Insomnia

Irregular hours for sleeping and waking, common among railroaders and their families, along with associated stress, can lead to the development of insomnia, the most common sleep disorder. People with insomnia report dissatisfaction with the amount or quality of their sleep.

Some wake up earlier than they wish, and cannot return to sleep. Some indicate that they feel unrefreshed on awakening, and irritable and moody while awake. Insomnia can make it hard to concentrate and pay attention, reduce motivation, and increase propensity for accidents and injuries.

While everyone experiences difficulty sleeping now and then, people with insomnia report that these problems occur frequently. About 10 percent of adults report having chronic insomnia, defined as trouble falling or staying asleep three or more nights a week, for three months or longer. Insomnia may contribute to or result from depression. In fact, having chronic insomnia increases a person’s risk for depression.

When sleep specialists diagnose insomnia, they verify that an individual’s difficulty sleeping occurs despite having adequate opportunities for sleep. Railroaders, and often their family members, struggle to create such opportunities. With work hours that may vary from day to day, railroaders seldom can go to bed and get up at the same time daily, and sleep for seven to nine hours, the amount most people need for optimal alertness.

That’s why sleep specialists recommend that people with irregular work hours strive to obtain anchor sleep, and sleep as many hours as possible at the same time every day. People who split their sleep into two or more chunks each day need to do their best to get the total daily amount of sleep they need, and not build up a sleep debt.

In addition to regularizing your schedule as much as possible, other tactics can help.

Use these self-help strategies:

• Create a sleep-friendly bedroom environment, free of noises, bright lights, and distractions, such as a television or computer.
• Develop a pre-sleep routine. Have a light snack, set out clothes or other items for the next day, and take a bath or shower.
• Avoid caffeine within four to six hours of bedtime. It usually lightens sleep, awakens you more often, prompts bathroom visits, and shortens overall sleep time, perhaps by as much as an hour.

• Avoid alcoholic drinks near bedtime. When alcohol’s sleep-inducing effect wears off, alcohol becomes a stimulant. It then may trigger early awakenings.

• Exercise if you can. Regular exercise benefits sleep. Some people find exercise close to bedtime delays sleep. Others say exercise near bedtime helps them relax and fall asleep faster. Since the best time for most people to exercise is whenever it’s convenient, exercise at different times of day, and let your experience be your guide.
• Finish writing email and playing computer games 30 minutes before bedtime. Then wind down. Listen to music or read.
• Don’t smoke. Nicotine also is a stimulant.

• Ask your healthcare provider about the impact of both prescription and non-prescription medications on your sleep. Medications taken for high blood pressure, colds, pain, asthma, and other illnesses, for example, often contain caffeine, and may prove arousing.

Treatment for insomnia

If you have persistent trouble falling asleep or staying asleep, talk with a healthcare provider. Several types of treatments may help.

• Mental or muscle relaxation exercises at bedtime can ease stress, and help you fall asleep. Learning meditation or yoga can reduce stress.

• Cognitive-behavioral therapies can help you improve sleep habits, and curb thoughts and worries that interfere with sleep.

• Herbal sleep aids. Rigorous scientific studies have not found herbal remedies sold as sleep aids to be effective.
• Prescription medications. Orhypnotics, commonly called sleeping pills, may help you fall asleep faster, and sleep more soundly. Some medications prescribed to reduce depression also may benefit sleep.
• Over-the-counter sleep aids. Products you can buy without a prescription often contain antihistamines, drugs that promote sleepiness. Use antihistamines with caution, as they may linger in the body, and cause drowsiness in waking hours.

• Melatonin supplements may help some people fall asleep a little faster, and perhaps sleep a little longer than they otherwise would. Melatonin is a hormone that tells your body it is night, and time to sleep. Melatonin supplements available without a prescription commonly contain 3 mg of melatonin, many times the amount the body usually makes on its own.