Top 10 Stress Management Techniques

Stress Management Techniques

1. Organize Yourself.
Take better control of the way you're spending your time and energy so you can handle stress
more effectively.
2. Control Your Environment by controlling who and what is surrounding you.
In this way, you can either get rid of stress or get support for yourself.
3. Love Yourself by giving yourself positive feedback.
Remember, you are a unique individual who is doing the best you can.
4. Reward Yourself by planning leisure activities into your life.
It really helps to have something to look forward to.
5. Exercise Your Body since your health and productivity depend upon your body's ability
to bring oxygen and food to its cells.
Therefore, exercise your heart and lungs regularly, a minimum of three days per week for 15-30
minutes. This includes such activities as walking, jogging, cycling, swimming, aerobics, etc.
6. Relax Yourself by taking your mind off your stress and concentrating on breathing and
positive thoughts.
Dreaming counts, along with meditation, progressive relaxation, exercise, listening to relaxing
music, communicating with friends and loved ones, etc.
7. Rest Yourself as regularly as possible.
Sleep 7-8 hours a night. Take study breaks. There is only so much your mind can absorb at one
time. It needs time to process and integrate information. A general rule of thumb: take a ten
minute break every hour. Rest your eyes as well as your mind.
8. Be Aware of Yourself.
Be aware of distress signals such as insomnia, headaches, anxiety, upset stomach, lack of
concentration, colds/flu, excessive tiredness, etc. Remember, these can be signs of potentially
more serious disorders (i.e., ulcers, hypertension, heart disease).
9. Feed Yourself / Do Not Poison Your Body.
Eat a balanced diet. Avoid high calorie foods that are high in fats and sugar. Don't depend on
drugs and/or alcohol. Caffeine will keep you awake, but it also makes it harder for some to
concentrate. Remember, a twenty minute walk has been proven to be a better tranquilizer than
some prescription drugs.
10. Enjoy Yourself.

It has been shown that happier people tend to live longer, have less physical problems, and are
more productive. Look for the humor in life when things don't make sense. Remember, you are
very special and deserve only the best treatment from yourself.

52 Proven Tips for Stress Relief

1. Get up fifteen minutes earlier in the morning. The inevitable morning mishaps will be
less stressful.
2. Prepare for the morning the evening before. Set the breakfast table, make lunches, put
out the clothes you plan to wear, etc.
3. Don't rely on your memory. Write down appointment times, when to pick up the
laundry, when library books are due, etc.
4. Do nothing which, after being done, leads you to tell a lie.
5. Make duplicates of all keys. Bury a house key in a secret spot in the garden and carry a
duplicate car key in your wallet, apart from your key ring.
6. Practice preventive maintenance. Your car, appliances, home, and relationships will be
less likely to break down/fall apart "at the worst possible moment."
7. Be prepared to wait. A paperback can make a wait in a post office line almost pleasant.
8. Procrastination is stressful. Whatever you want to do tomorrow, do today; whatever you
want to do today, do it now.
9. Plan ahead. Don't let the gas tank get below one-quarter full; keep a well-stocked
"emergency shelf" of home staples; don't wait until you're down to your last bus token or
postage stamp to buy more; etc.
10. Don't put up with something that doesn't work right. If your alarm clock, wallet, shoe
laces, windshield wipers - whatever- are a constant aggravation, get them fixed or get
new ones.
11. Allow 15 minutes of extra time to get to appointments. Plan to arrive at an airport one
hour before domestic departures.
12. Eliminate (or restrict) the amount of caffeine in your diet.
13. Always set up contingency plans, "just in case." ("If for some reason either of us is
delayed, here's what we'll do. . ." kind of thing. Or, "If we get split up in the shopping

center, here's where we'll meet.")

14. Relax your standards. The world will not end if the grass doesn't get mowed this
weekend.
15. Pollyanna-Power! For every one thing that goes wrong, there are probably 10 or 50 or
100 blessings. Count 'em!
16. Ask questions. Taking a few moments to repeat back directions, what someone expects
of you, etc., can save hours. (The old "the hurrieder I go, the behinder I get," idea.)
17. Say "No!" Saying "no" to extra projects, social activities, and invitations you know you
don't have the time or energy for takes practice, self-respect, and a belief that everyone,
everyday, needs quiet time to relax and be alone.
18. Unplug your phone. Want to take a long bath, meditate, sleep, or read without
interruption? Drum up the courage to temporarily disconnect. (The possibility of there
being a terrible emergency in the next hour or so is almost nil.) Or use an answering
machine.
19. Turn "needs" into preferences. Our basic physical needs translate into food, water, and
keeping warm. Everything else is a preference. Don't get attached to preferences.
20. Simplify, simplify, simplify. . .
21. Make friends with non-worriers. Nothing can get you into the habit of worrying faster
than associating with chronic worrywarts.
22. Get up and stretch periodically if your job requires that you sit for extended periods.
23. Wear earplugs. If you need to find quiet at home, pop in some earplugs.
24. Get enough sleep. If necessary, use an alarm clock to remind you to go to bed.
25. Create order out of chaos. Organize your home and workspace so that you always know
exactly where things are. Put things away where they belong and you won't have to go
through the stress of losing things.
26. When feeling stressed, most people tend to breathe short, shallow breaths. When you
breathe like this, stale air is not expelled, oxidation of the tissues is incomplete, and
muscle tension frequently results. Check your breathing throughout the day, and before,
during, and after high-pressure situations. If you find your stomach muscles knotted and
your breathing is shallow, relax all your muscles and take several deep, slow breaths.
27. Writing your thoughts and feelings down (in a journal, or on paper to be thrown away)

can help you clarify things and can give you a renewed perspective
28. Try the following yoga technique whenever you feel the need to relax. Inhale deeply
through your nose to the count of eight. Then, with lips puckered, exhale very slowly
through your mouth to the count of 16, or for as long as you can. Concentrate on the long
sighing sound and feel the tension dissolve. Repeat 10 times.
29. Inoculate yourself against a feared event. Example: before speaking in public, take
time to go over every part of the experience in your mind. Imagine what you'll wear,
what the audience will look like, how you will present your talk, what the questions will
be and how you will answer them, etc. Visualize the experience the way you would have
it be. You'll likely find that when the time comes to make the actual presentation, it will
be "old hat" and much of your anxiety will have fled.
30. When the stress of having to get a job done gets in the way of getting the job done,
diversion - a voluntary change in activity and/or environment - may be just what you
need.
31. Talk it out. Discussing your problems with a trusted friend can help clear your mind of
confusion so you can concentrate on problem solving.
32. One of the most obvious ways to avoid unnecessary stress is to select an environment
(work, home, leisure) which is in line with your personal needs and desires. If you hate
desk jobs, don't accept a job which requires that you sit at a desk all day. If you hate to
talk politics, don't associate with people who love to talk politics, etc.
33. Learn to live one day at a time.
34. Every day, do something you really enjoy.
35. Add an ounce of love to everything you do.
36. Take a hot bath or shower (or a cool one in summertime) to relieve tension.
37. Do something for somebody else.
38. Focus on understanding rather than on being understood; on loving rather than on
being loved.
39. Do something that will improve your appearance. Looking better can help you feel
better.
40. Schedule a realistic day. Avoid the tendency to schedule back-to-back appointments;
allow time between appointments for a breathing spell.

41. Become more flexible. Some things are worth not doing perfectly and some issues are
fine to compromise upon.
42. Eliminate destructive self-talk: "I'm too old to. . .," "I'm too fat to. . .," etc.
43. Use your weekend time for a change of pace. If your work week is slow and patterned,
make sure there is action and time for spontaneity built into your weekends. If your work
week is fast-paced and full of people and deadlines, seek peace and solitude during your
days off. Feel as if you aren't accomplishing anything at work? Tackle a job on the
weekend which you can finish to your satisfaction.
44. "Worry about the pennies and the dollars will take care of themselves." That's another
way of saying: take care of the todays as best you can and the yesterdays and the
tomorrows will take care of themselves.
45. Do one thing at a time. When you are with someone, be with that person and with no
one or nothing else. When you are busy with a project, concentrate on doing that project
and forget about everything else you have to do.
46. Allow yourself time - everyday - for privacy, quiet, and introspection.
47. If an especially unpleasant task faces you, do it early in the day and get it over with, then
the rest of your day will be free of anxiety.
48. Learn to delegate responsibility to capable others.
49. Don't forget to take a lunch break. Try to get away from your desk or work area in body
and mind, even if it's just for 15 or 20 minutes.
50. Forget about counting to 10. Count to 1,000 before doing something or saying anything
that could make matters worse.
51. Have a forgiving view of events and people. Accept the fact that we live in an imperfect
world.
52. Have an optimistic view of the world. Believe that most people are doing the best they
can.

2004 Santa C

What Causes Insomnia?

Insomnia can be caused by psychiatric and medical conditions, unhealthy sleep habits, specific
substances, and/or certain biological factors. Recently, researchers have begun to think about
insomnia as a problem of your brain being unable to stop being awake (your brain has a sleep
cycle and a wake cyclewhen one is turned on the other is turned offinsomnia can be a
problem with either part of this cycle: too much wake drive or too little sleep drive). It's
important to first understand what could be causing your sleep difficulties.

How Much Sleep Do You Need?

Video production in partnership with

Medical Causes of Insomnia

There are many medical conditions (some mild and others more serious) that can lead to
insomnia. In some cases, a medical condition itself causes insomnia, while in other cases,
symptoms of the condition cause discomfort that can make it difficult for a person to sleep.
Examples of medical conditions that can cause insomnia are:

Nasal/sinus allergies

Gastrointestinal problems such as reflux

Endocrine problems such as hyperthyroidism

Arthritis

Asthma

Neurological conditions such as Parkinson's disease

Chronic pain

Low back pain

Medications such as those taken for the common cold and nasal allergies, high blood pressure,
heart disease, thyroid disease, birth control, asthma, and depression can also cause insomnia.
In addition, insomnia may be a symptom of underlying sleep disorders. For example, restless
legs syndromea neurological condition in which a person has an uncomfortable sensation of
needing to move his or her legscan lead to insomnia. Patients with restless legs syndrome
typically experience worse symptoms in the later part of the day, during periods of inactivity, and
in the transition from wake to sleep, which means that falling asleep and staying asleep can be
difficult. An estimated 10 percent of the population has restless legs syndrome.

Sleep apnea is another sleep disorder linked to insomnia. With sleep apnea, a person's airway
becomes partially or completely obstructed during sleep, leading to pauses in breathing and a
drop in oxygen levels. This causes a person to wake up briefly but repeatedly throughout the
night. People with sleep apnea sometimes report experiencing insomnia.
If you have trouble sleeping on a regular basis, it's a good idea to review your health and think
about whether any underlying medical issues or sleep disorders could be contributing to your
sleep problems. In some cases, there are simple steps that can be taken to improve sleep (such as
avoiding bright lighting while winding down and trying to limit possible distractions, such as a
TV, computer, or pets). While in other cases, it's important to talk to your doctor to figure out a
course of action. You should not simply accept poor sleep as a way of lifetalk to your doctor or
a sleep specialist for help.

Insomnia & Depression

Insomnia can be caused by psychiatric conditions such as depression. Psychological struggles
can make it hard to sleep, insomnia itself can bring on changes in mood, and shifts in hormones
and physiology can lead to both psychiatric issues and insomnia at the same time.
Sleep problems may represent a symptom of depression, and the risk of severe insomnia is much
higher in patients with major depressive disorders. Studies show that insomnia can also trigger or
worsen depression.

What is Insomnia?
Video production in partnership with
It's important to know that symptoms of depression (such as low energy, loss of interest or
motivation, feelings of sadness or hopelessness) and insomnia can be linked, and one can make
the other worse. The good news is that both are treatable regardless of which came first.

Insomnia & Anxiety

Most adults have had some trouble sleeping because they feel worried or nervous, but for some
it's a pattern that interferes with sleep on a regular basis. Anxiety symptoms that can lead to
insomnia include:

Tension

Getting caught up in thoughts about past events

Excessive worrying about future events

Feeling overwhelmed by responsibilities

A general feeling of being revved up or overstimulated

It's not hard to see why these symptoms of general anxiety can make it difficult to sleep. Anxiety
may be associated with onset insomnia (trouble falling asleep), or maintenance insomnia
(waking up during the night and not being able to return to sleep). In either case, the quiet and
inactivity of night often brings on stressful thoughts or even fears that keep a person awake.
When this happens for many nights (or many months), you might start to feel anxiousness, dread,
or panic at just the prospect of not sleeping. This is how anxiety and insomnia can feed each
other and become a cycle that should be interrupted through treatment. There are cognitive and
mind-body techniques that help people with anxiety settle into sleep, and overall healthy sleep
practices that can improve sleep for many people with anxiety and insomnia.

Insomnia & Lifestyle

Insomnia can be triggered or perpetuated by your behaviors and sleep patterns. Unhealthy
lifestyles and sleep habits can create insomnia on their own (without any underlying psychiatric
or medical problem), or they can make insomnia caused by another problem worse.
Examples of how specific lifestyles and sleep habits can lead to insomnia are:

You work at home in the evenings. This can make it hard to unwind, and it
can also make you feel preoccupied when it comes time to sleep. The light
from your computer could also make your brain more alert.

You take naps (even if they are short) in the afternoon. Short naps can be
helpful for some people, but for others they make it difficult to fall asleep at
night.

You sometimes sleep in later to make up for lost sleep. This can confuse your
body's clock and make it difficult to fall asleep again the following night.

You are a shift worker (meaning that you work irregular hours). Nontraditional hours can confuse your body's clock, especially if you are trying to
sleep during the day, or if your schedule changes periodically.

Some cases of insomnia start out with an acute episode but turn into a longer-term problem. For
example, let's say a person can't sleep for a night or two after receiving bad news. In this case, if
the person starts to adopt unhealthy sleep habits such as getting up in the middle of the night to
work, or drinking alcohol before bed to compensate, the insomnia can continue and potentially
turn into a more serious problem. Instead of passing, it can become chronic.
Once this happens, worry and thoughts such as, "I'll never sleep," become associated with
bedtime, and every time the person can't sleep, it reinforces the pattern.

This is why it's important to address insomnia instead of letting it become the norm. If lifestyle
and unhealthy sleep habits are the cause of insomnia, there are cognitive behavioral
techniques and sleep hygiene tips that can help. If you have tried to change your sleep behaviors
and it hasn't worked, it's important to take this seriously and talk to your doctor.

Insomnia & Food

Certain substances and activities, including eating patterns, can contribute to insomnia. If you
can't sleep, review the following lifestyle factors to see if one or more could be affecting you:
Alcohol is a sedative. It can make you fall asleep initially, but may disrupt your sleep later in the
night.
Caffeine is a stimulant. Most people understand the alerting power of caffeine and use it in the
morning to help them start the day and feel productive. Caffeine in moderation is fine for most
people, but excessive caffeine can cause insomnia. A 2005 National Sleep Foundation poll found
that people who drank four or more cups/cans of caffeinated drinks a day were more likely than
those who drank zero to one cups/cans daily to experience at least one symptom of insomnia at
least a few nights each week.
Caffeine can stay in your system for as long as eight hours, so the effects are long lasting. If you
have insomnia, do not consume food or drinks with caffeine too close to bedtime.
Nicotine is also a stimulant and can cause insomnia. Smoking cigarettes or tobacco products
close to bedtime can make it hard to fall asleep and to sleep well through the night. Smoking is
damaging to your health. If you smoke, you should stop.
Heavy meals close to bedtime can disrupt your sleep. The best practice is to eat lightly before
bedtime. When you eat too much in the evening, it can cause discomfort and make it hard for
your body to settle and relax. Spicy foods can also cause heartburn and interfere with your sleep.

Insomnia & The Brain

In some cases, insomnia may be caused by certain neurotransmitters in the brain that are known
to be involved with sleep and wakefulness.
There are many possible chemical interactions in the brain that could interfere with sleep and
may explain why some people are biologically prone to insomnia and seem to struggle with sleep
for many years without any identifiable causeeven when they follow healthy sleep advice.

ant Sleep?
Causes, Cures, and Treatments for Insomnia

Do you struggle to get to sleep no matter how tired you are? Or do you wake up in the middle of
the night and lie awake for hours, anxiously watching the clock? Insomnia is a common problem
that takes a toll on your energy, mood, health, and ability to function during the day. Chronic
insomnia can even contribute to serious health problems. But you dont have to resign yourself to
sleepless nights. Simple changes to your lifestyle and daily habits can put a stop to insomnia
without the need for medication.

Cant sleep? Understanding insomnia and its symptoms

Insomnia is the inability to get the amount of sleep you need to wake up feeling rested and
refreshed. Because different people need different amounts of sleep, insomnia is defined by the
quality of your sleep and how you feel after sleepingnot the number of hours you sleep or how
quickly you doze off. Even if youre spending eight hours a night in bed, if you feel drowsy and
fatigued during the day, you may be experiencing insomnia.
Symptoms of insomnia can include:

Difficulty falling asleep despite being tired

Trouble getting back to sleep when waking up in the night

Waking up too early in the morning

Relying on sleeping pills or alcohol to fall asleep

Not feeling refreshed after sleep

Daytime drowsiness, fatigue, or irritability

Difficulty concentrating during the day

Causes of insomnia: Figuring out why you cant sleep

In order to properly resolve your insomnia, you need to become a sleep detective. Emotional
issues such as stress, anxiety, and depression cause about half of all insomnia cases. But your
daytime habits, bedtime routine, and physical health can also play a major role.
Common causes of insomnia

Sometimes, insomnia only lasts a few days and goes away on its own, especially when the
insomnia is tied to an obvious temporary cause, such as stress over an upcoming presentation or
a painful breakup. Chronic insomnia, however, is usually tied to an underlying psychological or
medical issue.

Psychological problems and emotional distress. Anxiety and

depression are two of the most common causes of chronic insomnia. Other
common emotional and psychological causes include chronic or significant
life stress, anger, worry, grief, bipolar disorder, and trauma.

Medical problems or illness. Many medical conditions and diseases can

contribute to insomnia, including asthma, allergies, Parkinsons disease,
hyperthyroidism, acid reflux, kidney disease, and cancer. Chronic pain is also
a very common cause of insomnia.

Medications. Many prescription drugs can interfere with sleep, including

antidepressants, stimulants for ADHD, corticosteroids, thyroid hormone, high
blood pressure medications, and some contraceptives. Common over-thecounter culprits include cold and flu medications that contain alcohol, pain
relievers that contain caffeine (Midol, Excedrin), diuretics, and slimming pills.

Sleep disorders. Insomnia is itself a sleep disorder, but it can also be a

symptom of other sleep disorders, including sleep apnea, restless legs
syndrome, and circadian rhythm disturbances tied to jet lag or late-night shift
work.

Causes of insomnia you may overlook (and that are within your power to change!)

Its important to identify all possible causes of your insomnia, including things youre doing
during the day or leading up to bedtime that interfere with quality sleep.

Is your sleep environment noisy, too bright, or not very comfortable?

Do you watch TV, play video games, or use a computer, tablet or smartphone
in bed?

Do you drink caffeinated beverages (coffee, tea, soda) within eight hours of
bed?

Do you keep an irregular sleep schedule?

Do you exercise or eat late in the evening?

Do you use alcohol to fall asleep?

Insomnia cures and treatments: Changing habits that disrupt sleep

If medical or emotional problems are contributing to your insomnia, treating them first is
essential. But you also need to look at daytime habits and bedtime routines that contribute to
sleeplessness.
Using a sleep diary to identify insomnia-inducing habits

Some habits are so ingrained that you may overlook them as a possible contributor to your
insomnia. Maybe your Starbucks habit affects your sleep more than you realize. Or maybe
youve never made the connection between your late-night TV viewing or Internet surfing and
your sleep difficulties. Keeping a sleep diary is a helpful way to pinpoint habits and behaviors
contributing to your insomnia.
Adopting new habits to help you sleep

Stick to a regular sleep schedule. Support your biological clock by going

to bed and getting up at the same time every day, including weekends.

Avoid naps. Napping during the day can make it more difficult to sleep at
night. If you feel like you have to take a nap, limit it to 30 minutes before 3
p.m.

Limit caffeine, alcohol, and nicotine. Stop drinking caffeinated beverages

at least eight hours before bed. While alcohol can make you feel sleepy, it
interferes with the quality of your sleep, and nicotine is a stimulant.

Avoid late meals. Try to avoid heavy, rich foods within two hours of bed.
Fatty foods can take a lot of work for your stomach to digest and spicy or
acidic foods can cause heartburn.

Get regular exercise. Regular exercise can improve the symptoms of

insomnia, but its not a quick fix. It takes several months to feel the full
effects. Aim for 30 minutes or more of activity on most daysbut not too
close to bedtime.

Develop a better bedtime routine

Its not just what you do during the day that affects the quality of your sleep, but also those
things you do to prepare your mind and body for sleep.

Make sure your bedroom is quiet, dark, and cool. Noise, light, and heat
can interfere with sleep. Try using a sound machine or earplugs to hide
outside noise, an open window or fan to keep the room cool, and blackout
curtains or a sleep mask to block out light.

Avoid stimulating activity and stressful situations before

bedtime. This includes vigorous exercise, big discussions or arguments, or
catching up on work. Instead, focus on quiet, soothing activities, such as
reading, knitting, or listening to soft music, while keeping lights low.

Turn off screens one hour before bedtime. The light emitted from TV,
tablets, smartphones, and computers suppresses your bodys production of
melatonin and can severely disrupt your sleep. Instead of emailing, texting,
watching TV, or playing video games, try listening to a book on tape, a
podcast, or reading by a soft light.

Coping with shift work

Working nights or irregular shifts can disrupt your sleep schedule. You may be able to limit the
adverse impact with these tips:

Adjust your sleep-wake cycle by exposing yourself to bright light when you
wake up at night, using bright lamps or daylight-simulation bulbs in your
workplace, and then wearing dark glasses on your journey home to block out
sunlight and encourage sleepiness.

Limit the number of night or irregular shifts you work in a row to prevent
sleep deprivation mounting up.

Avoid frequently rotating shifts so you can maintain the same sleep schedule.

Eliminate noise and light from your bedroom during the day. Use blackout
curtains or a sleep mask, turn off the phone, and use ear plugs or a soothing
sound machine to block out daytime noise.

Insomnia cures and treatments: Neutralize sleep anxieties

The more trouble you have with sleep, the more it starts to invade your thoughts. You may dread
going to sleep because youre going to toss and turn for hours or be up at 2 a.m. again. Or maybe
youre worried because you have a big day tomorrow, and if you dont get a solid eight hours,
youre sure to blow it. But agonizing about sleep only makes insomnia worse. Worrying floods
your body with adrenaline, and before you know it, youre wide-awake.
Learn to associate your bed with sleeping, not sleeplessness

Use the bedroom only for sleeping and sex. Dont work, read, watch TV,
or use your computer in bed or the bedroom. The goal is to associate the
bedroom with sleep alone, so that your brain and body get a strong signal
that its time to nod off when you get in bed.

Get out of bed when you cant sleep. Dont try to force yourself to sleep.
Tossing and turning only amps up the anxiety. Get up, leave the bedroom,
and do something relaxing, such as reading, drinking a warm cup of caffeine-

free tea, taking a bath, or listening to soothing music. When youre sleepy, go
back to bed.

Move bedroom clocks out of view. Anxiously watching the minutes tick by
when you cant sleepknowing that youre going to be exhausted when the
alarm goes offis a surefire recipe for insomnia. You can use an alarm, but
make sure you cant see the time when youre in bed.

Its also helpful to challenge the negative attitudes about sleep and your insomnia problem that
youve developed over time.
Challenging self-defeating thoughts that fuel insomnia
Self-defeating thought

Sleep-promoting comeback

Unrealistic expectations: I should be able to

sleep well every night like a normal person.

Lots of people struggle with sleep from time to

time. I will be able to sleep with practice.

Exaggeration: Its the same every single night, Not every night is the same. Some nights I do
another night of sleepless misery.
sleep better than others.
Catastrophizing: If I dont get some sleep, Ill I can get through the presentation even if Im
tank my presentation and jeopardize my job.
tired. I can still rest and relax tonight, even if I
cant sleep.
Hopelessness: Im never going to be able to
sleep well. Its out of my control.

Insomnia can be cured. If I stop worrying so

much and focus on positive solutions, I can beat
it.

Fortune telling: Its going to take me at least an I dont know what will happen tonight. Maybe
hour to get to sleep tonight. I just know it.
Ill get to sleep quickly if I use the strategies
Ive learned.

Insomnia cures and treatments: Tackle daytime stress and worries

Residual stress, worry, and anger from your day can make it difficult to fall asleep as night.

Get help with stress management. If the stress of managing work, family,
or school is keeping you awake at night, learning how to handle stress in a
productive way and to maintain a calm, positive outlook can help you sleep
better at night.

Talk over your worries during the day with a friend or loved one.
Talking face to face with someone who cares about you is a great way to
relieve stress and stop you rehashing worries when its time to sleep. The
person doesnt need to be able to fix your problems, but just needs to be an
attentive, nonjudgmental listener.

Harnessing your body's relaxation response

If you feel wound up much of the time and unable to let go of stress at the end of the day, you
may benefit from relaxation techniques such as meditation, yoga, and deep breathing. Not only
do relaxation techniques help you quiet your mind and relieve tension in the body, but they also
help you fall asleep faster and get back to sleep more quickly if you wake up in the middle of the
night.
Some popular smartphone apps can help guide you through the different relaxation methods, or
you can follow these techniques:

Abdominal breathing. Breathing deeply and fully, involving not only the
chest, but also the belly, lower back, and ribcage, can help relaxation. Close
your eyes and take deep, slow breaths, making each breath even deeper
than the last. Breathe in through your nose and out through your mouth.

Progressive muscle relaxation. Make yourself comfortable. Starting with

your feet, tense the muscles as tightly as you can. Hold for a count of 10, and
then relax. Continue to do this for every muscle group in your body, working
your way up from your feet to the top of your head.

Mindfulness meditation. Sit quietly and focus on your natural breathing

and on the way your body feels in the moment. Allow thoughts and emotions
to come and go without judgment, always returning to focus on breath and
your body.

It takes regular practice to learn these techniques and harness their stress-relieving power. But
the benefits can be huge. You can do them as part of your bedtime routine, when you are lying
down preparing for sleep, and if you wake up in the middle of the night.

Insomnia cures and treatments: Getting back to sleep if you wake up

While its normal to wake briefly during the night, if youre having trouble falling back to sleep,
the following tips may help.

Stay out of your head. The key to getting back to sleep is continuing to cue
your body for sleep. Hard as it may be, try not to stress over your inability to
fall asleep again, because that only encourages your body to stay awake. A
good way to stay out of your head is to focus on the feelings and sensations
in your body or to practice breathing exercises. Take a breath in, then breathe
out slowly while saying or thinking the word, Ahhh. Take another breath and
repeat.

Make relaxation (not sleep) your goal. If you find it hard to fall back
asleep, try a relaxation technique such as visualization, progressive muscle
relaxation, or meditation, which can be done without even getting out of bed.
Remind yourself that although theyre not a replacement for sleep, rest and
relaxation still help rejuvenate your body.

Do a quiet, non-stimulating activity. If youve been awake for more than

15 minutes, get out of bed and do a quiet, non-stimulating activity, such as
reading a book. Keep the lights dim so as not to cue your body clock to wake
up. Avoid using electronic screens of any kind as the light they emit
stimulates the brain.

Postpone worrying and brainstorming. If you wake at night feeling

anxious about something, make a brief note of it on paper and postpone
worrying about it until the next day when it will be easier to resolve. Similarly,
if a great idea is keeping you awake, make a note of it and postpone thinking
more about it until morning.

Insomnia cures and treatments: Sleep aids and sleeping pills

When youre tossing and turning at night, it can be tempting to pop a pill for relief. However, no
sleeping pill will cure the underlying cause of your insomnia, and some can even make the
problem worse in the long run.
Dietary supplements for insomnia

There are many herbal supplements marketed for their sleep-promoting effects. Some remedies,
such as lemon balm or chamomile tea, are generally harmless, while others can have side effects
and interfere with other medications and vitamins youre taking.
Two supplements for insomnia that are considered to be safe and effective are melatonin and
valerian.

Melatonin is a naturally occurring hormone that your body produces at

night. Melatonin supplements may be effective for short-term use, especially
in reducing jet lag. However, there are potential side effects, including nextday drowsiness.

Valerian is an herb with mild sedative effects that may help you sleep better.
However, the quality of valerian supplements varies widely.

Over the counter (OTC) sleep aids

The main ingredient in over-the-counter (OTC) sleeping pills is an antihistamine, generally taken
for allergies, hay fever, and cold symptoms. Sleep experts generally advise against their use
because of side effects, questions about their effectiveness, and lack of information about their
safety over the long term.
Prescription sleeping pills for insomnia

Prescription sleep medications may provide temporary relief, but can have serious side effects
and make insomnia worse in the long run. Its best to use medication only as a last resort, and
then, only on a very limited, as-needed basis. Evidence shows that lifestyle and behavioral
changes make the largest and most lasting difference when it comes to insomnia.

When to seek professional insomnia treatment

If youve tried the insomnia self-help strategies above and are still having trouble getting the
sleep you need, a doctor or sleep disorder specialist may be able to help. Seek professional help
for insomnia if:

Your insomnia doesnt respond to self-help

Your insomnia is causing major problems at home, work, or school

Youre experiencing scary symptoms like chest pain or shortness of breath

Your insomnia occurs almost every night and is getting worse

Bring a sleep diary with you. Your doctor may be able to diagnose an illness or sleep disorder
that's causing your insomnia, or refer you to a sleep specialist or cognitive behavioral therapist.
Cognitive behavioral therapy (CBT) for insomnia

CBT is aimed at breaking the cycle of insomnia. Poor sleep tends to lead to stress and anxious
thoughts about not being able to sleep. This in turn leads to stress and tension, which leads to
poor sleeping habits, such as the use of sleeping pills. This leads to worsening insomnia and so
on.
The Vicious Cycle of Insomnia

In addition to improving sleep habits, CBT is

aimed at changing thoughts and feelings about sleep that may be causing stress and contributing
to your insomnia. A therapist may also recommend sleep restriction therapy, whereby you
initially shorten your sleep time. The idea is that by limiting the time you spend in bed to the

number of hours you actually sleep, say from 1 a.m. to 6 a.m., you'll spend less time awake and
more time asleep. As your sleep efficiency increases you'll gradually start going to bed earlier
and getting up later until you reach your optimum sleep schedule.

Insomnia: Causes, Symptoms and Treatments

Written by Peter Crosta M.A.
Knowledge center
Last updated: Monday 21 September 2015
email
4463Share70

Insomnia is a sleep disorder that millions of people worldwide have to live with. Individuals
with insomnia find it difficult to either fall asleep and/or stay asleep.
Insomnia commonly leads to daytime sleepiness, lethargy and a general feeling of being unwell
both mentally and physically.
Contents of this article:
1. What is insomnia?
2. What causes insomnia?
3. Who gets insomnia?
4. Signs and symptoms
5. Tests and diagnosis
6. Treatment options

At the end of each section you may see details on recent developments that have been covered by
MNT's news stories.

What is insomnia?

According to a survey by the National Sleep Association, 22% of US people say they
experience insomnia every or almost every night.

Insomnia includes a wide range of sleeping disorders, from lack of quality of sleep to lack of
quantity of sleep.
Insomnia is commonly separated into three types:

Transient insomnia - occurs when symptoms lasts from a few days to some
weeks.

Acute insomnia - also called short-term insomnia. Symptoms persist for

several weeks.

Chronic insomnia - this type lasts for at least months, and sometimes
years. According to the National Institutes of Health1, the majority of chronic
insomnia cases are secondary, meaning they are side effects or symptoms of
some other problem.

Although insomnia can affect people at any age, it is more common in adult females than adult
males. The sleeping disorder can undermine school and work performance, as well as being a

cause of obesity, anxiety, depression, irritability, concentration problems, memory problems,

poor immune system function, and reduced reaction time. Insomnia has also been associated
with a higher risk of developing chronic diseases.
The National Sleep Foundation2 informs that between 30% and 40% of American adults say they
have had some symptoms of insomnia within the previous 12 months, and 10% to 15% of adults
claim to have chronic insomnia.
This video from NHS Choices gives expert information about insomnia, including what causes it
and different ways to deal with it.

What causes insomnia?

Insomnia can be caused by physical factors as well as psychological factors. There is often an
underlying medical condition that causes chronic insomnia, while transient insomnia may be due
to a recent event or occurrence.
Insomnia can commonly be caused by:

Studies have suggested that electronic devices with self-luminous "backlit" displays
can affect evening melatonin, which might result in delayed sleep.

Disruptions in circadian rhythm: jet lag, job shift changes, high altitudes,
noisiness, hotness or coldness

Psychological issues: people with mood disorders, such as bipolar disorder

or depression, as well as anxiety disorders or psychotic disorders are more
likely to have insomnia.

Medical conditions: brain lesions and tumors, stroke, chronic pain, chronic
fatigue syndrome, congestive heart failure, angina, acid-reflux disease
(GERD), chronic obstructive pulmonary disease, asthma, sleep apnea,
Parkinson's and Alzheimer's diseases, hyperthyroidism, arthritis

Hormones: estrogen, hormone shifts during menstruation

Other factors: sleeping next to a snoring partner, parasites, genetic

conditions, overactive mind, preganancy

Media technology in the bedroom - researchers from the University of

Helsinki, Finland, reported in the journal BMC Public Health that media
technology in the bedroom disrupts sleep patterns in children. They found
that children with TVs, computers, video games, DVD players and mobile
phones in their bedrooms slept considerably less than kids without these
devices in their bedrooms. In addition, a study conducted by Rensselaer
Polytechnic Institute found that back-lit tablet computers can affect sleep
patterns.

Medications - according to the American Association of Retired Persons3 (AARP), the following
medications are known to cause insomnia in some patients:

Corticosteroids - used for treating patients with allergic reactions, gout,

Sjgren's syndrome, lupus, rheumatoid arthritis, and inflammation of the
muscles and blood vessels. Examples include: prednisone, triamcinolone,
methylprednisolone and cortisone.

Statins - medications used for treating high cholesterol levels. Examples

include: simvastatin, rosuvastatin, lovastatin and atorvastatin.

Alpha blockers - used for treating hypertension (high blood pressure,

Raynaud's disease and BPH (benign prostatic hyperplasia). Examples include:
terazosin, silodosin, alfuzosin, prazosin, doxazosin and tamsulosin.

Beta blockers - used for treating hypertension and irregular heartbeat

(arrhythmias). Examples include: timolol, carvedilol, propranolol, atenolol,
metoprolol and sotalol.

SSRI antidepressants - used for treating depression. Examples include:

fluoxetine, citalopram, paroxetine, escitalopram, sertraline and fluvoxamine.

ACE inhibitors - used for the treatment of hypertension, and other heart
conditions. Examples include: ramipril, fosinopril, trandolapril, quinapril,
benazepril, enalapril, lisinopril, moexipril, perindopril and captopril.

ARBs (Angiotensin II-receptor blockers) - used when the patient cannot

tolerate ACE inhibitors or has type 2 diabetes or kidney disease from
diabetes. Examples include: candesartan, valsartan, telmisartan, losartan and
irbesartan.

Cholinesterase inhibitors - used for treating memory loss and other symptoms
for patients with dementia, including Alzheimer's disease. Examples include:
rivastigmine, donepezil and galantamine.

2nd generation (non-sedating) H1 agonists - used for treating allergic

reactions. Examples include: loratadine, levocetirizine, fexofenadine,
desloratadine, cetirizine and azelastine.

Glucosamine/chondroitin - dietary supplements used for relieving the

symptoms of joint pain and to reduce inflammation.

Who gets insomnia?

Shift workers commonly suffer with insomnia because of inconsistent sleep routines.

Some people are more likely to suffer from insomnia than others. These include:

Travelers

Shift workers with frequent changes in shifts

The elderly

Drug users

Adolescent or young adult students

Pregnant women

Menopausal women

Those with mental health disorders

Signs and symptoms of insomnia

Insomnia itself may be a symptom of an underlying medical condition. However, there are
several signs and symptoms that are associated with insomnia.

Difficulty falling asleep at night

Awakening during the night

Awakening earlier than desired

Still feeling tired after a night's sleep

Daytime fatigue or sleepiness

Irritability, depression or anxiety

Poor concentration and focus

Being uncoordinated, an increase in errors or accidents

Tension headaches

Difficulty socializing

Gastrointestinal symptoms

Worrying about sleeping.

Sleep deprivation can cause other symptoms. The afflicted person may wake up not feeling fully
awake and refreshed, and may have a sensation of tiredness and sleepiness throughout the day.
Having problems concentrating and focusing on tasks is common for people with insomnia.
According to the National Heart, Lung and Blood Institute4, 20% of non-alcohol related car crash
injuries are caused by driver sleepiness.

Tests and diagnosis

A sleep specialist usually will begin a diagnostic session by asking a battery of questions about
your medical history and sleep patterns. A physical exam may be conducted to look for
conditions that may be causing insomnia. Similarly, physicians may screen for psychiatric
disorders and drug and alcohol use.

The Stanford Center for Sleep Sciences and Medicine5 explains that the term "insomnia" is often
used colloquially in reference to "disturbed sleep".
For somebody to be diagnosed with an insomnia disorder their disturbed sleep should have
persisted for over one month. It should also negatively impact on the patient's well being, either
because of the distress it causes or because it undermines mood or performance.
A sleep specialist is trained to determine whether the symptoms are being caused by an
underlying condition.
The patient may be asked to keep a sleep diary in order to examine his or her sleeping patterns
more closely.
More sophisticated tests may be employed such as a polysomnograph, which is an overnight
sleeping test that records sleep patterns. In addition, actigraphy may be conducted, which uses a
small, wrist-worn device called an actigraph to measure movement and sleep-wake patterns.

Treatment options for insomnia

Some types of insomnia resolve themselves when the underlying cause is removed or wears off.
In general, treating insomnia focuses on determining the cause of the sleeping problems. Once
identified, this underlying cause can be properly treated or corrected. In addition to treating the
underlying cause of insomnia, both medical and non-pharmacological (behavioral) treatments
may be employed as adjuvant therapies.
Non-pharmacological approaches to treating insomnia include:

Improving "sleep hygiene" - don't over- or under-sleep, exercise daily,

don't force sleep, try to maintain a regular sleep schedule, avoid caffeine at
night, do not smoke, do not go to bed hungry, make sure the environment is
comfortable

Using relaxation techniques - such as meditation and muscle relaxation

Cognitive therapy - one-on-one counseling or group therapy

Stimulus control therapy - only go to bed when sleepy, refrain from TV,
reading, eating, or worrying in bed, set an alarm for the same time every
morning (even weekends), avoid long daytime naps

Sleep restriction - decrease the time spent in bed and partially deprive
your body of sleep so you are more tired the next night.

Medical treatments for insomnia include:

Prescription sleeping pills (often benzodiazepines)

Antidepressants

Over-the-counter sleep aids

Antihistamines

Melatonin

Ramelteon

Valerian officinalis.