Symptom Finder - Treatment of Insomnia
Insomnia
1. Exclude caffeinated beverages (coffee, tea, coke, etc.), chocolates, and nuts from diet.
2. If pain is the cause for insomnia, treat that.
3. Look for gastroesophageal reflux and treat.
4. Perhaps, airway obstruction (Allergic rhinitis, etc.) is the cause. Treat that, not the insomnia (antihistamines, Flonase, Breathe Right strips, etc.).
5. Encourage regular exercise (at least a half mile of walking daily) if possible.
6. Eliminate drugs that may cause insomnia if possible.
7. Get rid of the concept that you must sleep. Losing a few nights sleep is no disaster. It is far worse to worry yourself sick about it.
8. Prescribe a combination of valerian root, tryptophan, and melatonin (Alteril), an over-the-counter preparation.
9. Try a tricyclic antidepressant such as amitriptyline (Elavil: 50–150 mg h.s.).
10. A nonbenzodiazepine drug like zolpidem (Ambiens) 2.5–10 mg h.s. or eszopiclone (Lunesta) 2–3 mg h.s. may be tried for short periods, but is unwise for long term treatment.
11. Avoid benzodiazepines at all cost because, they accumulate in the body for long periods. For example, if a patient takes a single dose of diazepam for sleep, it may stay in the system for 3–6 months.
12. Refer for psychiatric evaluation.
13. Order an overnight sleep study.
1. Exclude caffeinated beverages (coffee, tea, coke, etc.), chocolates, and nuts from diet.
2. If pain is the cause for insomnia, treat that.
3. Look for gastroesophageal reflux and treat.
4. Perhaps, airway obstruction (Allergic rhinitis, etc.) is the cause. Treat that, not the insomnia (antihistamines, Flonase, Breathe Right strips, etc.).
5. Encourage regular exercise (at least a half mile of walking daily) if possible.
6. Eliminate drugs that may cause insomnia if possible.
7. Get rid of the concept that you must sleep. Losing a few nights sleep is no disaster. It is far worse to worry yourself sick about it.
8. Prescribe a combination of valerian root, tryptophan, and melatonin (Alteril), an over-the-counter preparation.
9. Try a tricyclic antidepressant such as amitriptyline (Elavil: 50–150 mg h.s.).
10. A nonbenzodiazepine drug like zolpidem (Ambiens) 2.5–10 mg h.s. or eszopiclone (Lunesta) 2–3 mg h.s. may be tried for short periods, but is unwise for long term treatment.
11. Avoid benzodiazepines at all cost because, they accumulate in the body for long periods. For example, if a patient takes a single dose of diazepam for sleep, it may stay in the system for 3–6 months.
12. Refer for psychiatric evaluation.
13. Order an overnight sleep study.
