleep. The muscle aches (myalgia) of the flu can wake you up. If your becoming short of breath when you lay flat that can be a sign of heart disease. Anemia sometimes presents as insomnia. Although one of the main symptoms of anemia is fatigue, many people often notice restless leg symptoms at bedtime. This is because as they lose iron,  the nerves of the legs to become increasingly sensitive to pain.

It may be your diabetic nerve pain (also called diabetic neuropathy) that’s causing pain at night.  Diabetic neuropathy can be one of the first symptoms on diabetes.

Are you reading this blog now when it should be bedtime?

I know my natural tendency is to be a little sedating, and I’ve been batting around the idea of using my blog as a sleep aid.  But screen time has a very strongly association with insomnia. The light coming from your screen (and this counts for cell phones, tablets and televisions) activates your optic nerve.  This stimulus will have direct effects on the sleep center in your brain, the Pineal Gland, which will lead to a wakeful state. By the way, you can find an excellent pineal gland meditation here

Are you going to be angry?

Are you laying down in a peaceful state?  Or are you plopping down in the bed after an 18 hour day in which you missed lunch, never stopped moving and multitasking.  Your state of mind can be a major source of insomnia that we definitely do not want to treat with prescription sleep aids.

What did  you eat before bed?

Your diet choices make a difference when it comes to your sleep.  Caffeine intake naturally will disrupt your sleep. Caffeine has many benefits, but it is a drug with many effects on the body.  You may be especially sensitive to the effects of caffeine, and a stop at the local coffee shop at work may guarantee you a long restless night.

Are you using alcohol to sleep?

Alcoholic beverages have an immediate sedating effect. Paradoxically,  alcohol disrupt the normal sleep cycle, leading to disrupted poor quality sleep.

Are you being treated for chronic pain with narcotics?

Opioids can disrupt normal sleep architecture.  You may fall asleep very quickly, but then you wake up within hours feeling tired.

Do you fall asleep during the day?

It’s natural to have periods during the day of fatigue or sleepiness. But if you’re finding your sleeping at inopportune times, such as on meetings, during conversations, or while  driving, this will require an in depth conversation with your physician.

I recommend patients jot down some notes prior to going to their physician as this can help.  Any information patients bring to the physician will help with a diagnosis and treatment.

In future post, I’ll dive deeper into what happens when humans sleep, as well as using the Chakra system to classify the causes of insomnia.

 

Author: Charlyce Davis

I am an Internal Medicine physician with 10 years of practice experience. I have become a student of Reiki and I have also studied yoga.

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