Essential Information for Patient and Family

• Temporary sleep problems are common at times of stress or medical illness.
• 6 hours of sleep per day may be normal and sufficient, especially for older people.
• The normal amount of sleep varies widely and usually decreases with age.
• Improving sleep habits (not sedative medication) is the best treatment.
• Worry about being able to sleep can worsen insomnia.
• Alcohol may help falling asleep but can lead to restless sleep and middle insomnia.
• Stimulants (including coffee and tea) can cause or worsen insomnia.

Specific Counselling to Patient and Family

• Maintain a regular sleep routine by:
  • relaxing activities in the evening
  • keeping to regular hours for going to bed and getting up in the morning, trying not to vary the schedule or "sleep in" on the weekend
  • Arise at the regular time even if the prior nights sleep was poor.
  • avoiding daytime naps since they can disturb the next night's sleep.
  • Practice relaxation exercises to aid in falling asleep.
  • Avoid caffeine and alcohol.
  • If unable to fall asleep after 20 minutes, get up and try again later when feeling sleepy.
  • Daytime exercise may help, but evening exercise may contribute to insomnia.
    

Medication

• Treat any underlying psychiatric or medical condition.
• Make needed changes in medication.
• Hypnotic medication may be used intermittently but should not be used regularly for more than 14 days because they lose their effect and patients can become dependent (e.g. Temazepam 10-20 mg at bedtime).

Specialist Consultation

• Consider consultation if you suspect more complex sleep disorders (e.g. narcolepsy, sleep apnoea).
• Consider consultation if significant insomnia continues despite the measures above.

What a doctor might say to a person with a sleep disorder