Finding out a way to get them to sleep is vital, before anything else.
Even before headaches, but usually we treat those things together or
at the same visit, because then the patient will do that much better next time.
And, very briefly, the keys to sleeping are not necessarily medications.
There are some, and there are commercials with butterflies, and there is always
wonderful commercials out there about medications. They're okay,
but if they were going to work, they probably would have already worked.
Almost any physician can write a prescription for a sleep medication.
They're not a bad thing, but without what we call good sleep hygiene,
or preparing for sleep, you're not going to sleep.
And sleep hygiene consists of everything as simple as not drinking coffee
or a lot of liquids 4 hours before you're going to sleep, so you don't
have to get up to go to the bathroom or you're not on a stimulant, such as caffeine.
Making sure that you're trying to do something physical during the day,
typically aerobic-type exercise, so that you are not just laying around on the couch
or napping throughout the day. It's hard to sleep if you haven't been physically active
during the day beforehand.
Making sure that you're eating a balanced diet and not overeating at dinner,
because a body that's digesting and is full doesn't tend to sleep well
Even if you go to sleep, you're going to tend to wake up
or not have a restful sleep.
And then the last couple things are 30 minutes before you sleep, not watching television;
not playing video games; not having bright lights on; and--you know--
it's a quiet room. It's--if you're reading--a very dim light.
Listening to relaxing music. Talking to someone. Listening to the radio, etc.
That's key. And, obviously, making sure that you're in an environment
where what you do is sleep there. So you shouldn't be laying on a couch
trying to get to sleep. You know--your bedroom should be for sleeping and
having sexual activities. It should not be for--you know--eating.
It shouldn't be for playing with your kids on the floor, and the reason
that's important is behaviorally you want to associate that bedroom
as a place for restfulness, a place of pleasure. Something where you want to go to--
kind of, settling down, not all these other activities.
Vital. If you do that,
that--in addition, if you learn some relaxation breathing techniques,
very often, that alone will begin them on the process.
Americans like medications, so very often you'll offer them a medication.
Typically they'll refuse it the first visit, because they haven't had good success with it.
But if you combine the right medication with
the things we've just talked about, people sleep.
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Successful recovery from post-deployment syndrome starts with good sleep hygiene.
Produced by Victoria Tilney McDonough and Brian King, BrainLine.
David Cifu, MD is chairman of the Department of Physical Medicine and Rehabilitation at the Virginia Commonwealth University (VCU) School of Medicine in Richmond, Virginia, and national director of the PM&R program office for the Veterans Health Administration.
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