Insomnia

Nightmares do not usually signify a medical or mental health problem, but when nightmares are recurrent it is worth considering whether you are having significant problems with depression or anxiety. One condition that commonly causes nightmares is "post-traumatic stress syndrome." In this case, the nightmares may be flashbacks to a severely stressful or painful event, but they do not have to be.

It is appropriate to discuss your symptoms with your doctor. In addition to addressing your mental health needs, you should consider these strategies to improve your sleep

• Seek training in relaxation or "biofeedback" techniques, such as tightening and relaxing each of your muscles in a planned order.

• Avoid going to bed hungry.

• Avoid daytime naps, and sleep only as much as you require.

• Maintain a regular bedtime.

• Establish an active daytime lifestyle that allows you to go to bed ready for rest. It is preferable that you complete any vigorous exercise four or five hours prior to your bedtime.

• Reduce the mental stimulation that you experience after you have put yourself to bed. This means discontinuing bedtime television, reading, and conversation.

• Reduce noise stimulation within your bedroom. This may require the use of a device that can drown out interesting noises with a monotonous sound, such as a fan or a radio that is tuned to static between stations.

Most people who are reacting to emotional stress do not require medications to assist with sleep and find relaxation techniques or therapy sessions to assist in stress management most helpful. If your sleep problems do not respond quickly to simple strategies to improve your sleep, you may obtain relief from treatment by a therapist or prescription treatment for your depression or anxiety. Some depression treatments are particularly helpful at assisting with insomnia. If you decide with your physician that a prescription sleep aid ("sleeping pill") may be helpful and it is one that is not also an antidepressant medicine, it is appropriate to use the sleep aid only for a short term (typically less than two weeks). Some doctors recommend sleeping pills during the time that a prescribed anti-depressant medicine has not yet had its full effect. Over-the-counter sleep treatments can cause symptoms that persist into daytime hours and are not recommended.

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