Patients often come to me complaining of the following symptoms, periodic drowsiness, and sleepiness during the day, or falling asleep at inappropriate times. They insist that they spend plenty of time in bed, at least 8 hours a night, so why are they so tired?
After ruling out other medical causes for their fatigue I proceed to ask a few questions:
• Do you consistently take more than 30 minutes each night to fall asleep?
• Do you consistently awaken several times each night and then have trouble falling back to sleep, or you awaken too early in the morning?
• Are you told you snore loudly, snort, gasp, make choking sounds, or stop breathing for short periods?
• Do you have creeping, tingling, or crawling feelings in your legs or arms that are relieved by moving or massaging them, especially in the evening and when trying to fall asleep?
• Do you feel as though you cannot move when you first wake up?
If the answer to one or more of these questions is yes, I explain that a sleep disorder might be the problem. It is estimated that 40 million Americans suffer from a sleep disorder such as insomnia (difficulty falling or staying asleep), sleep apnea (sleep-disordered breathing), restless legs syndrome, and narcolepsy (uncontrollable drowsiness). Although sleep disorders can significantly affect your health, safety, and well-being, they can be treated.
Why is Sleep So Important?
At one time sleep was thought of as simply a period of time when you are not awake. But due to a great deal of research and scientific studies, it is now known that sleep has stages that cycle throughout the night. In essence vital tasks are carried out during this “down time” that help maintain good health and enable people to function at their best.
You need sleep to think clearly, react quickly, and create memories. The pathways in the brain that help us learn and remember are very active when we sleep. Cutting back by even 1 hour can make it tough to focus the next day and can slow down your response time. When you are sleep deprived, you are more likely to make bad decisions which lower your ability to perform well at your job and to carry out other daily activities.
Insufficient sleep can make you cranky and is linked to poor behavior and trouble with relationships, especially among children and teens. People who chronically lack sleep are also more likely to become depressed.
Lack of sleep or getting poor quality sleep on a regular basis increases the risk of having high blood pressure, heart disease, and other medical conditions.
How much sleep is enough?
Does it really matter if you get enough sleep? Yes it does, without a doubt! Both the quantity and quality of your sleep is important. Most adults need 7-8 hours of sleep each night. Many people believe that this number changes as you age and older adults need less sleep. There is no real evidence to support this notion. However, we do know that as you age you are more likely to awaken easily and spend less time in the deep, restful stages of sleep.
What If You Discover You Have A Sleep Disorder?
I always assure my patients that having a sleep disorder is not life threatening. Most sleep disorders are treatable with changes in lifestyle routines combined with herbal sleep aids, or prescribed medications.
The first thing is to figure out why you are having trouble sleeping. It might be related to stress or illness. Sometimes patients drink too many caffeinated drinks or too much alcohol. Medications, diet, or daily living routines may affect the quality of sleep. After medical problems are ruled out I suggest trying a few self-care methods that I have found to be helpful.
Here are some recommendations by category of the most common sleep disorders:
• Stick to a regular bedtime schedule. Try to get out of bed at the same time each morning, even if it’s a weekend or holiday.
• Avoid napping during the day.
• Avoid stressful activities and vigorous exercise for two hours before going to bed. Do exercise regularly, but earlier in the day.
• Before going to bed, try relaxation techniques, such as deep breathing, yoga, or meditation.
• Make sure your bedroom is dark, quiet, and cool. Use earplugs or eye shades if needed.
• Consider trying nutritional supplements such as: Melatonin or herbal remedies such as: Valerian, Corydalis, Lavender, Chamomile, Passion Flower and Hops
• Avoid alcohol and sleeping pills.
• Consider an evaluation at a sleep laboratory for a device called continuous positive airway pressure (CPAP) that increases the air pressure inside your throat.
• Napping helps to relieve the sleepiness of narcolepsy.
• Some prescriptions such as Ritalin or dextroamphetamine help with alertness during the day.
• Provigil (modafinil) is a new, less powerful type of stimulant that has recently been found to be effective in maintaining wakefulness.
Restless Leg Syndrome
• Cut caffeine intake.
• Take a warm bath or do relaxation exercises before bed.
• Hot or cold packs on your legs may provide relief.
Getting a good night’s sleep is right up there with a healthy diet and being physically active when it comes to overall well-being. Don’t cut back on your sleep when you are in a rush to get things done. Make sure you get enough quality sleep to fully enjoy your life.
Mark Rosenberg, M.D.