This section is from the book "The Home Hand-Book of Domestic Hygiene and Rational Medicine. Volume 2.", by J. H. Kellogg, M.D.. Also available from Amazon: The Home Hand-Book of Domestic Hygiene and Rational Medicine, Volume 2.
A person who suffers from sleeplessness should avoid the use of tea and coffee, tobacco, alcoholic liquors, and all other stimulants and narcotics, but should especially avoid eating late at night Eating just before retiring has been recommended for sleeplessness, and, in some cases, a palliative effect is certainly produced, but the ultimate result is an aggravation of the difficulty instead of relief. If a person suffers "faintness" or "all gone feelings" at night, so that he cannot go to sleep, he should take a few sips of cold water or a glass of lemonade. As complete relief will generally be obtained as from eating, and the stomach will be saved the unpleasant task of attempting to digest a meal when it should be resting with the remainder of the body. A warm bath just before retiring, a wet-hand rub, a cool sponge bath, gentle rubbing of the whole surface of the body with the dry hand, massage; galvanism applied to the head and spine, hot and cold applications to the spine, and the application of a fomentation over the stomach, are all useful measures for the relief of sleeplessness. When the feet are cold, they should be thoroughly warmed by a hot foot or leg bath, and thorough rubbing. In many cases, the alternate hot and cold foot bath or the shallow cold foot bath are more effective than the hot foot bath. When the head is congested, these measures should be supplemented by the application of cold to the head, as the cold compress, the ice-cap, or a cold pour. In some cases a tight bandage about the head and a cold compress laid over the eyes, after the patient goes to bed, is effective. Persons suffering with hyperaemia or congestion of the brain, should raise the head of the bed a few inches, so as to diminish the tendency of the blood to the brain.
Persons who suffer for want of sleep from sedentary habits are benefited by a walk in the evening, just before retiring, or gentle calisthenics. In most cases it is important that the patient should retire early. This is especially the case with persons whose sleeplessness is connected with neurasthenia or nervous debility. Unfortunately, in many of these cases, the patient feels better in the evening than in any other part of the day, and consequently is very reluctant to go to bed, especially when he has the unpleasant prospect before him of tossing uneasily about till day-break. The disposition to put off retiring until a late hour should not be yielded to, as the unusual exhilaration felt in the evening is an unnatural condition, which, if encouraged, will aggravate the difficulty. All exciting influences should be avoided in the evening The patient should keep himself as quiet as possible. In man cases it is necessary to forbid conversation or reading, or even amusement of any sort which will excite the nerves or mental faculties. Hot-water bags, hot jugs, and bed-warmers of all descriptions, are of use for individuals whose circulation is unusually defective, though, in some cases, these means of relief may become a source of damage when depended upon too largely and for a great length of time. Attention should be given to the bed and the sleeping apartment. Feathers should be discarded. The bed should be neither too soft nor too hard, and should be thoroughly aired daily. An abundant supply of fresh air should be introduced into the bedroom in such a way as to secure its admission without drafts. As a general rule, a fire in a sleeping room, at the time of retiring, is disadvantageous. Care should be taken that the bed be thoroughly warmed and the apartment dried during the day, but the room should be at least ten degrees cooler at night than is required for comfort during the day.
Various devices have been proposed for the benefit of persons who lie awake at night for hours, unable to get to sleep on account of excessive mental activity, such as counting, repeating over some simple formula of words, etc. The best means of this kind we have ever become acquainted with, is the practice of prolonged deep inspirations. The lungs should be slowly filled to their utmost capacity, and then emptied with equal slowness, repeating the respiration about ten times per minute, instead of eighteen or twenty times, the natural rate. In the majority of cases in which sleeplessness is not due to any special exciting cause, this plan is quite effective. We have often recommended it with entire success. Simply stroking the head will often soothe the nerves of a patient till he readily falls asleep. This is not due, however, to any mesmeric or magnetic influence on the part of the rubber.
When a person falls asleep upon first going to bed, and after sleeping two or three hours, awakes, and is unable to get to sleep again, relief will in many cases be obtained by getting out of bed, and rubbing the whole surface of the body with the dry hand. Simply walking about the room for a few minutes, exposing the skin to the air, will have a quieting effect upon the nerves, so that when the person returns to bed he will quickly fall asleep. It is especially important with most persons who do not sleep well, that rest should be undisturbed after the patient falls asleep at night. Great care should be taken to avoid waking such a person, as if not roused he may sleep quietly until morning, when, if wakened, he will lose the whole night's rest.
The use of drugs for the purpose of inducing sleep should be avoided as much as possible. Opium is especially harmful, and its use should not be resorted to when it can be, by any possible means, dispensed with. Sleep obtained by the use of opiates, is by no means a substitute for natural sleep. The condition is one of insensibility, but not of natural refreshing recuperation. Three or four hours of natural sleep will be more than equivalent to double that amount of sleep obtained by the use of narcotics. When a person once becomes dependent upon drugs of any kind for producing sleep, it is almost impossible for him to dispense with them. It is often dangerous to resort to their temporary use, on account of the great tendency to the formation of the habit of continuous use. The use of opiates for securing sleep is one of the most prolific means by which the great army of opium-eaters is annually recruited. Chloral, bromide of potash, whisky, and other drugs, are to be condemned almost as strongly as opium. If any sleep-producing agent besides the simple remedies mentioned must be employed, lupulin, gelsemium, belladonna, and Indian hemp, are to be recommended rather than opium; but these should not be used except under the directions of a physician. A hop pillow is a popular remedy of some reputation for producing sleep. We have no doubt that it is beneficial in many cases.