Is stress to blame for sleeplessness?

DEAR DR. GOTT: In early March 2010, my husband broke his ankle in three places and shattered his heel. Despite the fact that he is now mobile and has passed through the worst part of recovery, he struggles with horrid sleep problems. Each night, he falls asleep almost immediately but is awake about two hours later and cannot fall back to sleep. Needless to say, this lack of sleep is taking its toll on him, as during the day he is completely drained. We have consulted our family physician, who has tried unsuccessfully prescribing various sleep medications. We have also tried melatonin, lavender, chamomile and more. You name it, he has tried it, to no avail. Is there anything else he can do at this point?

I also have had sleeping problems since his foot injury, but medication is working for me. We were both very much stressed after his injury because he was nonweight-bearing for three months and ran the risk of actually losing his foot due to the severity of the injury. Thank you for any help you can provide.

DEAR READER: Given that your husband’s sleeping difficulties followed a serious injury, it is likely the two are related. Stress could certainly be to blame, including post traumatic stress disorder (PTSD), but certain medications can also cause unwanted sleep disturbances. Because you don’t provide a list of what medications he is taking (likely an antibiotic and/or pain relievers), I cannot determine whether this is a possibility.

Because he has unsuccessfully tried so many prescription and home remedies, there is little left to recommend. I suggest that he review his medications with his physician to determine if one or more may contribute to the problem. Beyond that, he should learn some relaxation and stress-dealing techniques. Meditation, yoga, tai chi, deep breathing and more are all beneficial to calming both mind and body. In addition, yoga and tai chi are gentle exercises that may reduce his pain levels and allow him to regain some of the leg strength he lost during his injury and recovery. He may also benefit from counseling with someone who can help him deal with aspects of the trauma and recovery that may still be bothering him.

Readers interested in learning more can order my Health Report “Sleep/Wake Disorders” by sending a self-addressed stamped No. 10 envelope and a $2 check or money order to Dr. Peter Gott, P.O. Box 433, Lakeville, CT 06039. Be sure to mention the title when writing or print an order form off my website’s direct link at www.askdrgottmd.com/ order_ form.pdf.