Managing Sleep
and Anxiety

Insomnia

Insomnia is the medical term for difficulties with sleep.
There are many underlying causes of insomnia. These include environmental factors, shift work, certain drugs, dietary intake and pain, to name a few.

The initial management of insomnia should include looking for underlying causes of insomnia and managing them when possible.
For example, this may mean avoiding exercise or caffeine in the evening or treatment of pain.
Good sleep hygiene is also an important part in the management of insomnia. This involves:
- Making sure your bedroom is quiet and dark.
- Staying in bed to sleep only.
- Avoiding eating, drinking or exercise late at night.
If you continue to have insomnia despite good sleep hygiene then drugs may be considered. These may include:

Melatonin

Melatonin is a naturally occurring hormone in the body that helps us to fall asleep.
Melatonin can be taken as a supplement to help with falling asleep.
You can buy melatonin without a prescription from the pharmacy.
Typical doses for melatonin are between 3 to 5mg of melatonin daily, which should be taken up-to an hour before going to bed.

Z-type drugs

Z drugs are non-benzodiazepine type sedative drugs that are used to treat insomnia and other sleep disorders.
Examples include Imovane (zopiclone) and Ambien (zolpidem)
They must be prescribed by a physician or other healthcare professional.
They have many side effects so are recommended after other therapies have failed.
Although benzodiazepines are often prescribed for sleep, they have a lot of side effects and are NOT recommended for insomnia.

Anxiety is a very common problem in the general population.
Anxiety can develop at any age and often for no reason. However, it is important to make sure there are no treatable causes for the anxiety, such as thyroid problems.

The management of anxiety involves addressing any underlying causes.
Another option is Cognitive Behavioural Therapy (CBT).
- CBT is based on the idea that how you think affects how you then behave.
- CBT can help people to identify and change how they think, which can then change their behaviour.
- CBT has been shown to be very helpful for treating anxiety.
If CBT is not available or does not work, then medications may be used.
Antidepressants are the main type of medications used to treat anxiety.
- Antidepressants are prescription medications that are used to treat mood problems like anxiety and depression.
- There are different types of antidepressants which work in different ways, and so if one does not work then you may be switched to a different type of antidepressant.
- Some of the commonly used antidepressants include Celexa (citalopram), Remeron (mirtazepine), and Effexor (venlafaxine).
Benzodiazepines are not recommended for treatment of anxiety as they have many side effects and there are safer and more appropriate drugs available

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