Clinical Perspective of Insomnia in Sleep Medicine


Alexander Scheer, MD, medical director at Scheer Medical Wellness, provided his medical perspective on insomnia in the clinical practice of sleep medicine.

Alexander Scheer, MD, medical director at Scheer Medical Wellness

Alexander Scheer, MD

Credit: Scheer Medical Wellness

Insomnia is not merely a minor disturbance in one's sleep pattern; it's a prevalent sleep disorder that significantly affects daily life. Individuals with insomnia struggle to fall asleep, stay asleep, or experience a non-restorative sleep, which doesn't feel refreshing. The consequences stretch beyond nighttime, leading to daytime fatigue, mood swings, difficulty concentrating, and a general decline in productivity and quality of life. While occasional sleep disturbances are common, chronic insomnia is a deeper, more persistent issue, often requiring professional intervention to address its underlying causes and mitigate its pervasive effects.

Insomnia doesn't discriminate, but certain factors can elevate one's risk of developing this sleep disorder. Age is a significant factor, with older adults experiencing shifts in sleep patterns and health conditions that can interrupt sleep. Women, too, are particularly susceptible, often due to hormonal changes related to menstruation, pregnancy, or menopause. Psychological factors, notably stress and mental health disorders like anxiety and depression, create a conducive environment for insomnia. Furthermore, lifestyle choices such as irregular sleep schedules, poor dietary habits, and certain medications can disrupt the body's natural sleep-wake cycle, paving the way for sleepless nights.

Combatting insomnia begins with fostering an environment and routine conducive to sleep. Establishing a regular sleep schedule, going to bed and waking up at the same time every day, helps synchronize the body's internal clock. Creating a bedtime ritual that promotes relaxation, be it through reading, a warm bath, or meditation, signals the body that it's time to wind down. The sleep environment should be a sanctuary for rest, characterized by comfort, quietness, and minimal light. Moreover, limiting exposure to screens and blue light before bedtime is crucial, as they can disrupt the production of melatonin, the hormone responsible for sleep. Dietary habits also play a role; avoiding heavy meals, caffeine, and alcohol close to bedtime can prevent sleep disturbances.

For those grappling with insomnia, several strategies can offer relief. Cognitive Behavioral Therapy (CBT) for Insomnia is a structured program that addresses the thoughts and behaviors undermining sleep and replaces them with habits conducive to rest. In some cases, under medical supervision, sleep medications can provide temporary relief. However, their long-term efficacy and potential for dependence make them a less favorable option for chronic insomnia. Instead, incorporating stress management and relaxation techniques into daily routines can prove beneficial. Regular physical activity, too, promotes better sleep, though it's advisable to avoid vigorous workouts close to bedtime. Insomnia, while challenging, is not insurmountable. It necessitates a multifaceted approach, combining lifestyle adjustments, behavioral strategies, and, when necessary, professional intervention. Cultivating a conducive sleep environment and routine, managing stress and dietary habits, and staying physically active are foundational steps toward better sleep. With the right support and strategies, those suffering from insomnia can navigate their way to restful nights and more vibrant, energetic days. It's a journey of patience and persistence, but the destination—a good night's sleep—is within reach.

In conclusion, achieving restorative sleep and mitigating the effects of insomnia involves a holistic approach: maintaining a consistent sleep schedule to regulate the body's internal clock, creating a bedtime routine that signals the body to wind down, and ensuring the sleep environment is conducive to rest. It also includes managing stress through relaxation techniques or therapy, exercising regularly while being mindful of timing, and being cautious with dietary habits, particularly before bedtime. For persistent cases of insomnia, seeking professional advice for tailored treatments or cognitive behavioral strategies is crucial. Ultimately, understanding and addressing the multifaceted nature of sleep health is key to overcoming insomnia and embracing the rejuvenating power of quality sleep.

Scheer is a physician who treats patients in New York City with regenerative therapies. He trained in neurosurgery and provides treatment for back/neck pain, joint arthritis, sports injuries, systemic conditions as well. This includes ALS, MS, stroke, heart/kidney failure, neuropathy, COPD and many other conditions. Scheer attended medical school at New York Medical College, then served his internship at Mount Sinai Beth Israel and a residency in neurological surgery at the Albert Einstein College of Medicine.

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