Sleep Disorders

What Can You Do About Insomnia?


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Summary & Participants

Just about everyone has experienced insomnia at some point, but for many people it's a recurring problem. There are many remedies to try: from sleeping pills to warm milk to counting sheep. What really works? Can some techniques do more harm than good? Join our specialists as they examine the best and worst solutions for the sleepless.

Medically Reviewed On: July 21, 2009

Webcast Transcript


DAVID FOLK THOMAS: Welcome to our webcast. I'm David Folk Thomas.

Now if you are among the insomniacs of the world, you've probably tried any number of get-to-sleep-tricks. From counting sheep to sleeping pills to a warm glass of milk. What really works and what techniques do more harm than good?

Here to put the topic to rest are, on my left, Dr. Daniel Wagner. He's the medical director at the Sleep-Wake Disorder Center at the New York Presbyterian Hospital. And next to Dr. Wagner is Dr. Shelley Zak. She's an attending physician at the Sleep-Wake Disorder Center at the New York Presbyterian Hospital.

And let me start with you, Dr. Zak. What is insomnia?

SHELLEY ZAK, MD: Most people think of it as trouble falling asleep, but it can also be trouble staying asleep. Some people fall asleep fine and then keep waking up. And, finally, even unrefreshing sleep can be a symptom of insomnia.

DAVID FOLK THOMAS: So you're actually sleeping, but you're just not feeling refreshed?

SHELLEY ZAK, MD: Yes, when you wake up.

DAVID FOLK THOMAS: Now, Dr. Wagner, there's acute insomnia and chronic insomnia-- what's the difference between the two?

DANIEL WAGNER, MD: An acute insomnia is one that lasts less than two weeks. And in most cases, has an identifiable precipitant. Something happens or you have some big test coming up or a big presentation or something and you have trouble sleeping on account of that. And then once that situation passes, the insomnia goes away. That's usually trouble getting to sleep, but it may be trouble maintaining sleep as well.

DAVID FOLK THOMAS: And, Dr. Zak, what about the chronic form of insomnia, what is that?

SHELLEY ZAK, MD: This is the most difficult and this is the one that ends up lasting beyond a month. Multiple times during the week, you're waking or not being able to maintain sleep. And this is what we see most commonly. I think people with something that's acute, either it just passes or they go to their primary-care physician.

And chronic insomnia's often start from acute insomnias. We like to talk about perpetuating factors. In fact the irony is that some of the things people do to compensate for their short-term insomnia can promote insomnia and have it continue. So, for example, you don't get enough sleep. Well, the next night, you might try to go to bed much earlier than you should and spend too much time in bed. This doesn't get you any more sleep, it just fragments it and it has it become more unrefreshing.

Another thing people do, "Ah, I didn't get enough sleep, drink a lot of coffee." Well, that's fine, to some degree, because it can promote wakefulness at some level, but if you drink too much it will give you difficulty falling asleep the next night and then, again, you perpetuate it.

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