What to do when sleep becomes elusive

sleep diorder, insomnia, lack of sleep, sleep problems

Insomnia can be caused by poor sleeping habits

Photo credit: SHUTTERSTOCK

What you need to know:

  • To be able to sleep well, get a daily activity schedule and stick to it, plan and eat healthy balanced meals, take enough water during the day and not in the evening to avoid going to the washroom a lot at night, exercise (preferably in the morning) and practise good sleep hygiene.

Dear doctor, I am a 30-year-old woman with insomnia issues. Since two months ago, I am having a problem falling asleep. If I go to bed at 11pm, I will probably sleep around 4am (if I get any sleep at all). The insomnia is getting worse by the day. I am low on energy and this is affecting my productivity. Please advise if medication is appropriate for my sleep problems. Or what else can make the insomnia go away?

Dear reader,
Insomnia refers to having trouble falling asleep or staying asleep. Insomnia can be caused by poor sleeping habits (poor sleep hygiene), having an irregular sleeping pattern, stress, pain, physical illnesses, mental health conditions, some medications and sleep disorders.

To be able to sleep well, get a daily activity schedule and stick to it, plan and eat healthy balanced meals, take enough water during the day and not in the evening to avoid going to the washroom a lot at night, exercise (preferably in the morning) and practise good sleep hygiene.

Sleep hygiene refers to those practices that improve quality of night time sleep and contribute to alertness during the day. These include: 

Make your bedroom a relaxing place with a good bed and find a way to block out noise and light, for instance, using heavy curtains.

Sleep at the same time and wake up at the same time every day, whether it is a work day, weekend, leave day or holiday

Try to sleep when you are tired or sleepy to avoid spending too much time awake looking for sleep.

If you are unable to fall asleep after 20 or more minutes, wake up and do something boring or calming, with the lights dimmed, until you feel sleepy again. Avoid bright light and gadgets (like TV, computer, phone) or anything very interesting.

A well timed bath (one to two hours before bedtime) may help you sleep better.

Develop and follow a sleep time ritual. For instance, every day I shower at 9pm, read a book for 30 minutes then pray for 10 minutes in the dark in my bedroom before I get into bed.

Keep your day time routine the same, whether you had enough sleep or not. Hopefully, by evening, you will be tired enough to have a good night’s sleep. Avoiding your day time activities or sleeping during the day may worsen the insomnia.

Expose yourself to natural light during the day and keep the bedroom dark at night. The light and darkness will help your internal clock with the sleep-awake cycle.

Avoid using the bed or bedroom for work or watching TV, using the laptop or the phone.

Avoid caffeine or tea before sleep as they can be stimulating. Do not take a heavy meal just before bed time. Milk has tryptophan, which is a natural sleep inducer, so taking a cup of milk may be helpful. Also avoid alcohol about four to six hours before sleep as it interferes with the quality of sleep.

Avoid sleeping during the day. If you have to, take one 20 to 30 minutes day-time nap before 3pm.

Do not watch the clock when you are unable to sleep. It adds to your stress and makes it more difficult to sleep. If this is a problem for you, hide the clock.

If practising sleep hygiene does not help with the insomnia, then a pill can be prescribed temporarily. Sleeping pills can affect the quality of sleep and create dependency. It is more important to manage the underlying problem. There is a sleep diagnostic and treatment centre in Nairobi, where you can be reviewed.

Dear doctor,
Is there any other family planning method, other than condoms, that we men can use to prevent pregnancy?
Moree, Mombasa

Dear Moree,
For a man, the contraceptive methods currently available are the withdrawal method, vasectomy and condoms. In the withdrawal method, you pull out of the vagina just before ejaculation to avoid any semen getting deposited in or around the vagina. This method can be difficult to achieve every time and has a failure rate of about 22 per cent. For vasectomy, the surgeon cuts and seals off the tube that the sperms pass through. After about three months, there will be no more sperms coming out when you ejaculate. The procedure is usually simple, short, pain-free and it doesn’t affect your ability to perform. However, it is difficult to reverse and is considered a permanent form of birth control.

You can also abstain from intercourse during your wife’s fertile days. 

You can be taught how to do this at a natural family planning clinic.

Other contraceptives that are still undergoing research include tablets and injectable medications for men. There has been an ongoing study at Kenyatta National Hospital on the use of a male contraceptive gel.

Hi doc.
My head is always full of dandruff. Every shaving time there is a lot of white stuff on the scalp. What could be the cause? Any cure for dandruff?

Dear Stan,
Dandruff, otherwise known as seborrheic dermatitis, is a skin condition that causes itching and flaky scales.

It usually affects the scalp but it can also affect other parts of the body. 

It has no exact known cause, but it can be affected by stress, having oily skin, having a fungal infection and also cold, dry weather. Some medical conditions and medicines can also trigger it. It worsens and gets better over time.

You can use shampoos that have ketoconazole or selenium, zinc or salycilic acid. They are sold in pharmacies or can be prescribed by the doctor. Also, take a lot of water and eat a balanced diet. And try not to scratch your scalp because it can lead to infection. If it continues despite this, visit a skin specialist (dermatologist).

Send your health questions to [email protected]


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