I am Not Able To Sleep. What Measures Can I Take?

Patient

Q: Im 19 years old and im having alot of trouble sleeping in the last few months, i goto bed when i feel tired but i toss and turn, i go to bed at a resonable hour (9pm-10.30pm) but i can still be awake for hours sometimes till 2-3am ! i have tryed everything but i just cant seem to relax .. i dont drink caffeine and rarely have alcohol, iv tried breathing excersises no tv or electronics, when i lay down to sleep my mind races and i start to stress out which ccauses me not to sleep, i just want to relax and have a good night sleep ! help!!

Doctor

A:   Insomia is a common complaint and is caused by difficulty in initiating or maintaining sleep. This leads to daytime drowsiness and decreased productivity. Insomia may be a symptom of an underlying pathology and needs evaluation. From the information that you have written I gather that you are having trouble initiating sleep (sleep onset insomnia) and this has been present for a few months.
In most of the cases, there is an underlying problem that leads to insomnia. This may be  due to psychiatric disorders (depression and anxiety), drug and alcohol abuse,  sleep apnea and certain underlying medical problems like obstructive pulmonary disease, congestive heart failure and gastroesophageal reflux disease.
It may be helpful in your case to consult your doctor who may order test like polysomnography, actigraphy and rule out evidence of depression and anxiety which are one of the main causes of insomnia. Nonpharmological treatments (sleep hygiene) are preferred during the initial phase of treatment with medications reserved only for severe cases of insomnia. Significant improvements are seen after initiating treatment, though regular follow ups are need to ensure compliance.

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