sleep

I have tapper off of Effexor and finally have been off it for 2 weeks. My question is I am able to fall asleep however I once I wake up I can\t fall back asleep. What can I do to help me sleep through the night, I am tired and it is starting to affect my work. I had to by a tape recorder to help me do my job so I don't forget.

[Sandra Y, RPh]

Behavioral treatments teach you new sleep behaviors and ways to make your sleeping environment more conducive to sleep. Studies have shown behavior therapies are equally or more effective than are sleep medications. Behavior therapies are generally recommended as the first line of treatment for people with insomnia.

Behavior therapies include:

■Education about good sleeping habits. Sleep hygiene teaches habits that promote good sleep.
■Relaxation techniques. Progressive muscle relaxation, biofeedback and breathing exercises are ways to reduce anxiety at bedtime. These strategies help you control your breathing, heart rate, muscle tension and mood.
■Cognitive therapy. This involves replacing worries about not sleeping with positive thoughts. Cognitive therapy can be taught through one-on-one counseling or in group sessions.
■'Stimulus control.' This means limiting the time you spend awake in bed and associating your bed and bedroom only with sleep and sex.
■Sleep restriction. This treatment decreases the time you spend in bed, causing partial sleep deprivation, which makes you more tired the next night. Once your sleep has improved, your time in bed is gradually increased.
■Light therapy. If you fall asleep too early and then awaken too early, you can use light to push back your internal clock. During times of the year when it's light outside in the evenings, you go outside for 30 minutes or obtain light via a medical-grade light box.

If these measures don't work, your doctor may recommend medications to help with relaxation and sleep.