Sleep Easy

Contrary to the messaging from sleep-aid commercials and mattress marketers, most of us are capable of sleeping well most of the time, if we avoid some self imposed obstacles.

Sleep Easy“For most people, there are no sleep challenges,” says Dr. Richard Kanak, a Monterey sleep disorders specialist and medical director of the Sleep Disorders Center at Community Hospital.

“As long as they go to bed when they’re tired, they’re going to fall asleep and stay asleep without difficulty. However, man is the only animal that willingly delays sleep. The amount of sleep we get is reduced most frequently by staying up too late and getting up too early the next morning, which is understandable considering the demands of the day.

But cheating sleep is a choice, not a condition.”

There are, however, some conditions that do keep us up, awaken us, or impair the quality of the sleep we get. The most common is sleep apnea, affecting an estimated 22 million Americans. This breathing disorder causes loud snoring and interrupts breathing during sleep, resulting in a true awakening or at least some level of sleep disturbance up to hundreds of times a night.

Treatment usually involves use of a continuous positive airway pressure (CPAP) device, which supplies a steady current of air through a small mask over the nose or soft silicone plugs in the nostrils. The air pressure keeps breathing consistent, promoting restful sleep.

Other frequent sleep thieves include insomnia and restless legs syndrome.

“Insomnia is usually a subjective complaint, not a specific disorder,” Kanak says. “Most people with insomnia complain about difficulty falling asleep, repeated unexplained episodes of waking, prolonged wakefulness, or waking up too early, unable to go back to sleep for the last hours of night. The most common cause of waking up early and not going back to sleep is depression, while trouble falling asleep at the beginning of the night is often related to anxiety, chronic pain, sleep apnea, or restless legs syndrome.”

With restless legs syndrome, people feel an unexplainable need to move their legs or arms at night and often have vague, uncomfortable sensations in the limbs.

The discomfort usually begins at or near bedtime, causing sufferers to get out of bed during the night, mostly during the first 2 to 3 hours. Sometimes stretching or walking around helps. Sometimes there is an underlying medical condition, usually iron deficiency, which can be treated with iron supplements. But most cases are probably hereditary, Kanak says. Drugs commonly used to treat Parkinson’s disease are the most effective treatment, though narcotics and other types of medications may also be helpful.

Sleep often eludes women during menopause. Bouts of nocturnal anxiety, hot flashes, or night sweats can result in wakefulness. In addition, loss of estrogen during menopause puts women at twice the risk of sleep apnea as they had premenopause.

And men and women find new sleep challenges once they get into their 70s.

“Many people over age 70 have difficulty sleeping more than 5 or 6 hours at night,” he says. “This leads to the myth that older people need less sleep.

But they generally still need the same amount of sleep as when they were younger; so with decreased sleep at night, they tend to run out of steam during the day and often benefit from a midday nap. That nap isn’t a cry for extra sleep; they’re just catching up on what they missed.”

How much sleep do we need?

The optimal range for 95 percent of the population, based on physical and mental performance, seems to be between 6.5 and 9.5 hours a night, Kanak says. The majority of people need between 7.5 and 8.5 hours of sleep. Many people get less than that.

 

Dr. Richard Kanak

Dr. Richard Kanak, medical
director of Community
Hospital's Sleep Disorders
Center

“You can help yourself get enough sleep by developing good sleep habits,” Kanak says. “It helps to set a standard or consistent wake-up time, and to go to bed when you are tired. You also should avoid alcohol, caffeine, smoking, vigorous exercise, and watching television or working on the computer in bed; these things can stimulate rather than relax you.”

Healthy people who practice good sleep habits but still can’t fall or stay asleep may consider physician-supervised use of sleep medication. It is, however, a complex option with pros and cons that depend on a person’s medical history, current health status, and other medication they take, Kanak says.

Another option might be a doctor recommended sleep study, performed at a facility such as Community Hospital’s Sleep Disorders Center, the only sleep center in Monterey County accredited by the American Academy of Sleep Medicine.

For more information, call the Sleep Disorders Center at 649-7210 or go online at chomp.org.

Sleep Tips

These practices may help you get a restful sleep

* Go to bed only when you are drowsy.

* If you can’t fall asleep or stay asleep, leave your bedroom and engage in a quiet activity elsewhere. Do not allow yourself to fall asleep outside the bedroom. Return to bed once you are sleepy.

* Maintain a regular wake-up time, even on weekends and holidays.

* Use your bed only for sleep, illness, and intimacy.

* If you must nap, limit it to less than 1 hour and no later than 3 p.m.

* Avoid alcohol, caffeine, and nicotine for 4–6 hours before bedtime.

* If you are a nighttime worrier, schedule your planning, worrying, and problem-solving for earlier in the day. If you’re still prone to worry at night, have a notepad by the bed to write down your concerns, confident they will keep until morning.

* A light snack a few hours before bedtime can help promote sound sleep; a heavy meal can thwart it.

* Participate in regular exercise, but schedule strenuous workouts at least 4 hours before bedtime.

* Distract your mind: Read, listen to music, or get lost in a book on tape.

* Minimize light, noise, and temperature extremes in the bedroom.

* Avoid watching the clock. Face it away from you to avoid obsessing about the passing hours.

* Take a warm bath, have a massage, meditate, pray, sip some decaffeinated tea, or do other soothing rituals before bed.

SOURCE: American Academy of Sleep Medicine