Sleep Disorders

Jun 1, 2013
2013 / June 2013

Sound sleep is critical to our health and well-being. We should wake up feeling refreshed and alert, and not feel sleepy during the day. If this is not the case, poor sleep hygiene may be the culprit, but it is important to consider any unrecognized sleep disorder which can lead to poor quality of life, accidents and great expense. If you are not sleeping well, see your health care provider or a sleep specialist.

According to research, most adults need seven to eight hours of sleep a night. Sufficient sleep is increasingly recognized as an essential aspect of chronic disease prevention and health promotion. Inadequate sleep is associated with chronic conditions such as diabetes, cardiovascular disease, high blood pressure, obesity and depression, not only contributing to their onset but also complicating their treatment and outcome.

Stress, anxiety, depression, medications, caffeine, nicotine, alcohol and medical conditions can all contribute to insomnia. Other causes include a change in environment or work schedule, poor sleep habits or “learned insomnia” (worrying excessively about not being able to sleep and trying too hard to fall asleep).

As you get older, changes can affect sleep. You may experience a change in sleep patterns, a change in activity, a change in health and increased use of medications. Activity promotes a good night’s sleep, and you may be less physically or socially active with age. The chronic pain of arthritis, back problems, depression, anxiety and stress can interfere with sleep. Older men who develop an enlarged prostate awaken during the night with the need to urinate. In women, hot flashes that accompany menopause can disrupt sleep.

Risk factors of insomnia include being a woman (due to hormonal shifts during menstrual cycles and menopause) and being older than 60. Mental health disorders can also disrupt sleep. If you are under a lot of stress from the death of a loved one, loss of a job, divorce, poverty or unemployment, your risk for insomnia increases. Working at night, frequently changing shifts or traveling multiple time zones can upset your circadian rhythm, thus disrupting sleep.

Over-the-counter sleep aids might help temporarily, but lifestyle changes are usually the best approach to easing insomnia. “Sleep hygiene” refers to measures that promote regular, quality nighttime sleep and full daytime alertness: simple habits and environmental factors mostly under your control.

Many people return to restful sleep by changing habits and addressing underlying causes. Go to bed at the same time each night and rise at the same time each morning. Make sure your bedroom is a quiet, dark and relaxing environment with a cool temperature. Make your bed and bedroom comfortable and use them only for sleeping and sex, not for other activities such as reading, watching TV, working on a laptop or listening to music. Avoid large meals and beverages and take time to unwind before bedtime.

If you have tried to fall asleep for 20 minutes, get up and leave the room. Keep the lights low. Do something relaxing, such as reading a book or listening to soft music. Do not go back to bed until you are sleepy. Exercise is great for your body and mind, but it is stimulating, so exercise during the day and not at night. Avoid or limit caffeine and nicotine and resist the urge for a nightcap. Alcohol may help you fall asleep, but your sleep will not be restful. Daylight exposure is key to regulating sleep patterns. Get outside in the natural sunlight for at least 30 minutes each day.

Behavioral therapies are generally the first-line treatment for people with insomnia. Relaxation techniques include progressive muscle relaxation, biofeedback and breathing exercises to decrease anxiety at bedtime, helping you control your breathing, heart rate, muscle tension and mood. Cognitive behavioral therapy (one on one or in groups) replaces worries about not sleeping with positive thoughts. Stimulus control limits the amount of time you spend awake in bed. Sleep restriction uses partial sleep deprivation to make you more tired the next night; once sleep improves, your time in bed is gradually increased. Light therapy uses light to push back your internal clock and is effective if you fall asleep or awaken too early.

Sleeping pills have side effects such as dizziness, headache, gastrointestinal problems, prolonged drowsiness, severe allergic reaction, sleep behaviors such as sleep-driving and sleep-eating, and daytime memory or performance problems. Sleep medications may not be safe if you are pregnant or breastfeeding, and may increase the risk of falls in the night and injury in older adults. Health care providers may prescribe a lower dose for older adults.

When traveling, the hotel should provide a quiet sleeping environment with a supportive bed, a selection of pillows and freshly laundered soft sheets. If there is outside noise or disturbances, ask to move to a quieter room. Many hotels have soundproof windows and walls, blackout shades and drapes; and some provide white-noise machines upon request to enhance the sleep environment. Request a room away from elevators. Some hotels offer light sleep-inducing snacks and aromatherapy, along with a wellness spa. For those who arrive suffering from jet lag, many hotels offer a napping kit that may contain a sleep mask, lavender oil to be added to a warm bath, warm milk and cookies, and a special “Nap in Progress” door hanger. Keep naps to less than an hour and do not nap after 3 p.m., since it could interfere with sleep at night.

The content of this article is for informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition.

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