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Dear Gulab Abbas Ji,

Thank you for reaching out. Given that traditional sleeping pills have not been effective and your sleep is limited to a few hours after 4 a.m., it's important to explore alternative approaches to improve your sleep quality.

Melatonin Supplements:

Melatonin is a hormone that regulates the sleep-wake cycle. While melatonin supplements can benefit certain sleep disorders, such as jet lag or shift work-related sleep disturbances, their effectiveness in treating chronic insomnia is limited. Studies have shown that melatonin may not significantly improve sleep onset or duration in adults with chronic insomnia. Additionally, over-the-counter melatonin supplements can vary in dosage and purity, leading to inconsistent results. It's advisable to consult with a healthcare professional before starting melatonin to determine if it's appropriate for your situation.

Alternative Approaches:

1. Cognitive Behavioral Therapy for Insomnia (CBT-I):

   • CBT-I is a structured program that helps identify and replace thoughts and behaviours that cause or worsen sleep problems. It has been shown to be more effective than medication in treating chronic insomnia. CBT-I addresses the underlying causes of insomnia rather than just the symptoms.
     
     

   Sleep Hygiene Practices:

   • Consistent Sleep Schedule: Go to bed and wake up at the same time every day, even on weekends.
   • Bedtime Routine: Establish a relaxing pre-sleep routine, such as reading or taking a warm bath.
   • Sleep Environment: Ensure your bedroom is quiet, dark, and calm.
   • Limit Stimulants: Avoid caffeine and nicotine, especially in the afternoon and evening.
   • Screen Time: Reduce exposure to screens (phones, computers, TVs) at least an hour before bedtime, as the blue light can interfere with melatonin production.

2. Consult a Sleep Specialist:

   • A sleep specialist can conduct a comprehensive evaluation to identify any underlying conditions contributing to your insomnia and recommend appropriate treatments.

Addressing chronic insomnia requires a multifaceted approach. Implementing behavioural strategies and making environmental adjustments can significantly improve sleep quality. Working closely with your doctor to develop a personalized plan tailored to your needs is essential.