Sleep Disorders

Although two-thirds of Americans have sleep problems, fewer than 3% are seeing a physician about it. According to the National Commission on Sleep Disorders Research, the vast majority of people with sleep disturbances suffer in silence. They enjoy life less, are less productive, and endure more illnesses and accidents at home, on the job, and on the road.

There are some general ways to improve sleep

Many things can interfere with sleep, ranging from anxiety to an unusual work schedule. People who have difficulty sleeping often discover that their daily routine holds the key to nighttime woes. Before examining specific sleep problems, let's look at some common enemies of sleep and some tips for dealing with them.

Cut down on caffeine
Caffeine drinkers may find it difficult to fall asleep. Once they drift off, their sleep is shorter and lighter. For some people, a single cup of coffee in the morning means a sleepless night. That's because caffeine is an adenosine blocker, impeding the very neurotransmitter that promotes sleep. Caffeine can also interrupt sleep by increasing the need to urinate during the night.

People who suffer from insomnia should avoid caffeine as much as possible, since its effects can endure for many hours. Because caffeine withdrawal can cause headache, irritability, and extreme fatigue, some people find it easier to cut back gradually than to go cold turkey. Those who can't or don't want to give up caffeine should avoid it after 2 p.m., or noon if they are especially caffeine-sensitive.

Stop smoking or chewing tobacco
Nicotine is a central nervous system stimulant that can cause insomnia. This potent drug makes it harder to fall asleep because it speeds your heart rate, raises blood pressure, and stimulates fast brain wave activity that indicates wakefulness. In people addicted to nicotine, a few hours without it is enough to induce withdrawal symptoms; the craving can even wake a smoker at night. People who kick the habit fall asleep more quickly and wake less often during the night. Sleep disturbance and daytime fatigue may occur during the initial withdrawal from nicotine, but even during this period, many former users report improvements in sleep. Quitting also offers many other health benefits, including a lower risk for cancer, heart disease, and stroke. But those who continue to use tobacco should avoid smoking or chewing it for at least one to two hours before bedtime.

Use alcohol cautiously
Alcohol depresses the nervous system, so a nightcap can help some people fall asleep. However, the quality of this sleep is abnormal. Alcohol suppresses REM sleep, and when it's metabolized a few hours later, the soporific effects are gone. Drinkers have frequent awakenings and sometimes frightening dreams. Alcohol is blamed for 10% of chronic insomnia cases.

Some people fail to get even the short-term benefit from a nightcap because alcohol raises their epinephrine levels and makes falling asleep difficult. Also, because alcohol relaxes throat muscles and interferes with brain control mechanisms, it can worsen snoring and other nocturnal breathing problems, sometimes to a dangerous extent.

Besides contributing to middle-of-the-night wakefulness, alcohol can cause dangerous drowsiness during the day or evening. Drinking during one of the body's intrinsic sleepy times — midafternoon or at night — will induce more sleepiness than imbibing at other times of day. Even one drink can make a sleep-deprived person drowsy. In an automobile, the combined effect of alcohol and sleepiness can be deadly, with the two factors significantly increasing a person's chances of having an accident.

Avoid a sedentary life
Aerobic exercise like walking, running, or swimming promotes restfulness by decreasing the time it takes to fall asleep, reducing the frequency of awakenings, and increasing the amount of deep sleep. According to a Duke University study, physically fit older men fell asleep in less than half the time it took for sedentary men, and they woke up less often during the night.

Exercise is the only known way for healthy adults to boost the amount of deep sleep they get. Researchers from the University of Washington found that older men and women who reported sleeping normally could still increase the amount of time they spent in deep sleep if they engaged in aerobic activity. Exercising five or six hours before bedtime will encourage drowsiness when it's time to go to sleep, but strenuous activity within two hours of bedtime can keep you awake. If you can't exercise several hours before bedtime, exercising earlier in the day can also help you sleep better.

Improve your sleep surroundings
Like Pavlov's dogs, humans learn to respond to environmental cues. Removing the television, telephone, and office equipment from the bedroom is a good way to reinforce that this room is meant for sleeping.

An ideal environment is quiet, dark, and relatively cool, with a comfortable bed and a minimal amount of clutter from daytime responsibilities. Reminders or discussions of stressful issues should be banished to another room.

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