How to get the Sleep You Need

Does your spouse seem to fall asleep as soon as his head hits the pillow while you ponder how you can avoid another night of restlessness?

Insomnia visits many people throughout the year but seems especially prevalent during the holidays. There’s so much going on with work, family, holiday parties, shopping — you name it. The to-do list starts rolling, and sleep ends up being the last box we check.

An estimated 70 million Americans suffer from various sleep problems — insomnia, the Latin word for “no sleep,” is the most common complaint. The problem is defined as the inability to fall asleep or remain asleep. The term is also used to describe one’s inability to wake up feeling energized or refreshed.

Acute insomnia can last one or several nights, while the term chronic indicates the problem lasts months to years. The National Center for Sleep Disorders Research at the National Institutes of Health reports 30 to 40 percent of adults have some symptoms of insomnia during the course of a year, with 10 to 15 percent of adults suffering from the chronic form. And surprise, surprise — the prevalence of insomnia is higher among women and older people.

Women experience more sleep disturbances because of menstruation, pregnancy and menopause. Some of the nodding off can also be linked to the complexity of women’s lives today. Juggling responsibilities as mothers, workers and caregivers of aging parents takes its toll. Often the stress and anxiety that come with modern living keep churning long after the lights are out.

“We are a sleep-deprived society,” says Paul Ingmundson, Ph.D., board-certified sleep medicine specialist at the Audie L. Murphy Division, South Texas Veterans Health Care System, and clinical professor of psychiatry and neurology at The University of Texas Health Science Center at San Antonio. “People are sleeping one hour less per day than they did 70 years ago. Socially and culturally, we have moved toward a 24-hour day, and sleep has been a casualty.”

Dangers of deprivation

Sleep-deprived women are at risk for depression, heart disease and obesity. Recent studies indicate that people who don’t get the sleep they need are at risk for obesity because the lack of sleep interrupts the production of hormones that regulate feelings of fullness and hunger. Without quality slumber, you’re more likely to have less energy, more irritability, concentration problems and a lowered immune system.

Furthermore, the drowsiness that results from insomnia makes everyday activities, such as driving, dangerous. According to a report in The Journal of the American Medical Association (JAMA), about 100,000 motor vehicle crashes reported to police each year involve drowsy drivers. An estimated 4 percent of these crashes cause fatalities. The JAMA article states, “The role that sleepiness plays in those crashes is largely underestimated, and drowsy drivers pose a major public health and safety threat.” Combine the effects of insomnia with driving home late after a holiday party and you have a recipe for disaster. In fact, the American Medical Association (AMA) advises drivers not to drive between midnight and 6 a.m., the body’s natural “down time.”

Handling the holidays

Everyone wants to enjoy the holidays, but the nature of the season doesn’t lend itself to maintaining a regular sleep regimen. It often means entertaining, evening festivities and traveling.

The key to avoiding some of the stress of the holidays is to plan ahead. Shop online, decorate early and ask for help so you don’t feel overwhelmed. Eliminating or reducing anxiety can do a lot to clear your head and help you fall asleep more easily.

Whether your sleep problems are caused by stress or an underlying medical problem, experts recommend establishing good sleep hygiene. Not only will this advice help you get through the holiday hubbub, it can also improve daily living by helping you consistently get the sleep your body needs.

Rules of good sleep hygiene:

Go to bed and get up at the same time every day, even on weekends. Varying the time by more than 90 minutes can affect your sleep/wake cycle. “We advise patients with sleep disturbances to set an alarm clock for bedtime as well as for waking,” says Gustavo Rom87n, M.D., professor of medicine at the Health Science Center and director of the Sleep Disorders Clinics in the University Health System.

Don’t spend too much time in bed. This means if you want eight hours of sleep, you shouldn’t be in bed longer than eight and a half hours.
Keep up your regular exercise routine. Just avoid working out too close to bedtime.
Avoid smoking and drinking caffeinated beverages — both disturb sleep. If you’re a Starbucks® addict, opt for decaf after lunchtime.
Watch your alcohol intake. Many people drink a little more than usual during holiday parties. Although alcohol makes you sleepy at first, it can result in a poor quality of sleep.
Use your bedroom only for sleep. That means no laptop in bed and no TV blaring.
Avoid taking daytime naps.
Take a hot shower before bed and keep your room cool. The temperature change helps you feel sleepy.
Try to relax just before bedtime. Don’t do anything that might raise anxiety, such as paying bills or watching a disturbing movie.
Make the room as dark and comfortable as possible.
New sleep environments can also wreak havoc on sleep, so plan ahead when you travel. Bring something that’s comforting to you, such as your own pillow. Taking along some comfortable earplugs to block out noise is also a good idea.

Finding the “real” problem

Determining a treatment for insomnia largely depends on identifying the underlying cause. Whether it’s stress-induced, a physical disorder or hormonal changes that trigger the insomnia, it’s important to see your physician before initiating any treatment. Often your doctor will conduct a complete physical and history, so it’s important to be honest about what’s going on in your life. Things like a recent traumatic event, snoring (yes, women snore too!), menopause, pain, caffeine intake, restless legs, iron deficiency and allergies are important pieces of information your doctor needs to know.

Also tell your doctor all the medications you’re taking (including herbal/natural supplements), since some medications can lead to insomnia, including those taken for:

colds and allergies
high blood pressure
heart disease
thyroid disease
birth control
pain medications
depression (especially SSRI antidepressants)
If nothing is physically apparent, he or she may send you for a sleep study, a sophisticated way to monitor your body during sleep. Among other things, your stages of sleep, airflow from your mouth and nose, your sleep position, limb movements and your oxygen intake will be recorded. Sleep studies can often shed light on the “real problem,” which might be something like sleep apnea or restless leg syndrome.

Rescue remedies

Once the physical or psychological problem is identified, your doctor can recommend the appropriate treatment, which may include changes in sleep routines, cognitive behavioral therapy, medical devices or medication.

These days you can’t watch TV or read a magazine without the latest sleeping pill wafting its way into your consciousness. New-generation sleeping pills, like Ambien and Lunesta, are designed to help people get over short-term sleep problems, such as after the death of a family member.

Dr. Meir Kryger, author of A Woman’s Guide to Sleep Disorders, says sleep medications should never be the first or only course of treatment. “People are starting to think about these things as though they are painkillers you take for a headache,” she said in the April 24, 2006, issue of Newsweek magazine. “I personally don’t think it’s a good development.”

Although some of the new-generation sleeping pills don’t have the addictive qualities of the older medications, users still need to follow their doctor’s instructions carefully.

Nighty night

It’s wise to be as vigilant about your sleep health as you are about diet, exercise and disease prevention. So if you’re experiencing insomnia, don’t just toss and turn tonight. Instead, take stock of your sleep hygiene and make an appointment with your doctor. Pleasant dreams and productive days await!

Author: Kelly A. Goff

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