(Everything you wanted to know about sleep but were too tired to ask.)
© 2014 Dr. Sharon Norling
By Sharon Norling, MD, MBA
Do you long to fall asleep as soon as you go to bed? Do you want to sleep peacefully throughtout the night without interruption? Would you love to wake up without an alarm clock, alert and full of energy for your day? Or this all a dream?
If you tend to lie awake at night watching the ceiling while everyone else is in la-la-land you are not alone. Insomnia occurs in all age groups. Sleep is the most basic biological activity. Its purpose is protective and restorative. At age 70 the average person has spent cumulatively 20 to 25 years asleep!
Are you so sleep-deprived you can hardly stay awake in the afteroons? Being exhausted is miserable but insomnia can also be life-threatening.
Problems with falling asleep or daytime sleepiness affect approximately 35 to 40 percent of the U.S. adult population and are a significant cause of morbidity and mortality. Sleep problems are 1.5 times more common in women.
Insomnia impacts daytime alertness and performance. Patients usually complain of an impaired daytime functioning with a feeling of fatigue, sleepiness, irritability, risk of mistakes, difficulty focusing and short-term memory loss.
Health Risks Associated with Sleep Disturbances
Insomnia can affect not only your energy level and mood, but also your health. The impact can be cumulative. People with chronic insomnia are more likely than others to develop psychiatric problems such as depression or anxiety. And sleep is critical for our immune function.
Lack of sleep has been shown by research to increase gastrointestinal symptoms. People with irritable bowel disease have sleep disturbances even when they do not have symptoms. This is due to inflammation. According to Sleep Medicine Review in 2005, increased inflammation causes difficulty sleeping and increases high sensitivity C-reactive protein.
The journal, Hypertension, in 2000, reported that short sleep causes high blood pressure. Individuals getting less than five hours of sleep significantly increase their risk of coronary heart disease (CHD). The sympathetic nervous system is stimulated with poor sleep.
Trying to lose weight? You need to sleep better. A recent study documented impaired glucose control, increased cortisol, increased insulin resistance, and increased diabetes in participants with inadequate sleep.
The journal, Sleep Medicine Clinics, in 2007, published that decreased sleep increased hunger by 24 percent and appetite by 23 percent, resulting in 33 to 45 percent higher carbohydrate intake compared with those who sleep well. Lack of sleep also raises the body mass index (BMI).
Good health and happiness are impossible when we are robbed of sleep for very long. According to the journal, Sleep, in 2002, “Compared to good sleepers, severe insomniacs reported more medical problems, had more physician-office visits, were hospitalized twice as often, and used more medication.
The Sleep in America survey, sponsored by the National Sleep Foundation (NSF), found that 40 percent of adults are so sleepy during the day that they have difficulty carrying out their responsibilities. Severe insomniacs had a higher rate of absenteeism, missing work twice as often as good sleepers. They also had more problems at work (including decreased concentration, difficulty performing duties, and more work-related accidents).”
Sleep Deprivation Results in More Accidents
Drowsy driving is an underestimated risk factor in official statistics. As many as 15 to 30 percent of today’s traffic accidents are related to drowsiness, making it is an even greater risk factor than alcohol. Drowsy drivers suffer from inattention, impaired concentration and may even fall asleep at the wheel.
Accidents during dozing result in three times as many fatalities as other accidents. About 100,000 police-reported accidents site fatigue as the cause. NSF reports that 1,550 people die each year as a result. A whopping 62 percent of drivers drive when they are tired. Studies show sleep-impaired drivers’ reaction performance skills are as poor as those of alcohol-impaired drivers!
According to a study in the Journal of Sleep, research on the association between sleep and fatal occupational accidents concluded that “self-reported disturbed sleep is a predictor of accidental death at work.” Accidental death was nearly twice as likely in subjects who reported difficulty sleeping during the previous two weeks. Lack of sleep also slows your problem-solving skills and may make you take unnecessary risks.
Don’t give up hope! You can sleep naturally.
All of this might be hard to take, but take heart—part of the problem is that although one adult out of four complains of insomnia, only one insomniac out of four brings it to the attention of their practitioner during a visit to solve another problem. Only one out of 20 schedules a visit to discuss specifically the problem of insomnia.
Insomnia may be considered an ordinary complaint (after one poor night) or as a chronic disease. Only a few patients with insomnia take a treatment for it and many times they self-medicate with over the counter products.
What to Avoid
Pharmaceutical drug companies are always looking for the next expanding market for drug development. Lunesta reached $329 million in sales this year, second only to Ambien with $2 billion in sales for its sleep medication.
Drugs rarely produce restful sleep and are plagued with numerous side effects such as next day drowsiness, sleep-walking and confusion. When mixed with alcohol, other medications or drugs they can be life-threatening.
In March, 2007 the FDA issued new warnings for prescription sleep medications.
Associated Causes of Poor Sleep
Slow-wave (deep sleep) and REM (rapid eye movement or dream sleep) are important for a good night’s rest. If you are not dreaming or are dreaming too much, you may not be sleeping well. If you have teenagers or a caregiver, you may not be sleeping well.
Insomnia is not a single disease but is a symptom of a wide range of problems. It’s important to bring your problem to the attention of your doctor to help determine the cause and appropriate remedy.
Some potential causes are:
1. Neurotransmitter imbalance; low esrotonin, high nor-epinephrine, low GABA
2. Restless leg syndrome; related to high dopamine.
3. Adrenal fatigue.
6. Blood Sugar swings.
7. Stress. Concerns about work, school, health or family can keep your mind too active, making you unable to relax.
8. Societal and family demands.
9. Stimulants. Prescription drugs, including some antidepressants, high blood pressure and corticosteroid medications, can interfere with sleep. Many over the counter (OTC) medications, including some pain medication combinations, decongestants and weight-loss products, contain caffeine and other stimulants. Antihistamines may initially make you groggy, but they can worsen urinary problems, causing you to get up more during the night.
10. Change in your environment or work schedule. Travel or working a late or early shift can disrupt your body’s circadian rhythms. Research has shown a higher incidence of cancer in individuals who work the night shift.
11. Long-term use of sleep medications. If you need sleep medications longer than several weeks, talk with your doctor, preferably one who specializes in sleep medicine.
12. Medical conditions that cause pain such as arthritis, fibromyalgia and neuropathies.
13. Eating too much, too late in the evening. Having a light protein snack before bedtime may help you sleep better. Some people wake up at night because of low blood sugar.
14. Physical disorders such as kidney disease, heart failure, asthma, sleep apnea, narcolepsy, restless legs syndrome, Parkinson’s disease and hyperthyroidism.
15. Environmental conditions such as noise levels, extremes in temperature and changes in sleeping locations and time zones.
Some Tips to Achieve Healthy Sleep
In spite of all the negative information about sleep deprivation, the International Classification of Sleep Disorders distinguishes more than 80 different disorders which can be effectively treated.
Here are a few ideas to help you sleep more soundly until you visit your doctor:
• Minimize your consumption of caffeine, alcohol and nicotine. This includes coffee, colas and chocolate. It is advised to restrict consumption after 3 p.m.
• Balance your hormones and neurotransmitters without pharmaceutical drugs.
• Establish a consistent, positive routine. Stick to a schedule. Go to bed at the same time and get up at the same time.
• Eat a small healthy snack with protein before bed to prevent low blood sugar from waking you.
• Have sex as it releases hormones that enhance sleep.
• Take time for yourself and keep your schedule reasonable. Your life depends on it.
• Your bedroom should be dark, quiet, relaxing and climate-controlled.
• Use the bedroom only for sleep. Watching TV contributes to insomnia.
• Use an eye mask or ear plugs as needed.
• Relax to prepare for sleep. Listen to calming music or meditate.
• Exercise 20 to 30 minutes a day, preferably 4 to 5 hours before sleep.
• Remove animals from the bedroom—many people resist this and choose to sleep with their animals rather than sleeping well.
• Gentle supplements promote restful sleep. Calm the mind and relax the muscles. Melatonin, seratonin support, valerian or magnesium are some to consider.
• Speak to a knowledgeable professional before using herbal products, supplements or hypnotherapy to help you sleep.
You deserve a good night’s sleep every night. Your life depends on it. For more information on this important health risk call now 818.707.9355.