fullcortex.net

WHAT IS IT?
Sleep is safe harbor, the source of renewal of body and soul for most of us. But for 70 million Americans, it’s a nightmare: They can’t get to sleep, or can’t stay asleep through the night. And it’s not just their problem: Lack of sleep causes 100,000 driving accidents with 1,500 deaths every year. Researchers estimate that as many as two-thirds of adults in this country don’t get enough sleep.While sleep disorders have many causes, they tend to fall into three groups:

Trouble getting to sleep
Insomnia while trying to get to sleep is by far the most common sleep problem. It affects 20 to 40 percent of us now and then, and almost 10 percent of us have trouble getting to sleep most nights.

Trouble staying asleep
Disturbed sleep is poor sleep. Sleep apnea (breathing that stops and starts during sleep), restless leg syndrome, pain, snoring, and many other sleep disorders can wake sufferers up to hundreds of times a night, and leave them groggy during the day. Some people have no trouble falling asleep, but they wake up often in the middle of the night or very early in the morning and can’t get back to sleep. Trouble staying asleep is also called insomnia.

Trouble staying awake
People with narcolepsy have no control over when they fall asleep. They nod off all of a sudden, just about anywhere, anytime during the day.

In a 2000 survey, 62 percent of American adults said they have had problems sleeping at least a few times a week during the previous year. Most people with sleep troubles can be helped with medical treatment or home care.
WHAT IS HAPPENING?
It may seem like nothing at all happens when we are asleep: We just slip into idle and stop responding to the world around us.

Yet sleep is one of our most needed activities. And the kind of sleep you get matters as much as the amount. Experts are finding that it’s only during deep, dreamless sleep that the body restores itself, fixing wear and tear and building new skin, bone, and muscle.

Sleep comes in four stages, plus the rapid eye movement (or REM) stage when dreams occur. Stage one is a light doze. A few minutes later, the sleeper begins an hour-long slide through stages two and three into the deep, dreamless sleep of stage four. During the night, you move in and out of these sleep stages, with REM sleep bringing brief dreams each time you reenter the deep sleep stages.

When these cycles are broken, we don’t get enough quality sleep. We’re tired the next day and can’t function well mentally or physically. Some researchers think long-term sleep debt may be a factor in diabetes, obesity, and a weakened immune system.

But how much sleep is enough? No two people have the exact same sleep needs, or sleep and awake cycles. Some feel rested after 5 hours, while others need 10 hours. Researchers at the National Institute of Mental Health have found that the ideal amount of sleep for most people is 8 hours, 15 minutes each night.
WHAT CAUSES IT?
There are as many reasons for sleep disorders as there are people with the problems. A change of routine or time zone, disease, distress, good fortune-or just your unique body-can bring them on.

Insomnia can be rare and brief, due to a specific cause such as stress, a change in schedule, or excitement. Jet lag from traveling through time zones can trigger insomnia, for example. So can a change to working the night shift. It may last a few weeks after a trauma, illness, or pain; or become a chronic problem that keeps you from sleep every night or most nights.

Obstructive sleep apnea is a tiny hitch in breathing that wakes sleepers many times a night. It is most common in overweight men who sleep on their backs. The muscles in the throat sag, closing off the airway for ten seconds or so. The effort to catch a breath wakes the sleeper. People with sleep apnea don’t get enough deep sleep and feel tired during the day. It can cause serious health problems over time, including heart disease.

Those with restless legs syndrome are bothered by a crawly feeling in their legs and a strong urge to move them when trying to fall asleep. These feelings may even wake them up. They can’t get back to sleep, or they get out of bed and walk for relief and then feel tired the next day. No one knows what causes it.

People with narcolepsy can be eating, talking, or even having sex when they fall asleep. No one knows what causes it, but it involves a problem with the basic brain process that governs sleep.

THINGS YOU CAN’T CHANGE

Gender
Women are twice as likely to complain of sleep problems. As women reach their forties and fifties, the frequency of sleep trouble zooms up by as much as 40 percent.

Family history
Some sleep problems run in families, including narcolepsy and restless legs syndrome.

Age
Sleep problems increase along with your years: Elders get less sleep overall, but they also get less deep, healing sleep. Aches and pains that come with aging may account for some sleep loss.

Some health problems
Sleep problems can be a sign of illnesses that have no cure, such as Alzheimer’s disease, Parkinson’s disease, and chronic emphysema.

THINGS YOU CAN CHANGE

Sleep habits
How, when, and where you sleep can have a major effect on how well you sleep.

Diet
Eating food and beverages that contain caffeine, like coffee and chocolate, may keep you from resting well. Eating right before bed can also prevent you from getting to sleep.

Smoking, and alcohol and drug use
Poor sleep can be blamed on smoking, alcohol use and abuse, and drug use.

Your weight
Overweight people are more likely to have sleep apnea and to snore.

Pain and poor health
Some 56 million Americans say pain has kept them from sleeping or getting to sleep. And many treatable illnesses such as thyroid disorders and chronic bronchitis can cost you sleep.

Medications
Some over-the-counter drugs and drugs your doctor prescribes can cause sleep problems. Among them are decongestants and tranquilizers.

Stress and distress
High emotions make for low sleep quality: Anxiety, anger, grief, stress, and even joy will affect your sleep.

Depression and mental illness
Sleep problems can be a sign of depression. Depressed people are often tired. They can fall asleep but then wake up in the middle of the night.
WHAT YOU CAN DO FOR YOURSELF
Often, lifestyle changes and home care can put you back in Slumberland. A recent study found that changing sleeping habits is more effective than taking drugs. But if a sleep problem persists for more than two weeks, see your doctor for help. There may be a medical reason.

Get rid of sleep-stopping habits
Stop using caffeine, alcohol, and tobacco: All are bad for sleep. If you can’t quit, stop caffeine for six hours before bedtime, alcohol and tobacco at least two hours before you go to bed. Also avoid stimulating books, TV, movies, or contact with people or things that upset or excite you.

Follow a routine
Go to bed and wake up at the same times every day: It sets a pattern. Find a soothing bedtime routine that suits you. Use whatever helps you empty your mind of worries and woes. Replace thoughts with meditation, prayer, breathing exercises, sex, counting sheep, or a soothing tape of music or relaxation techniques. Try a hot bath: A small study showed a half-hour soak before bed brought on deeper sleep with less middle-of-the-night wakeups. When you repeat a routine each night, it signals the body that it’s time for sleep.

Create a special sleep place
You spend a third of your life there: Make it a place of comfort for you. Choose a bed, pillows, and bedclothes that suit you. Make sure your bedroom isn’t too hot or too cold. Also make sure it’s quiet and dark, with good air flow. If you can’t darken the room completely, wear a sleep mask.

Save your bed for sleeping only
If you use your bed as a second living room for watching TV, reading, or even work, it will be hard for your body to connect going to bed with going to sleep.

Accept it when you can’t sleep
Don’t toss and turn: Get up if you can’t get to sleep (or back to sleep) within 20 minutes. Make a cup of herbal tea or warm milk, read something dull, or do a simple chore such as folding laundry.

If you’re a woman, check your hormones
Shifting levels of progesterone and estrogen, which can accompany menstrual periods, perimenopause (the two to six years before menopause), or menopause can disrupt sleep. Talk to your doctor if you think your hormones might be out of balance.

Exercise and lose weight
Daily exercise helps your overall health and promotes deep sleep. But don’t exercise within three hours of bedtime; it can make it difficult to fall asleep. If you have sleep apnea, losing any extra weight can help.

Be wary of sleeping pills
Drugs that make you sleep replace one problem with another: They are habit-forming. And experts find use of sleep drugs makes it harder for you to find and fix the basic problem.

Reset your inner clock
If you wake up in the middle of the night often, try to reset your body clock by staying up two or more hours later, and getting up at your usual morning time. Experts say a week of this can force sounder sleep. Don’t cheat by taking a nap or staying in bed a bit longer after the alarm goes off.

Keep a journal
Write down the worries that keep you up at night, and list the steps you have taken to quell them. Keep pen and paper by your bed at night for added thoughts.

Try stress reduction
Techniques that teach your body to relax will lead your mind to sleep also. Ask your doctor to refer you to a class or teacher.

Don’t sleep on your back
For obstructive sleep apnea and snoring, sew a pocket for a tennis ball into the back of your pajamas so you won’t sleep on your back.

Try a snoring aid
For mild snoring, try an over-the-counter nasal strip that widens your nostrils and eases breathing.

Nap-with caution
For narcolepsy, try to schedule one or more daytime naps at set times. But if you have insomnia, don’t nap during the daytime.

Try alternative therapies
Some herbs, such as valerian, have shown promise in inducing sleep. The label should say 0.8 percent valeric acid extract. Take 300 mg to 900 mg one hour before bed. Results may take up to a week.

The hormone melatonin can help shift-workers or travelers with jet lag get back on track (or avoid getting jet lag in the first place). Experts doubt, however, that it can ease classic insomnia. Melatonin, like valerian, is available at health food stores, usually in 3 mg tablets. Experts disagree on the recommended dose, so proceed with caution: Melatonin and herbs are as potent as drugs, and no one regulates them, so there’s no way of knowing how pure they are. Ask your doctor for advice.
WHAT YOUR DOCTOR CAN DO FOR YOU
If you have a sleep problem that lasts more than two weeks, see your doctor. He or she can:

Rule out or treat a medical cause
Disease-or drugs for a disease-may be the cause of your sleep problem. If pain is keeping you awake, your doctor can treat the problem and give you drugs to relieve the pain. If depression and anxiety are part of the insomnia pattern, your doctor can help you get treatment. Be sure to give your doctor as many facts as you can to help find the problem. Tell the truth about alcohol or drug use.

Prescribe drugs
Sleep-inducing drugs may ease short-term insomnia due to stress, trauma, or a major life change. Drugs may also help if you have a health problem that’s costing you sleep. But this is not a cure: Long-term use of sleep drugs is habit-forming, and may even keep you from sleeping.

Your doctor can also prescribe drugs that may relieve the twitching and discomfort of restless legs syndrome, or stimulants and antidepressants to treat narcolepsy.

Give you a device to limit snoring
For severe snoring, ask your doctor or dentist about a retainer-like device that moves your tongue or lower jaw forward. Or ask your doctor about a special device called CPAP (continuous positive airway pressure) that pumps air to you through a mask as you sleep.

Refer you to a sleep expert
If your sleeping problems go on and on, you may need to see a specialist or a sleep clinic for diagnosis.

Operate for sleep apnea
Surgery helps some-but not all-snoring and apnea problems. One type removes parts of the soft palate at the back of the mouth. Another removes the uvula, the fleshy cone that hangs down from the soft palate at the back of the throat.