Financial Stress and Insomnia: Should You Try a Sleeping Pill?

If you've ever experienced stress-related insomnia, you probably know the basic sleep rules: Relax before bed, set a consistent schedule, and as you're lying awake at 3 a.m., try not to think about things that are bothering you.

But that's easier said than done. So is it really possible to push all that emotion aside at bedtime? Or is now the time to get help from a doctor or a sleeping pill?

The answer involves how well you're able to manage stress, says Mary Susan Esther, MD, president of the American Academy of Sleep Medicine. Dr. Esther, who practices sleep medicine at Charlotte Eye Ear Nose & Throat Associates in North Carolina, is no stranger to economy-related sleep woes.

"Charlotte has been really hit recently; Wachovia [is] based here, and so our phones have just been ringing off the hook the past few weeks with people complaining about sleeplessness and insomnia," she says, referring to the ailing bank that could be swallowed up by Wells Fargo. "The economy means our jobs, and that's always much more threatening than other problems that can seem easier to intellectualize and think through, especially when we're lying awake and things seem hopeless. It's our bread and butter, our source of pride, and that hits home a lot faster than other crises."

Stress takes a physical toll. The progressive decline of the economy has been taking a physical and emotional toll on people across the country, according to a Stress in America survey released in 2008 by the American Psychological Association. About half of the people polled said they are increasingly stressed about their ability to provide for their family's basic needs, and 80% say the economy is a significant source of stress. Women especially reported worries about money, job stability, housing costs, and health problems affecting their families.

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Compared with 2007, more respondents also said they are fatigued, irritable or angry, and lying awake at night as a result of stress. Almost one-fifth of Americans reported drinking alcohol to manage their stress, and 16% reported smoking—two factors that can affect your ability to get quality sleep (gauge your personal stress level here.)

Another survey by Betty Confidential found that women are concerned about issues like "affording groceries and other staples like gas," "losing what took so long to acquire," and "things getting worse in the country and it affecting me." One respondent wrote, "I don't sleep more than four hours a night. I get headaches. I worry that my kids can't go to college and my doctor now has me on antianxiety meds. (Thankfully, they are cheap!)" It's not just U.S. citizens who are affected by the global crisis, either: British website NetDoctor.co.uk found that one-fifth of U.K. residents surveyed are regularly getting fewer than five hours of sleep a night, and one-fourth wake up more than three times a night. Two-thirds of those reporting insomnia cited money and work as sources of their sleep troubles.

Is it possible to chill out? Some people may be able to break this cycle by taking a step back: "Turn off the news and turn off your computer a couple of hours before bed," advises Dr. Esther. "We now have access to news 24 hours a day and we are certainly taking advantage of it. And this is a particularly difficult time because it's been such a roller-coaster ride and everyone is just waiting, checking back constantly to see what will happen. It reminds me of what people went through right after 9/11, this sense of unknown anxiety."

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A break from all that intensity may be just what you need. Read a fashion magazine or a funny book—something to make you laugh and get your mind off money and the news. Try getting your news updates in the morning, when you have a fresh start.

Basic sleep hygiene rules are still important: Be sure you're getting enough downtime before bed, even if it means putting away your checkbook and bills after dinner or promising yourself you'll leave work at a decent hour. Pay attention to how you handle stress too: If you're turning to alcohol or cigarettes more than usual, alter your habits—try exercising or taking a walk instead.

Get Help if You Need It

If these tactics don't help after a few weeks of sleeplessness, see a doctor. "If patients come to me and say that they just can't get their minds off these problems, it's a perfectly appropriate time to use a sleep aid," Dr. Esther says. She doesn't often recommend over-the-counter medications (most include antihistamines and can leave people feeling drowsy or hungover the next day); instead, she might prescribe a few weeks' worths of prescription hypnotic medication to break a cycle of sleeplessness.

You and your doctor should decide how—and how often—you'll take this medication. Some patients benefit from a pill every night, while others may take pills only as needed, such as two or three times a week.

"Often Sunday nights are particularly difficult because you've been up all weekend and you're worried about work the next day," says Dr. Esther. "It always depends on the patient." Newer prescription sleep medications, called nonbenzodiazepines, have been shown to cause less rebound insomnia—so you can stop taking them as soon as your sleep problems are under control, provided you continue to practice good sleep habits.

It's also important to talk to your doctor to see if you may be at increased risk for depression—especially if your sleeplessness lasts for more than a few weeks or leads you to spend your daylight hours sitting at home dozing in and out. An antidepressant may work better than a normal sleeping pill in such cases.

Whether you're out of work or overworked, a few things remain constant. Establishing a regular routine—including waking up at the same time, exercising, and getting out in the sunshine during the day—and working step-by-step toward goals can help keep you focused and upbeat. And putting your sleep needs first—whether that means closing your laptop, devoting eight hours to bed, or talking to your doctor about short-term solutions—will leave you better able to overcome the challenges ahead.