You’re Getting Verrrrrry Sleeeeeeepy (hopefully)….
By Ann Byrd, Clinical pharmacist
Sleep may come easy to some, while others have to fight for it. Up to 2/3 of adults periodically experience some form of sleep disorder or insomnia. A sleep disorder is any disorder that causes a disruption of sleep or inadequate wakefulness (don’t sleep well and are tired when awake).
As a pharmacist at the VA, encountering patients with insomnia is common. Insomnia is more likely to occur with older age, lower socioeconomic status, and those diagnosed with anxiety or depression. It’s not uncommon for a person to experience difficulty sleeping once in a while, but chronic insomnia is when a person experiences symptoms at least three times a week for at least three months (despite efforts made to improve sleep) and may require additional intervention.
There are many reasons a person may not sleep well, and some simple changes may help improve the amount or quality of sleep. Some medications can cause difficulty sleeping because they increase heart rate, alertness, or energy (like Albuterol, Ritalin, steroids or medications containing caffeine) so if possible, it’s best to dose them earlier in the day to prevent “revving up your engine” right before bedtime.
Other causes may be due to a medical or neurological condition. For example, mood disorders, sleep apnea, asthma, acid reflux, Parkinson’s, and dementia (just to name a few), can cause difficulty sleeping. It’s important to work with your doctor and/or pharmacist to manage these conditions (and others) to help decrease the possibility of sleep disturbance. It’s hard to sleep if every time you lay down your reflux flares, or you can’t breathe because of sleep apnea or asthma.
Sleep hygiene is something that is often overlooked, but small changes can yield great results. For example, maintaining a consistent sleep schedule, in a restful environment are helpful. Healthy sleep habits like starting to wind down an hour before bedtime, avoiding eating or drinking before bedtime, and getting regular exercise can help promote better sleep (just try to avoid exercising too close to bedtime). Try to use the bed only for sleep and intimacy. If you find yourself on electronics or watching tv in bed, it may make it harder to unwind and sleep. Also, pets are living their best life if allowed to sleep on the bed, but even though they can promote comfort and relaxation, it’s best to keep them out of the bed. They can make movements or sound that can affect the quality or depth of the human’s sleep; it’s hard to take them on walks if you are exhausted from not sleeping well…it can lead to the dog walking/dragging the human!
If these changes are not enough, there are other treatments that might help like speaking with a therapist or considering medications. Therapy is not often considered for problems sleeping, but if stress and/or life events are what is keeping someone up at night, talking to someone might help. If the insomnia requires pharmaceutical intervention, there are a variety of options ranging from over-the-counter products to prescription medications. It’s important to factor in the patient’s age, current prescriptions, and/or disease states when deciding what sleep therapy to pursue. You don’t want oversedation to be the new problem as that can lead to falls and cognitive impairment. Talk to your doctor or pharmacist to see what options are right for you.
NOTE: If you're a Veteran enrolled with us, please consider talking to your care team about any sleep issues you're having. We believe there are many parts to living your best life and want to work with you to make sure your health--your whole health--is the best it can be. Recharging is a critical part of that whole health picture.
(This column was also shared in a guest column in the Sheridan Press January 5, 2026.)