Can't Sleep? Ready To Call The Doctor? And What Will They Say?
What do you do when you can’t face another night of tossing and turning? After googling ‘why can’t I sleep’ and reading 100 articles that tell you to ‘just relax’ or spray some lavender on your pillow – you’re ready to scream. Staring at the clock, not able to sleep can be a very lonely place.
Sleep is one of the most essential things to health – and yet more than 30% of people in the UK report getting a poor night sleep most nights. And unfortunately more than 1/3 (35%) have suffered sleep problems for more than five years.
So, when you decide to reach out for help – where do you go? Do you make an appointment with your GP? Local holistic health adviser? Or try a meditation teacher?
I’m writing a series of articles interviewing health professionals and experts in the field to find out their opinions on what to do if you can’t get a good night’s sleep and why it’s become such an issue for so many of us.
For this interview, I spoke to a retired general doctor who practised for over 30 years in the UK. I wanted to find out what would typically happen if you book in to see your doctor and say, ‘I just can’t sleep’?
As she was retired and no longer practising, she was uncomfortable putting her name on this article. So, for her privacy sake, I will refer to her as ‘Dr. X’.
Michelle: What’s the first thing you would do when a patient comes in because they’re having difficulty sleeping?
Dr. X: The first step, we would always take is to take a personal history of the person and the issue. Our goal is to understand the patient’s current situation and what could be causing the sleep issues. Sometimes the person may be experiencing an acute bout of insomnia due to a divorce or bereavement or others it may be a more chronic issue that needs to be addressed. Sleep issues can be very complex and it’s important to try to understand as much as possible.
Michelle: What are the common causes of sleep issues and why do you think it’s such a problem for so many people?
Dr. X: The most common causes generally are stress, depression, worries, anxiety, family issues, job issues and of course caffeine. I don’t think people always have the coping skills to deal with stressful situations or understand the impact they can have on their health and their bodies in general. Something as simple as being how much caffeine there is in products like coffee or chocolate or energy drinks– and how much you’re consuming can make a big difference.
Michelle: What type of advice would you give someone who can’t sleep?
Dr. X: Well, I would encourage them to look at their lifestyle and see how they can add in things like more regular exercise and cutting back on caffeine. I would also advise patients to look into meditation, yoga or therapy to help cope with stress and anxiety. In some cases of depression or anxiety, medication could be helpful.
Michelle: And what if someone had done all of that and still was struggling, are there underlying medical issues that could be driving their sleeplessness?
Dr. X: Yes, in some cases a hyperactive thyroid could be causing sleep issues. Your doctor would see if there were other symptoms and check this with a blood test to measure your hormone levels.
We would also look out for symptoms of sleep apnoea, which is a relatively common condition where the walls of the throat relax and narrow during sleep, interrupting normal breathing.
(FYI - quick note from Michelle's - ‘apnea’ and ‘apnoea’ are the same condition and both correct spellings. Sleep Apnea is used in the United States and Sleep Apnoea in the United Kingdom, while Australia tends to use both versions.)
Sleep apnoea may lead to regularly interrupted sleep, which can have a big impact on quality of life and increases the risk of developing certain conditions. If we suspect someone has sleep apnoe, then usually you will be referred to a sleep clinic where your sleep will be monitored by a polygraph machine. You can learn more about this condition here.
Michelle: And what about sleeping pills? When would you prescribe them and do you think their helpful?
Dr. X: The decision to prescribe sleeping pills is taken on a case by case basis and very much down to the individual’s situation. Generally, if the patient was having acute insomnia – due to a stressful situation for example a redundancy, bereavement or divorce, I would prescribe sleeping tablets for a short period to help break the cycle.
In situations where it’s chronic insomnia, it’s much more difficult as sleeping tablets are not only very addictive, but also don’t deliver the same quality of sleep that you get naturally. They impact your thinking skills, memory and ability to function the next day.
Michelle: I know a lot of people who buy sleeping pills over the counter or online. If someone suspects they’re addicted to the pills, what advice and support is there for them from their doctor?
Dr. X: If someone is concerned about a possible addiction to sleeping tablets then they should definitely get in touch with their GP. Working together, they can work out a withdrawal plan and in some severe cases the GP can refer the person to a drug treatment session. Weaning yourself off tablets can be difficult and you will need to accept that in addition to changing some habits, you’ll likely have to experience a few sleepless nights.
So there you have it - what at least one doctor would say to you if you stepped into their office saying you can't sleep. So often, we struggle on our own with sleep issues, not wanting to ask for help. But there is help out there for you.
Making an appointment with your local doctor can open up some new thinking, advice and options. A professional medical opinion can break a stuck pattern and help with solutions – so take care of yourself and your body by getting the help you need.
p.s. - think you may have a problem with sleeping pills? Some signs that sleeping pill use has gotten out of control include:
Having several failed attempts to quit
Getting cravings for sleeping medications
Seeing more than one doctor for prescription refills
Continuing to take pills despite negative consequences
Experiencing frequent memory loss from the pills
If you are someone you know is experiencing issues with sleeping pills – you can get advice from a free 24/7 hotline here.