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Sleep tight: Ideas to help you fall asleep, stay asleep

Thursday, February 23, 2006

Dr. W. Keith Graham, medical director at the Saint Francis Medical Center Sleep Disorders Center, worked with the lab's monitoring equipment.
(Submitted photo)
Forget counting sheep.

For most people, such an exercise to bring about sleep is an exercise in futility.

Most people need seven to nine hours of uninterrupted sleep each night. Occasionally, though, something interrupts the sleep pattern -- and that makes us cranky. Chronic sleep deprivation can advance from cranky to fatigued, resulting in work errors, impaired concentration, and a higher incidence of workplace and traffic accidents.

Cheryl Counts, director of the Diagnostic Sleep Institute at Perry County Memorial Hospital in Perryville, Mo., says people often blame other conditions for their loss of sleep when it can be the other way around.

"Some patients have clinical symptoms of high blood pressure or diabetes when actually, if you plug into their history, the sleep disorder is actually the culprit," Counts said.

An estimated 6 million Americans suffer from some type of sleep disorder. Left untreated, sleep disorders can increase the risk of high blood pressure, coronary artery disease, heart failure and stroke, health professionals say. A lack of sleep can also increase the risk for depression. Good sleep enables us to work productively, make good judgments, avoid harm and interact well with other people. Interrupting the body's natural day-night cycle -- the circadian rhythm -- causes problems for people.

"It's amazing until recently people were passing different things off and not even looking at sleep as being the culprit" for their ailments, Counts said. "Sleep disorders are more common with shift workers and truck drivers whose circadian rhythm gets out of whack because of the way they sleep."

Dr. W. Keith Graham, director of the Sleep Disorders Center at Saint Francis Medical Center, said that frequently-changing shifts tend to be more detrimental than shifts that last a few weeks or more. He said that people who work a few days on one shift then switch to another may have less trouble adjusting if the shifts move forward rather than against the clock.

"If they can," Graham said, "we recommend they try to avoid shift work."

For those who can't avoid shift work, Graham said he suggests patients try to keep their schedule as constant as possible. If they're on a fairly regular night shift, he suggests they keep their weekends on the same schedule so as not to interrupt their circadian rhythm.

Other forms of sleep disorders include problems that the patient might not be aware of, but others in the family do notice, such as sleepwalking.

Some prescription medicines can affect an ability to get a good night's sleep.

Graham said medications are available to help people who either can't sleep or who have trouble staying awake. He said physicians who treat sleep disorders in general try to avoid sleep medications to prevent patients from becoming dependent on them.

Aging can also keep us up at night.

"As we get older our bodies and our needs change, especially older women," Counts said. "Women going through menopause, even if they did not snore before, as they go through menopause with their hormones changing, they will have more testosterone and that will cause them to snore more."

Post-menopausal woman also tend to develop sleep apnea, more commonly associated with men, she said. As men age, they have more pain and body aches and take more mediations which can affect their sleep.

A recent study reported by USAToday.com indicates that a lack of sleep may also lead to weight gain. Eve Van Cauter, a researcher from the University of Chicago, said that 25 years of research on the hormones that are affected by sleep turned up the conclusion that sleep deprivation activates a small part of the hypothalamus, the region of the brain that also is involved in appetite regulation.

Other research at the University of Wisconsin, Stanford University and Columbia University support Van Cauter's findings, that people eat more because they're hungrier, they're awake longer and consume far more calories than they burn in the extra hours they're awake.

According to the Web site WebMD.com, after age 40 people's sleep patterns naturally change, and we wake more frequently at night. Psychological stressors may also affect sleep.

Sleep labs generally will administer the Epworth Sleepiness Scale test to determine if a patient has a sleep disorder. Some patients may be further evaluated by an overnight test that monitors sleep patterns, breathing, oxygen levels and other functions.

Once detected, sleep disorders can be corrected through medication, diet, surgery or the use of a device which improves breathing during sleep.

Overcoming a sleep disorder is possible, Graham said.

"They tend to be things that seem to be chronic," he said. "We begin the appropriate therapy and can straighten them out in a few months. It does take work and most of the time what the patient will have to do. Other disorders tend to be more long-standing problems and require therapy for a long time."

Physician referral is required for participation in a sleep study. Insurance providers, Medicare and Medicaid cover the study, and some providers also cover any special equipment required to treat a sleep disorder, according to Saint Francis Medical Center.

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