5 doctors weighed in:
I have a sleep problem (wake up 4am) and I don't know what to do?
5 doctors weighed in

Dr. Heidi Fowler
Psychiatry
2 doctors agree
In brief: Terminal insomnia
Terminal insomnia is classically associated with depression.
When was the last time your had a comprehensive medical evaluation to include assessment of sleep. I agree with the recommendations for sleep hygiene. 1. Keep a regular bedtime & wakening time (to include weekends). Get up the same time each day, regardless of what time you fell asleep. 2. Make a regular, relaxing bedtime routine. Relax.

In brief: Terminal insomnia
Terminal insomnia is classically associated with depression.
When was the last time your had a comprehensive medical evaluation to include assessment of sleep. I agree with the recommendations for sleep hygiene. 1. Keep a regular bedtime & wakening time (to include weekends). Get up the same time each day, regardless of what time you fell asleep. 2. Make a regular, relaxing bedtime routine. Relax.
Dr. Heidi Fowler
Dr. Heidi Fowler
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1 comment
Dr. Heidi Fowler
Relaxing rituals prior to bedtime may include a warm bath or shower, aroma therapy, reading, or listening to gentle music. 3. Sleep in a dark, quiet, cool room on comfortable mattress & pillows. 4. Use the bedroom only for sleep & sex. Have work materials, computers, & TVs in another room. 5. Finish eating at least 2-3 hs prior to your regular bedtime. 6. No caffeine within 6 hours; alcohol & smoking within 2 hours of bedtime. 7. Exercise regularly; finish a few hours before bedtime. 8. No naps. 9. Go to bed only when sleepy. Lay in bed only for sleeping, not for work or watching TV. 10. Designate another time to write down problems & possible solutions in the late afternoon or early evening, not close to bedtime. 11. After 10-15 minutes of not being able to get to sleep, go to another room to read or watch TV until sleepy. Consider chamomile tea before bed. Warm milk. Lavender oil in bath or lavender scent on pillow. Melatonin is very helpful. Acupuncture often works well for insomnia.
Dr. LUIS IRIZARRY
Family Medicine
2 doctors agree
In brief: Sleep hygiene
Avoid caffeine, alcohol, moutain dew, energy drinks.
Avoid strenous exercise 4 hr before bed time. Take a warm bath. No tv, radio, computer when ready to go to bed. With your doctor go over stress, anxiety, depression, or medical conditions that may cause sleep disorders and treat the cause if any. Then consider sleeping pills.

In brief: Sleep hygiene
Avoid caffeine, alcohol, moutain dew, energy drinks.
Avoid strenous exercise 4 hr before bed time. Take a warm bath. No tv, radio, computer when ready to go to bed. With your doctor go over stress, anxiety, depression, or medical conditions that may cause sleep disorders and treat the cause if any. Then consider sleeping pills.
Dr. LUIS IRIZARRY
Dr. LUIS IRIZARRY
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