Dear New Shrink,

I have a very hard time getting the rest I need each night. My doctor has given me some medication but told me not to take it every evening. I don’t really want to take it at all but sometimes it is the only way I can sleep for more than a couple of hours.

I often fall asleep but wake up within a few hours and toss and turn and I worry about things like work, family, problems my friends are having, finances; I guess I worry about everything. Sometimes it is work related and I am figuring out how to handle something the next day, but often it is really nothing to worry about because I can’t do anything about it. My parents are older now and I worry about them dying, but as you can see, I can’t really do much of anything about this.

I hate this because I want to get up and workout and I need to if I am going to keep my weight down. Also, I feel much more energetic if I work out in the morning, but if I don’t sleep, I sometimes do not have time to go to the gym in the morning before I leave for work.

Do you have any thoughts on what is wrong or what I can do?

Signed,

Insomniac

Dear Insomniac,

Please don’t feel alone. Research shows that over one third of people report problems with sleep.

You mention medication. Your doctor is probably worried about you becoming dependent on the medication, which can definitely happen and then you will either need to continue it indefinitely or taper off of it. Most people do not become addicted to sleep aids and there are newer ones that don’t even create dependence. Addiction is where you take more and more and go to any lengths to obtain a drug and you also have a change in your normal behavior and emotions. This might happen with those who have histories of addiction but it is uncommon.

You also say you prefer not to take medication. The good news is that the research has shown that you don’t need to because the equally, if not more, effective treatment for insomnia is a what is called “Cognitive-Behavioral Therapy.” Advertisements from the pharmaceutical companies make us believe we need medicine but this is not always the case at all.

Cognitive-Behavioral treatment generally consists of no more than eight sessions and it includes a lot of education, some of which I will give you here.

If this article does not help, then you should seek therapy with a sleep expert.

First you should know that not all people actually need eight hours of sleep, a common myth. Some people feel rested with four to five hours but they are people who sleep well. Also, how long we need to sleep changes with age and differences we may experience in body temperature with physiological changes or different seasons.

Our sleep hygiene is extremely important and this is the first thing I hope you will consider. You will need to take a look at your diet and exercise, although it sounds like you take care of this most of the time. Alcohol and caffeine intake during the last few hours before going to bed, and general activities before going to bed, especially the last hour or so, do not help. Also, the bed you sleep in is important. If your mattress is not a good one for you, you may need to replace it.

You definitely should not be working during the last hour before you attempt to go to sleep. If you are watching television and what you see disturbs you, change it. Do something that is truly relaxing for you the last hour before you go to sleep. Do not eat or drink much of anything other than water, an herbal tea or warm milk before going to bed.

If you go to sleep and wake up, do not turn a TV on. This is one of the worst things you can do. If you can’t get back to sleep, go into another room to watch TV or read, until you are sleepy again.

Lastly, you talk about worrying, worrying a lot actually. My first thought is that you may be worrying about not sleeping when you go to bed and this may create a kind of secondary insomnia, if you will.

Finally, all this worrying that you do sounds really troubling and while it’s beyond the scope of this article, I will tell you this, worrying is simply our way of feeling like we are in control. It is an otherwise useless activity that only causes harm to our bodies and selves. Try to give it up or get help with it.

Good luck!

Dr. JoAnne Barge is a licensed psychologist with offices in Brentwood. Visit her at www.drbarge.com or e-mail your anonymous questions and responses to newshrink@gmail.com.