Struggling with Sleep: A 38-Year-Old's Battle with Insomnia

Unable to sleep at night and unable to sit still during the day?

Dear Dr.
Chen,
I have a wonderful sister who is 38 years old this year.
She has been unable to fall asleep on her own at night and relies on medication to sleep for only two or three hours.
During the day, while others can sit comfortably in a chair, she cannot enjoy such simple pleasures.
It is truly heartbreaking.
I am unsure how to help her, and I would willingly sacrifice my own life if it could save her.
I hope that someone kind can assist us.
I also seek your guidance, Dr.
Chen, and I would be eternally grateful for your help.
Thank you, and I wish you health and happiness.
Sincerely,
Kine
November 19, 2001

kine, 40~49 year old female. Ask Date: 2002/11/19

Dr. Chen Guifeng reply Internal Medicine

Insomnia has many causes, most of which are psychological or mental factors.
If it is severe, it must be treated with psychotherapy by a psychiatrist.

Reply Date: 2002/11/19

More Info

Dear Kine,
Thank you for reaching out regarding your sister's struggles with insomnia. It's clear that you care deeply for her well-being, and it's commendable that you're seeking help on her behalf. Insomnia can be a complex issue, and understanding its underlying causes is crucial for effective treatment.

Insomnia, defined as difficulty falling asleep, staying asleep, or waking up too early, can stem from various factors, including psychological, physiological, and environmental influences. In your sister's case, relying on medication to sleep for only two to three hours each night suggests that there may be underlying issues that need to be addressed.

1. Psychological Factors: Anxiety and stress are common culprits of insomnia. If your sister is experiencing significant life stressors, such as work-related pressures, personal relationships, or unresolved emotional issues, these could be contributing to her sleep difficulties. Cognitive Behavioral Therapy for Insomnia (CBT-I) is a highly effective non-pharmacological treatment that focuses on changing thoughts and behaviors related to sleep. It may be beneficial for her to consult a mental health professional who specializes in this area.

2. Physiological Factors: Conditions such as depression, chronic pain, or hormonal changes (like those experienced during perimenopause) can also disrupt sleep. A thorough medical evaluation is essential to rule out any underlying health issues. Your sister may benefit from a comprehensive assessment by a healthcare provider, including a review of her medical history, physical examination, and possibly sleep studies to monitor her sleep patterns.

3. Sleep Hygiene: Encouraging good sleep hygiene practices can significantly improve sleep quality. This includes maintaining a consistent sleep schedule, creating a comfortable sleep environment, limiting screen time before bed, and avoiding stimulants like caffeine and nicotine in the hours leading up to sleep. Engaging in relaxation techniques, such as mindfulness meditation or gentle yoga, can also help reduce anxiety and promote better sleep.

4. Medication Management: While medications can provide short-term relief, they are not a long-term solution for insomnia. It's important for your sister to discuss her current medication regimen with her healthcare provider. They may consider adjusting her dosage, switching to a different medication, or exploring alternative treatments. Gradually tapering off sleep medications under medical supervision may also be necessary if she has been using them for an extended period.

5. Support System: As her sister, your support is invaluable. Encourage her to talk about her feelings and experiences, and remind her that she is not alone in this struggle. Sometimes, just knowing that someone cares can alleviate some of the burden she may feel.

In conclusion, insomnia is a multifaceted issue that requires a comprehensive approach to treatment. By addressing psychological, physiological, and lifestyle factors, your sister can work towards achieving better sleep. Encourage her to seek professional help and explore various treatment options. Your willingness to support her in this journey is a powerful testament to your love and commitment to her health.

Wishing you both the best in navigating this challenging situation.

Warm regards,
Doctor Q&A Teams

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