“If Only I Could Get a Good Night’s Sleep!”

Musicians' Assistance Program

Volume CIV, No. 4April, 2004

Leslie Cardell, CSW

We’ve all had bad nights, when we toss and turn, unable to fall asleep. Persistent sleep problems can lead to a loss of productivity, irritability, diminished pleasure in daily life, and increased health problems. Sleep is not simply a “time out” from life, but an active state that’s essential for mental and physical restoration.

Difficulty falling asleep, or staying asleep, commonly called insomnia, affects as many as one in three American adults. Twice as many women as men have trouble sleeping, and since sleep patterns change with age, the older we get, the more likely we are to have problems sleeping.


There are three basic types of insomnia: transient, short-term and chronic.

Transient insomnia is an inability to sleep well over a period of a few nights. It’s usually brought on by some kind of excitement or stress. Maybe you have a really important meeting the next day, or you had a fight with your spouse that night. If you’re on the road, you may have trouble sleeping in a strange environment, especially if you’ve traveled across several time zones.

Short-term insomnia lasts for two to three weeks, and can result from periods of ongoing stress at work or at home. You may have several weeks of poor sleep until the stressful situation resolves, or you’ve been able to adjust to it.

Chronic insomnia persists for more than three weeks. There can be medical causes, and it can also result from conditioning, or bad sleep habits. Chronic sleep problems can have potentially serious consequences, including negative effects on the immune system.


Chronic insomnia is generally a symptom of another problem, and there are a number of factors that can be the cause. It may be a physical illness, a stress-filled life, too much caffeine or bad sleep habits, such as napping during the day, and going to bed at irregular hours. It’s often linked to alcohol or drug use, and to certain medications.

Psychological factors account for half of all insomnias evaluated by sleep therapists. Persistent stress such as a troubled marriage or serious financial problems can often contribute to poor sleep. Counseling can help people with these kinds of problems to gain a new perspective, and begin to take positive actions.

Sometimes psychiatric problems are an issue. Depression is one of the most common causes of insomnia. Treating the underlying disorder, often with some combination of medication and psychotherapy can improve sleep.

There are a number of lifestyle factors that can be a cause of insomnia. Drinking a cup of coffee or a caffeinated soda near bedtime may not interfere with the onset of sleep, but can cause you to wake during the night. Nicotine is also a stimulant, and can make it more difficult to fall asleep.

The ingredients of many common drugs, including nonprescription drugs for weight loss, asthma and colds, can cause problems sleeping.

Alcohol may help you to fall asleep, but it is likely to make your sleep more fitful and fragmented throughout the night.

Erratic hours — staying up late some nights for gigs, and then getting up early with the kids during the week — can result in sleep problems.

Sometimes the underlying cause of insomnia is a physical illness. Certain breathing disorders, such as sleep apnea, can cause a sleeper to wake multiple times during the night. Severe cases often benefit from a treatment that keeps the breathing passages open with a steady stream of air delivered through a mask worn over the nose and mouth during sleep.

Chronic pain resulting from arthritis, heartburn, angina and other illnesses may be a problem. You should see your doctor if pain is keeping you awake.


Good sleep habits can be helpful in alleviating all kinds of sleep disorders. These are useful guidelines for every one to follow in order to sleep well:

  • Try to establish a regular routine, going to bed, and getting up around the same time every day.
  • Create a comfortable sleep environment — a quiet, dark, slightly cool room is often best. Some people find that earplugs help, and make sure you have a good pillow.
  • Use your bed only for sleeping (and whatever else you use your bed for!)
  • Develop relaxing bedtime rituals — a warm bath, 10 minutes of light reading or listening to music.
  • Exercise regularly. Vigorous exercise should be done earlier in the day — at least six hours before bedtime, and mild exercise (walking, stretching) at least four hours before going to bed.
  • Avoid drinking caffeine within six hours of bedtime, and try not to smoke close to bedtime
  • Avoid sleeping pills, or use them conservatively.

If you’d like more information on how to address a sleep problem, don’t hesitate to call the Musicians’ Assistance Program at (212) 397-4802 for an appointment.

This column was based on material provided by the American Sleep Disorders Association, and from articles found on these Web sites:;