4 Sleep Disorders Solved
By Stephanie Schorow, Special to LifescriptPublished October 25, 2009Do you toss and turn at night, or wake up feeling exhausted? You could have a sleep disorder that’s keeping you from getting the zzz’s you need. Find out what causes these 4 common sleep woes and how to banish them for good. Plus, test your sleep IQ with our quiz…
Sleep: New moms dream about it. Night shift workers rarely get enough. But they’re not the only ones not getting adequate pillow time. Adults need an average of 7-9 hours of sleep per night, according to the National Sleep Foundation. Yet most women age 30-60 are getting by on less – six hours and 41 minutes to be exact. Unfortunately, it’s not just dark circles women have to worry about. Lack of sleep can trigger a host of problems, including:
Daytime sleepiness
Problems concentrating
Poor performance on the job or at school
Irritability
Increased likelihood of illness
Weight gain
“The more common the sleep loss, the worse the problems get,” says Douglas Kirsch, M.D., a sleep specialist at Brigham and Women’s Hospital in Boston. Experts agree that most people who boast about their ability to operate on five or six hours of sleep are kidding themselves.
“They don’t realize how much better they would be with seven to eight hours,” says David Schulman, M.D., director of the Emory Sleep Disorders Laboratory in Atlanta. Here are some common problems that get in the way of slumber and what to do about them:
1. Insomnia
What it is: Insomnia is difficulty falling asleep or staying asleep. Most people experience the occasional sleepless night, usually during periods of stress. However, about 10% of American adults report chronic insomnia. Women are more likely than men to report ongoing problems, according to the American Academy of Sleep Medicine. Pregnancy and menopause can trigger insomnia, probably due to shifts in estrogen levels. In fact, a 2007 National Sleep Foundation poll found that 30% of pregnant women and 42% of post-partum women say they rarely or never get a good night’s sleep, compared to 15% of all women. Causes of insomnia: A few sleepless nights, particularly during a period of stress or major life change, is no cause for alarm. Such “reactive insomnia” often goes away on its own, says Schulman of the Emory Sleep Disorders Laboratory. But if those sleepless nights pile up, it can set the stage for chronic insomnia. Going to bed becomes an exercise in anxiety because “you can’t get sleep off your mind, so you can’t sleep,” Schulman says. Simply put, you psych yourself out. Women seem to be more likely than men to “catastrophize” their inability to sleep – that is, they begin to see their lack of sleep as a sign of an impending health disaster, says Gregg D. Jacobs, M.D., an insomnia specialist at the Sleep Disorders Center at the University of Massachusetts and author of Say Goodnight to Insomnia (Holt). This only serves to reinforce patterns of sleeplessness, Jacobs says. Depression and anxiety can also be underlying causes of insomnia. That’s why you should discuss long-term insomnia with a health care professional.
How to treat insomnia: If you have trouble sleeping, your instinct might be to reach for a sleeping aid. That may be OK for a few nights, but experts caution against using sleeping pills for more than a month. That’s because sleep medications have side effects including drowsiness and memory loss, and they can become psychologically, if not physically, addicting, Jacobs says. Of course, if you’re pregnant talk to your doctor before taking any sort of sleeping aid. The best way to overcome insomnia is to take inventory of your bedtime routines and sleeping habits. Most of the time, small changes can make a difference. Start by cutting back on caffeine. Also, make sure your room is dark and cool. And try to adhere to a consistent sleep schedule by waking up and going to bed at the same time every day, even on weekends.
2. Restless leg syndrome (RLS)
What it is: RLS is a neurological disorder characterized by unpleasant sensations in the legs and an uncontrollable urge to move when at rest. Some people describe it as an “odd” feeling in their leg or an inability to sit still. Others describe a sensation of burning, creeping, tugging, or even insects crawling inside the legs. RLS can be a serious condition that disrupts sleep. Women are nearly twice as likely to suffer from RLS than men, according to the American Academy of Sleep Medicine. Causes of RLS: RLS’s cause is unclear but it seems to be related to deficiencies of iron and/or dopamine in the body, says Schulman of Emory’s sleep lab. Women may be particularly affected because menstruation tends to deplete iron in the system. How to treat RLS: Treatment depends on the severity of the symptoms. For less serious cases, a doctor may recommend hot or cold showers, using heating pads, exercising or massage therapy – all relax the muscles. Severe cases may warrant anti-seizure medications and drugs that mimic dopamine, says Brigham’s Kirsch. Another effective option is iron supplements. If you have RLS, be aware that several medications can aggravate your symptoms. These include antidepressants, tranquilizers and non-prescription allergy and cold medications with antihistamines.
3. Obstructive sleep apnea
What it is: Obstructive sleep apnea is a breathing disorder that causes loud snoring and pauses in breathing. Most pauses last between 10 and 30 seconds, but can be longer. Apnea results in fragmented or poor quality sleep. More ominously, it’s also associated with high blood pressure, heart problems, memory problems and headaches. It may lead to poor job performance and even motor vehicle crashes among sleep-deprived drivers. In fact, the National Transportation Safety Board has urged commercial truck and bus drivers and merchant ship pilots to be screened for the condition. What causes sleep apnea: Sleep apnea occurs when certain airway muscles relax during sleep, causing soft tissue in the back of the throat to collapse and block the upper airway, Sleep apnea can also be weight-related. It’s believed that as weight accumulates, fatty tissue can further block the air passage, making sleep apnea worse. According to the American Academy of Sleep Medicine, about 9% of women and 24% of men have obstructive sleep apnea. Not all, however, report daytime sleepiness as a result. As women age and go through menopause, they tend to report more sleep apnea. This may be due to weight gain and hormone changes. How to treat sleep apnea: Apnea can be treated with lifestyle changes, such as losing weight, avoiding alcohol and tobacco, and changing sleeping position. (Apnea tends to be worse when sleeping on the back.) More severe cases may be treated with a Continuous Positive Airways Pressure (CPAP) mask that gently blows air into the throat during sleep. While CPAP masks are considered quite effective, the awkwardness of wearing it can take some getting used to.
Another option is surgery to widen the breathing passages. This involves removing, shrinking or stiffening excess tissue in the throat.
4. Narcolepsy
What it is: In TV shows and movies, narcoleptics fall asleep mid-sentence and wake up as if nothing happened. In reality, a person suffering from narcolepsy has intense daytime sleepiness and dozes off gradually, Schulman says, sometimes in inappropriate situations.
“People with narcolepsy are very sleepy but it’s not as if they are walking and suddenly drop over asleep,” Schulman says. Narcoleptics may also have to deal with the double-whammy of insomnia too. Not only do they fall asleep during the day, but they can have periods of intense wakefulness during the night. About one in every 2,000 people suffers from narcolepsy.
Narcolepsy is associated with a condition called cataplexy. People with cataplexy sometimes experience episodes of partial or total muscle loss, often triggered by emotional reactions such as anger or laughter. It may look frightening to see someone go completely slack for 30 to 60 seconds but cataplexy itself is not life-threatening, says Schulman. “People are awake during cataplexy attacks but they just can’t move.” Narcolepsy seems to affect men just slightly more than women, according to the American Academy of Sleep Medicine. It generally starts in the teens but may not be diagnosed until a person is 20 to 30 years old. Often, it’s never diagnosed. “People just get used to being tired,” Schulman says. What causes narcolepsy: Research has found differences between normal sleepers and narcoleptics during the REM (rapid eye movement) stage of sleep. Narcoleptics go into REM sleep much more quickly than normal sleepers. The brain chemical hypocretin may be to blame. Hypocretin helps regulate wakefulness and keeps REM sleep stable. Narcoleptics have lower levels of this chemical, but researchers don’t know why. There could be a genetic link: Up to 10% of people with narcolepsy report having a family member with the same symptoms, according to the National Institutes of Health. And narcolepsy knows no bounds: It appears throughout the world and in every racial and ethnic group. How to treat narcolepsy: There’s no cure for narcolepsy, so daytime sleepiness and drowsiness is treated symptomatically. Short naps can be particularly effective. In extreme cases, medications – often stimulants – can be prescribed.
Good Sleep Habits
If you suspect you have any of these conditions, talk to your doctor. You may be referred to a local sleep clinic. In the meantime, take these steps to improve your sleep:
No TV, laptops, or snacks in bed. Limit the use of your bed to sleep and sex. If you get in the habit of watching TV, eating or other activities in the bedroom, your mind won’t associate it with snoozing. Relocate after 30 minutes of tossing and turning. Get out of bed, read a book or do some other activity. “It’s like taking a break from a math problem,” Schulman says. “It takes pressure off trying to get to sleep.” Avoid caffeine after noon. Those java jolts you drink throughout the day have a way of kicking in all night long. Watch out for the caffeine in chocolate, energy drinks, some teas and cola beverages. Exercise at the right time. Working out will generally help with insomnia but not if you do it too close to bedtime. The “fight or flight” hormones that build up in the body during intense activity can keep you awake at night.
Pass the cheese, please. To help you drift off, eat a small piece of hard cheese before bed. Cheese naturally has the amino acid tyramine which seems to induce relaxation – similar to how tryptophan in turkey seems to make people sleepy, Schulman says. But don’t eat too much: Going to sleep on a full stomach may not produce restful sleep because it causes fluctuations in blood sugar levels. Keep your bedroom dark and cool. People sleep better in cooler temperatures, Schulman says. The National Sleep Foundation recommends temperatures between 54-75 degrees. Maintain a consistent sleep schedule. Go to bed and to get up at the same time every day. Going to bed earlier than usual may only prolong sleeplessness and getting up late on weekends produces the equivalent of jet lag, Jacobs says. Let the sunshine in. Being in the sunlight at some point during the day enhances your body’s natural tendency to sleep when it’s dark.
Are You Smart About Sleep?
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