Sleep problems: what really works?

Possible causes of sleep problems

Waking up frequently, waking too early, or struggling to fall asleep are all signs of poor sleep. Insomnia is diagnosed when these issues occur at least three times a week and result in negative daytime effects, such as fatigue or irritability. Sleep problems can arise from various causes, including:   

• Poor sleep habits, such as going to bed too late, napping during the day, engaging in vigorous activities late in the evening, or keeping irregular schedules.   
• Lifestyle factors: an unbalanced diet, lack of physical activity, excessive or late caffeine consumption, smoking, and alcohol use.   
• Pain caused by illnesses or injuries, such as headaches, fractures, or arthritis.   
• Menopause: hormonal changes during this phase often disrupt sleep for many women.   
• Worrying before bedtime: when external distractions fade at night, recurring anxious thoughts can dominate.   
• Stress and anxiety: research indicates that stress and anxiety disorders significantly impair the ability to fall and stay asleep.   
• Medication and underlying health conditions can also contribute to sleep difficulties.   

Identifying the root cause of (severe) sleep problems is crucial for finding a solution. You can always consult a doctor to discuss your symptoms and explore potential treatments. Lifestyle changes, supplements, or medication may help address insomnia.   

How lifestyle can help improve sleep

Lifestyle plays a key role in the duration and quality of sleep. Diet, exercise, and sleep habits all influence rest. Here are some practical tips to improve sleep:   

• Follow a balanced diet rich in vegetables, fruits, whole grains, healthy fats, and water. Avoid smoking, alcohol, and caffeine later in the day. Limit water intake before bed to minimise nighttime bathroom visits.   
• Review your sleep habits: maintain a consistent bedtime and wake-up schedule, use the bedroom solely for sleeping, and switch off screens an hour before bed. Establish a calming bedtime routine.   
• Regular physical activity reduces stress and supports overall physical and mental well-being.   
• Breathing exercises can help relax the body and calm the mind.   

If these tips don’t provide sufficient relief, supplements or medication may offer support. It’s always important to identify the underlying cause. Supplements and medication should only be used temporarily and under medical supervision.   

Better and longer sleep with supplements?

Supplements can aid in improving or extending sleep. Always consult your doctor before using them, as some supplements may interact with medications or cause side effects. Research suggests that certain natural remedies may support better sleep, such as:   

• Melatonin: This hormone regulates sleep and is vital for our circadian rhythm (biological clock). Consult a doctor before use, as prolonged use may suppress the body’s natural melatonin production.   
• Magnesium: An essential mineral for various bodily functions. Some studies suggest magnesium may positively influence sleep quality and duration.   
• Valerian: Small studies suggest it may enhance sleep quality and help with falling asleep. However, more research is needed to confirm its long-term effects and potential side effects.   
• Glycine: An amino acid that promotes serotonin release, a hormone that helps the body relax. This may improve sleep quality, though further research is required to establish a direct link.   
• L-theanine: This amino acid may help reduce anxiety, stress, and sleep disturbances.   

If lifestyle changes and supplements don’t yield the desired results and you continue to experience (severe) sleep problems, consult a doctor. Medication is only prescribed in exceptional cases for severe insomnia.   

Which medication helps with insomnia?

In some cases, medication may be necessary to temporarily address or alleviate sleep issues. However, these medications can be habit-forming and are prescribed with caution. In certain situations, benzodiazepines are used to treat severe sleep problems. Short-acting medications, such as brotizolam, loprazolam, zolpidem, or zopiclone, are preferred. These are prescribed for short-term use, as their effectiveness diminishes after two weeks. A doctor may recommend them for short-term severe insomnia or when it significantly disrupts daytime functioning.   

How do sleep medications work?

Most sleep medications act on the brain, relaxing the muscles, calming the body, and inducing drowsiness. Short-acting medications are primarily used to help with falling asleep, while long-acting medications are prescribed to maintain sleep. It’s important to note that daytime drowsiness may also occur. Before considering medication, it’s essential to evaluate lifestyle and sleep habits due to the risk of dependency and side effects.   

What are the most common side effects?

All medications can cause side effects to varying degrees. Depending on the type of sleep medication, the most common side effects include:   

• Drowsiness (including during the day);   
• Constipation or diarrhoea;   
• Dizziness;   
• Headache;   
• Weakness;   
• Fatigue;   
• Stomach pain;   
• Acid reflux.   

Sleep medication is not recommended for individuals with hypersensitivity to any of its ingredients.   

Don’t wait to address sleep problems

Are you struggling with sleep problems or severe insomnia? Don’t delay—seek advice from a doctor. At Dokteronline, you can complete an online questionnaire to report your symptoms and receive a tailored treatment plan. One of our affiliated doctors will review your request and help determine the best course of action, with or without medication.