Insomnia: Sleep Hygiene

Part 3
February 7, 2014 Updated: February 6, 2014

If you are having trouble sleeping, you may need to pay more attention to sleep hygiene. Sleep hygiene requires attention to details across a range of environmental, chemical, emotional, behavioral, and dietary factors.

Careful evaluation of these details should be followed by diligent action to mitigate and correct the obstacles to natural sleep.

Sleep hygiene works best when specific patterns are followed repeatedly and consistently without significant variation or interruption on a daily and weekly basis. This means that sleep and waking cycles should be observed and adhered to with as much regularity as possible.

Weekend changes in pattern and shift work that demands alterations in sleep cycles should be avoided. For best results, follow the same schedule, without significant variation, 24–7, year-round.

Evaluation and Care

If you have insomnia, a thorough medical screening is essential since nearly 50 percent of cases are related to pre-existing medical conditions.

Any underlying illness or condition can be associated with insomnia. Some of the more common conditions include headaches, asthma, fibromyalgia, GERD, menopause, and pain syndromes.

Holistic management of these conditions can help improve your sleep by resolving the underlying situation and benefit your overall health by limiting your exposure to potentially toxic treatments and their side effects.

Classical homeopathic and holistic medical management can also reduce dependency on medications, thereby significantly reducing the risk of sleep complications from many illnesses.

Psychiatric and Emotional Disorders

Emotions have an extremely powerful effect on brain chemistry and sleep.

Approximately 40 percent of people with chronic insomnia suffer from coexisting psychiatric or emotional problems. Almost any psychiatric condition can contribute to insomnia. Examples include depression, bipolar disorder, anxiety disorder, panic disorder, obsessive-compulsive disorder (OCD), and paranoia.

In addition to psychiatric conditions, any significant change in emotional status can contribute to acute insomnia. Grief, worry, fear, joy, exaltation, and boredom are all associated with altered states of brain chemistry that can potentially disrupt your sleep.

A thorough mental-emotional inventory, including a review of significant changes in personal relationships, should be part of your treatment plan.

Investigation should also address any emotional state that may have been present at the time when the sleep disturbance initially developed, particularly if this condition began during childhood.

The role of emotional factors and stresses must be considered, including any learned fear of sleep or dread of insomnia, which can contribute to the problem.

Attention must be paid to any history of abuse, neglect, or trauma, which are all commonly associated with insomnia. These may require psychological counseling and psychotherapeutic intervention before improvement in sleep can be expected.

Since any strong emotion can impair your ability to sleep, it is important to become aware of them so that appropriate steps can be taken to resolve them. A variety of methods exist to help with these emotional states; however, the solution may be as simple as a conscious decision to set aside the issues at night and pick then up in the morning.

Techniques like meditation, visualization, and relaxation are extremely helpful tools that should be instituted early in treatment.

Many other interventions, including depth psychotherapy, cognitive behavioral therapy (CBT), autogenic training, biofeedback, hypnosis, paced respirations, and progressive muscle relaxation can be helpful in calming these emotional factors and increasing the likelihood of sleep.

Techniques of “paradoxical intention,” whereby the insomniac is advised to gently try to remain awake for as long as possible, can also be effective.

Classical homeopathic treatment can be helpful in many cases of psychiatric and emotionally driven insomnia.

The use of pharmaceutical medications to quell symptoms of insomnia should be reserved as a means of last resort since these agents will frequently complicate any chemical imbalances, introduce unpleasant and crippling side effects, and eventually worsen sleep in the long run.

Gift Within the Challenge

In some cases, shifting one’s perspective to accept the inevitability of insomnia can help neutralize the stress created by this condition. Once this situation is de-stressed, the time can be constructively utilized for inward reflection or meditation.

In this way, insomnia can be perceived as a window of opportunity to explore and quietly contemplate one’s life (an opportunity that is frequently missing in the busy, hectic world).

The gift of insomnia means that nighttime can become a time of deep reflection, introspection, poetic inspiration, solitude, and silence. Taking advantage of insomnia in this manner can diffuse angst and stress while providing personal insight, emotional freedom, and greater self-understanding. Insomnia might be considered an opportunity to creatively explore within.

This is the third of a 10-part series.

Next week: Chemical and herbal causes of insomnia

Dr. Whitmont is a classical homeopathic physician and internist who practices in New York. He is a clinical assistant professor of family and community medicine at New York Medical College. His website is