Sleep Problems

Damien Johnson :

In the fast-paced lifestyle of the 21st century, it is not surprising that sleep disorders are on the rise. There’s just a lot that needs to be done in our daily lives, career, studies, kids, the car that broke down, meetings, the outdoor hike… just thinking about it keeps you up all night.

But getting yourself sleep-deprived just won’t do. If you do, your career will be long gone before you know it, you’ll see D’s – nope, not the bra size – D’s on your paper, you’ll be short-tempered with your kids, you’ll never figure out how to change your tires, you’ll be having a heatstroke after a mile hike, and oh! You just missed your meeting!

Sleep deprivation does that and more. And there’s just no way you’re going to let that happen to you. Here are ways to achieve better sleep without compromising your daytime activities:

1. Develop good sleeping habits!

* Create a sleeping environment that is conducive for sleeping. Make sure your bedroom is dark, quiet, clean and well-ventilated, and a bed with comfortable mattress, linens and pillows.

* Avoid eating and doing other activities like eating, working, working out, listening to the radio and watching TV inside your bedroom. It should be for sleeping and sexual activities exclusively.

* Establish a regular sleep/wake cycle. Going to bed at the same time each night and getting up at the same time each morning does the trick. Or when you are on shifting work schedules, sleep with minimal light and expose yourself to bright light when you wake up. Avoiding daytime naps will also help you establish your sleeping routine.

* Do not stay in the bedroom if you are not yet sleepy. Get out of bed and do something relaxing like listening to soft, mellow music or hypnosis CDs or reading a non-stimulating book. Don’t stay in bed tossing and turning or worrying when you’re going to be able to sleep. It’s best to develop a bedtime routine such as hot baths and body massages before climbing to bed.

2. Watch what you eat!

* Finish dinner two to three hours before bedtime.

* A light snack of bread, crackers, cheese or milk before bedtime may be helpful. An empty stomach can keep you from sleeping, but heavy meals should be avoided as well.

* Spicy foods as well as sweets also interfere with sleep.

* Try not to drink anything at least an hour before bedtime to avoid having to get up at night to go to the bathroom.

* Getting yourself a cup of lavender tea to help you relax, or a glass of tart cherry juice which naturally contains melatonin, a substance that helps promote sleep, may also be helpful.

3. Stay away from stimulants!

* Caffeine-containing products such as most teas, coffee, colas, chocolates and chocolate-containing foods should be avoided. They’ll keep you up all night.

* Smoking may be relaxing but it will you cause to wake up constantly all throughout the night causing disrupted sleep. Avoid smoking too close to bedtime.

* Alcohol may make you drowsy but don’t be fooled. As the alcohol levels in body drops, so does its depressant effects. It can cause you to have nightmares and constant wakefulness. It can also make the apnea worse if you have it.

4. Exercise regularly! (It’s best to do it in the daytime or at least three hours before bedtime.)

You see, achieving better sleep isn’t that hard. You won’t have to resort to sleeping pills and other drastic methods to conk you out. Just follow the guidelines above and you’ll be off to dreamland in no time. Now, you won’t have to miss your meetings and your outdoor activities and will be able to spend more time bonding with your spouse and kids instead of bickering.

Enjoy life to the fullest! Don’t let sleeplessness get in the way. Remember, a good sleep promotes a better quality of life.

Dhandapani Premkumar and Premkumar Remya :

Feeling crabby lately? It could be you aren’t getting enough sleep. Work, household responsibilities and child care can make sleep difficult to come by. Factor in other unexpected challenges such as financial worries, layoffs, relationship issues or an illness, and quality sleep may be even more elusive.

You may not be able to control or eliminate all of the factors that interfere with your sleep, but you can create an environment and adopt habits that encourage a more restful night. Try these suggestions if you have trouble falling asleep or staying asleep:

*Go to bed and get up at about the same time every day, even on the weekends. Sticking to a schedule helps reinforce your body’s sleep-wake cycle and can help you fall asleep better at night.

*Don’t eat or drink large amounts before bedtime. Eat a light dinner about two hours before sleeping. If you’re prone to heartburn, avoid spicy or fatty foods, which can make your heartburn flare and prevent a restful sleep. Also, limit how much you drink before bed. Too much liquid can cause you to wake up repeatedly during the night for trips to the bathroom.

*Avoid nicotine, caffeine and alcohol in the evening. These are stimulants that can keep you awake. Smokers often experience withdrawal symptoms at night, and smoking in bed is dangerous. Avoid caffeine for eight hours before your planned bedtime. Your body doesn’t store caffeine, but it takes many hours to eliminate the stimulant and its effects. And although often believed to be a sedative, alcohol actually disrupts sleep.

*Exercise regularly. Regular physical activity, especially aerobic exercise, can help you fall asleep faster and make your sleep more restful. Don’t exercise within three hours of your bedtime, however. Exercising right before bed may make getting to sleep more difficult.

*Make your bedroom cool, dark, quiet and comfortable. Create a room that’s ideal for sleeping. Adjust the lighting, temperature, humidity and noise level to your preferences. Use blackout curtains, eye covers, earplugs, extra blankets, a fan, a humidifier or other devices to create an environment that suits your needs.

*Sleep primarily at night. Daytime naps may steal hours from nighttime slumber. Limit daytime sleep to about a half-hour and make it during midafternoon. If you work nights, keep your window coverings closed so that sunlight, which adjusts the body’s internal clock, doesn’t interrupt your sleep. If you have a day job and sleep at night, but still have trouble waking up, leave the window coverings open and let the sunlight help wake you up.

*Choose a comfortable mattress and pillow. Features of a good bed are subjective and differ for each person. But make sure you have a bed that’s comfortable. If you share your bed, make sure there’s enough room for two. Children and pets are often disruptive, so you may need to set limits on how often they sleep in bed with you.

*Start a relaxing bedtime routine. Do the same things each night to tell your body it’s time to wind down. This may include taking a warm bath or shower, reading a book, or listening to soothing music. Relaxing activities done with lowered lights can help ease the transition between wakefulness and sleepiness.

*Go to bed when you’re tired and turn out the lights. If you don’t fall asleep within 15 to 20 minutes, get up and do something else. Go back to bed when you’re tired. Don’t agonize over falling asleep. The stress will only prevent sleep.

*Use sleeping pills only as a last resort. Check with your doctor before taking any sleep medications. He or she can make sure the pills won’t interact with your other medications or with an existing medical condition. Your doctor can also help you determine the best dosage. If you do take a sleep medication, reduce the dosage gradually when you want to quit, and never mix alcohol and sleeping pills. If you feel sleepy or dizzy during the day, talk to your doctor about changing the dosage or discontinuing the pills.

If you’re having problems sleeping more than three times a week for a month’s time, see your doctor. You could have a sleep disorder, such as obstructive sleep apnea or restless legs syndrome. Identifying and treating the cause of your sleep disturbance can help get you back on the road to a good night’s sleep.

Nishanth Reddy :


Sleep forms part of human’s biological need to rest. As a person sleeps, the various physiological processes of a human body figuratively put into an apparent arrest and some parts of our system that were mostly exploited can be replenished for future use.

However, imagine a system so disrupted that our normal scheduling for sleeping and waking is totally altered. Some people tend to sleep early and wake up early in the morning and some cannot sleep early and as a consequence, wakes up late.

These and other sleep-related problems are manifestations of a malfunctioning biological circadian clock and characterize several forms of Circadian Rhythm Syndrome. Circadian activity is a unique by 24-hour period or cycles in which our body is physically patterned.

24-hour vs. 25-hour cycle

Earth rotates around the sun in a 24-hour cycle, so as our body functions in this 24-hour time schedule. All living organisms charismatically subscribe to this cyclic resting and activity patterns so that their body could function in sync with the environment in which they live.

Although humans externally operate under a 24-hour environment, research found that our body clocks evidently works significantly different than what we see in the environment.

It shows that the human body closely behaves as if it were under a 25-hour environment. Convincingly, humans’ reluctance to wake up at a required time and sleeping late at night probably explains this theory.

To compensate for this discrepancy, the body uses time “cues” to effectively counter-manage this asynchronous rhythmical. Setting an alarm helps us wake up at a designated time of the day and allows us to function as if it were under the 24-hour rhythmic schedule.

Dark vs. Light

Light and temperature provides the determining factor by which the body responds to the 24-hour activity period. The presence or absence of light mainly affects the part of the brain, which paces your bodily activities.

It was understood that the fundamental locus or location of our biological clock is the brain specifically in the suprachiasmatic nucleus (SCN) of the hypothalamus.

In complex animals like humans, hypothalamus forms part of the autonomous nervous system, which in part, controls the functions of organs that are not voluntarily controlled, hence involuntary. Involuntary, meaning, they are not governed by conscious will to act. These include breathing, heartbeat and intestinal digestion.

Eyes, Light and SCN

One interesting point to make is that the location of SCN is just above the optic chiasma (cross). Optic chiasma can is described as a location where optic nerve fibers meet and cross (chiasma-cross).

It is fitting to say that; the perception of light through the opening in the eyes triggers the wake/sleep patterns in humans since this is one way the organism receives such physical message.

As retina (a portion of the eye where initial image of an object is stored) traps light rays, an optic fiber relays the image to the brain via characteristic electrical pulses.

This unique sensory impulse is carried along the optic fibers to the occipital lobe (rear part) of the brain and is perceived as images. The proximity of the optic chiasma to the SCN perhaps provides the opportunity for the hypothalamus to “sense” the referred electrical impulses.

Forms of Circadian Rhythms Syndrome/Disorders

Circadian Rhythm defects can come many distinct forms depending on the amount and timing of waking up and sleeping. Others, as in the case of Seasonal Affective Disorder (SAD), result in the changes in the length of day and night.

People who tend to sleep at a later time of the day and wake up late as well are said to be exhibiting Delayed Sleep Phase Syndrome (DSPS). These people tend to develop insomnia, an abnormal inability to take adequate amount of sleep due to not being able to sleep at the right time of the night.

Still, other people, especially the elderly, are more likely to sleep early around 7:00 PM and consequently wake up early around 1:00 AM or 2:00 AM. This is a symptom of disrupted natural biological rhythms known as Familial Advanced Sleep-Phase Syndrome (FASPS).

The amount of a substance called melatonin is also perceived as a motivating factor in sleep-related disorders in humans. In a study among vertebrate mammals, melatonin is secreted in response to the absence of light.

This means more melatonin is secreted in the period of darkness and less in the presence of light. It presupposes the idea that melatonin is related to the 24-hour sleep/wake cycle of every human being.

Recommendations

With the knowledge gained in the preceding discussion, it can be assumed that the presence and absence of light affects our sleeping/waking schedule. With these in mind, keep yourself committed to your schedule to rest and sleep and set aside things, which are not really important.

Keep your room as dark and gloomy as possible, to make it easy for you to sleep. Colorful objects stimulate your senses and disrupt sleep. Keep it ventilated and air-conditioned.

Studies show that as we sleep, our body temperature drops and allows the neurotransmitter melatonin to be produced at a rapid pace.

Keep those things in mind and do not forget to seek medical help should your condition progresses.

Gabrielle Lichterman :


Have you tried practically everything to get a better night’s sleep? You’re not alone. More than 1.6 million Americans say that they’ve experimented with herbal remedies, relaxation techniques and other methods to fall sleep, according to a recent study from the National Center for Complementary and Alternative Medicine. But which really work? Researchers have come up with a few suggestions:

* Try a cup of chamomile tea.

This beverage contains glycine, a chemical that acts as a mild sedative, say researchers from Imperial College London. And since glycine is also a muscle relaxant, it may help reduce menstrual pain. Tip: Drink your tea an hour or more before bedtime if nighttime trips to the bathroom pose a problem.

* Consider the possibility of reflux.

Even if you don’t feel the pain of heartburn, acid reflux may be waking you up at night, according to a study conducted at the Lynn Health Science Institute in Oklahoma City. Dubbed “silent reflux” due to its lack of symptoms, this condition affects about one in four troubled sleepers. Tip: If you have sleep problems that don’t have an obvious cause, talk to your doctor about whether you might be suffering from reflux.

* Duck from dawn’s early light.

“Avoid very early morning sunlight if you wake up too early,” says James Maas, Ph.D., a sleep researcher at Cornell University and author of Power Sleep. “Your body will start to come out of its sleep cycle when it should still be in a deep sleep.” Since sunlight helps set your body clock, exposure to the bright light of early morning contributes to the premature peak in your body cycle. Keep your bedroom very dark, but get plenty of light after rising to boost mood and alertness.

To reset your body clock so that you get better sleep and don’t wake up too early in the morning, take a late afternoon walk, advises Maas: “Melatonin is a hormone that sets your inner clock and tells your body when it’s time to be sleepy. By getting late afternoon sunshine, you’ll be forcing your body to produce melatonin later in the day. This will cause your inner body clock to peak later, making you sleep more soundly at night.”

* Check your medicine cabinet.

Have you been prescribed medicine for high blood pressure or depression? Some of these drugs can cause insomnia. For instance, a study published in the European Journal of Clinical Pharmacology found that some beta-blockers-used to treat high blood pressure-slashed production of melatonin by 80 to 90 percent. In addition, taking the antidepressants known as selective serotonin reuptake inhibitors (SSRIs) can lead to trouble falling asleep or nighttime awakenings. If you use either of these types of drugs and you have sleep problems, talk to your doctor about changing your dosage or switching to a drug that doesn’t disrupt sleep.

Using these strategies, you just may zap your sleep problems and get better rest.

Writer: Gabrielle Lichterman

©MediZine’s Healthy Living, Second Quarter 2007



powerful sleep

Steve Hefferon :

What’s the most time-consuming thing you do, day in and day out, every day of your life? Eating? I hope not. Sitting in traffic? Ditto. Watching TV? Nope. It’s sleeping.

You spend between six and 10 hours a night in bed. That’s one-third of your life. And when it comes to back pain, those are some of the most important hours in your day.

Sleep helps your body heal. It’s really the only time your muscles can completely rest and recover. There are a ton of studies linking sleep with healing. They show that, among other things, human growth hormone and melatonin, both of which play a big role in tissue recovery and immunity, are produced during sleep.

So if you’re not getting good sleep-whether it’s due to pain, anxiety, fear or whatever-you’re not giving your muscles, especially your back muscles, time to rejuvenate themselves for the next day’s activities.

Believe me, I know. In my struggles with all kinds of pain over the years, I’ve come to understand first-hand the importance of restful sleep. In this article, I’d like to share with you what I’ve learned.

What’s the Best Mattress

Is firm better than soft? From a physiological standpoint, a more supportive mattress is better regardless of what sleep position you prefer.

But having said that, the real answer is this: The best mattress is the one that helps you sleep well and wake up without any added pain and stiffness. It’s really about personal preference and what you are used to.

In my experience, I have tried them all. I tried a memory foam mattress but it was too soft. (I gave to my parents, and they love it.) I now use a firm box spring and mattress plus a towel under the sheets to give added support to my hips and pelvis.

Special Secret Tip:

You read that right-I put a towel under my fitted sheet. A small blanket works well too. Here’s what you do: Fold the towel or blanket in half (and in half again if it’s thin). Place it under the fitted sheet-so it doesn’t move around during the night-under the small of your back and spreading down toward your knees. This extra support helps prevent your pelvis from sagging into the mattress. It might only make a difference of a few millimeters. But that is a huge difference when it comes to preventing the added stress that comes with remaining in any sleeping position all night long.

What’s the Best Position to Sleep In?

As with the mattress you chose, the position you sleep in is based on your personal preference or physical limitations based on pain or restrictions from your doctor because of surgery. In general, back sleeping is the most stable position for your spine and the least irritating to your muscles. Side sleeping is the next best. Stomach sleep is the least desirable if your back is not adequately supported.

I personally like a modified side-lying position, using full-length body pillow. I sleep “hugging” the pillow with my arms and legs, which is really comfortable and takes pressure off my lower back. You should try it. Body pillows can be found at most retail bedding stores. They are not expensive and may give you an alternative sleeping position that will make a big difference in your comfort level, thus improving the quality and duration of sleep.

Why am I Sore When I Wake Up?

Typically, those with back pain don’t roll over as much as those without pain. You may even find your self with limited movement. And because the hips are the heaviest part of the body, they sag into the mattress over time. That puts undue pressure on the ligaments, joints and muscles of the lower spine. This is why I recommend the added support under the fitted sheet.

Think of it as like stretching the same muscles for six to eight hours straight. Would that feel good? Of course not. So it’s no wonder you wake up sore. Find a way to support your body and you will minimize the irritation.

I hope these tips help, and I encourage you to think of your own comfort-enhancing positions and/or techniques.

A Few More Tips

* Don’t drink any fluids 60 minutes before bedtime. This is so you don’t have to go to the bathroom and then have trouble falling back asleep.

* No physical activity for at least 45 minutes before bed. Exercising will rev your body up, making it hard to calm yourself and fall into a restful sleep.

* Take 10 deep breaths as you tell yourself you are going to sleep. When you awake you will be feeling great and ready for the new day.

* As you lay in bed ready to go to sleep, reflect on your day. Express gratitude and give thanks for all you have. It helps you look forward to waking up with renewed enthusiasm and the belief that tomorrow will bring you one day closer to your goals.

* Dress in warm bedclothes if you are cold and cool clothes if you are hot. I have taken this to the extreme and love the results. I wear wool socks, flannel pants, a sweatshirt and a knit hat. It sounds strange, but if you can minimize the stress on the body in this case trying to keep warm your body will be more relaxed. Healing is always better when the body is relaxed.

* Do some reading. In my work on back pain, I scour the latest resources and reference guides. So let me recommend and urge you to read the best book ever written on sleep. It’s called “Power Sleep: The Revolutionary Program That Prepares Your Mind for Peak Performance,” by Dr. James B. Mass. It’s available on Amazon.com for about $10. That would be money well spent.

Steve Gillman :

The idea of a power nap isn’t new. They used to be called catnaps. They consist of just a little bit of sleep in order to refresh you. There has been some research done more recently, though, and it shows that there is a right way and a wrong way.

More precisely, there is a right length and a wrong length. If you sleep for longer than twenty to thirty minutes your body gets too deep into the sleep cycle, and you may feel even more groggy than before, the tiredness can last for an hour or more afterwards. So keep those naps short enough. As long as you do that, you can try any one of the following three routines.

1. The Basic Power Nap

If you fall asleep easily, you can simply find a quiet place to lay down and close your eyes. If you are particularly skilled at falling asleep anywhere and anytime, you might just lean back in your chair at work. If you find that you don’t wake back up within twenty-five minutes or so, you may need an alarm (the ones on watches are great for this).

2. The Coffee Nap

This is one I heard about from a sleep researcher at a major university. You drink a cup of coffee just before closing your eyes. Then you sleep for the usual fifteen or twenty minutes. The idea is that the caffeine from the coffee will hit your system just about the time you wake up. That means you get the benefit of the nap and a fast recovery from any residual grogginess. I only recommend trying this if you are already a coffee drinker though.

3. Brainwave Entrainment Power Nap

You may have heard of “brainwave entrainment” or “binaural beats.” It’s a technology that’s almost forty years old now, based on early research into states of consciousness and electrical patterns in the brain. Now it has become common in audio products for meditation. Beats or sounds are embedded in a certain way in a background of music or other sounds (rain or waves are common). The result, when listened to with headphones, is an altering of one’s brainwave pattern. More specifically, the usual beta brainwaves (above 14 hertz, or cycles per second) are slowed to the alpha range (8 to 14 hertz) or the theta range (4 to 8 hertz).

This causes a meditative state just by listening. That’s the usual intent, and these products are great for those who want to meditate deeply without months of practice. However, they are also great for taking a power nap. After all, some people can’t fall asleep at will on their own, but most people can be knocked out easily with a good brainwave entrainment CD.

Find one that is thirty minutes long or shorter. I’ve used one that is just ten minutes, and even that was long enough (and powerful enough) to put me to sleep. Generally you need to use headphones for these to be effective. One last suggestion: Combine the second and third power nap routines and you can get deep rest followed by a burst of mental energy.

Zach Thompson :


Light is very important for our mental and physical health. Without sufficient light many people suffer from depression and ailments that they cannot really pinpoint. Depression can give rise to many ailments and can even develop into more serious mental problems.

Now there are several ways to combat this problem:

Light box therapy: (Phototherupy) this type of general therapy is also known as bright light therapy. Phototherupy requires the patient to sit near a fluorescent light box that simulates sunlight. Ideally, the light should be 2,500 lux to be effective, and daily exposure is recommended. A doctor will prescribe the right exposure strength and duration.

Seasonal Affective Disorder: The problem with depression in winter is known as Seasonal Affective Disorder or SAD. It is a known fact that many people get very depressed in winter time when there is less light, and even go so far to say that they are feeling less energetic and just not well. This condition can also give rise to overeating and a whole new set of problems. There are special light boxes for this disorder. They are called SAD light boxes. Again, before starting therapy consult your doctor.

Sleep and jet lag: Light boxes can help sleep disorders and jetlag. These devices can simulate daylight and nighttime, which helps people adjust to regular sleep hours. These light boxes help to reset the body’s clock that determines when you will sleep. This is very important as lack of sleep can cause serious accidents while driving and interference with many facets of your life.

Dementia and Alzheimer: With these disorders, the body’s natural clock or circadian rhythms gets disrupted, due to nerve and brain damage. This is further aggravated by poor sight in the elderly, which means that normal indoor light may not be sufficient for them to determine the difference between night and day. Light boxes are being used in experiments to see if the sleep and activity cycles can be improved with these patients.

Skin problems: Some skin problems such as: stretch marks, patches of psoriasis, vitiligo, and pale scars may be helped with UVB or UVAI light. These are the types of lights that tanning beds use. Caution should be taken to only focus the light on the skin to be treated and to avoid damage to normal skin. Be careful not to overexpose.

Colored lights: (Intense pulsed light therapy). Different colored floodlights are used for this light therapy. Different colors are thought to be better for different problems, for example:

1. Blue is good for helping to destroy acne bacteria

2. Green lights help with pigmentation problems, like age spots and liver spots.

3. Yellow is thought to aid vascular problems, such as rosacea and thread veins.

4. Green and yellow light is said to help fine lines and wrinkles.

5. Red is meant to help arthritis when directed at the exact point. It is also thought to be good for headaches.

When trying any of these light therapies, always consult your doctor. He will know if you have any latent ailments that could be aggravated by light therapy. Also, sometimes the duration and strength of exposure will need to be adjusted for the best effect.

Juliet Cohen :

Advanced sleep phase syndrome (ASPS) is a condition in which patients feel very sleepy early in the evening and wake up very early in the night. The disorder is more likely to appear in the elderly. ASPS may be corrected through exposure to bright light for two hours during the evening, which may shift the body’s circadian timing mechanism and delay the onset of sleep until a typical bedtime. The exact cause of ASPS is not known, but the disorder is related to circadian rhythms, which regulate the internal biological clock and influence functions such as sleep-wake patterns. It has been postulated that ASPS is a circadian rhythm disorder in which the phase of the circadian rhythm of sleep and wake is advanced in relation to the “normal timing,” which is synchronized, to the external environment.

Advanced sleep phase syndrome is frequently encountered in the elderly and in post-menopausal women. There may be more than one cause of a sleep disorder, and they may be difficult to identify. Advanced sleep phase syndrome is characterized by the inability to fall asleep before early morning and difficulty waking in the morning. This disorder is also known as the advanced sleep phase type(ASPT). If a person tries to force the body into a particular phase, symptoms such as excessive daytime sleepiness, fatigue, and altered eating habits might develop. Drug therapy (such as melatonin) may be helpful for a short time, but behavioral modifications in tandem with helpful drugs can be even more effective.

Advanced sleep phase syndrome is mediated with chronotherapy or bright light therapy. Chronotherapy would affect a efficient advancement of bedtime until the desired bedtime is achieved. Bright light therapy would involve inducing a phase delay and the light exposure must be in the early evening. There is not a lot of data about the effectiveness of light therapy for ASPS. People receiving treatment gradually adjust to an earlier bedtime with sleep therapy. This therapy usually combines proper sleep hygiene practice and external stimulus therapy such as bright light therapy and chronotherapy. Bright-light therapy is designed to reset a person’s circadian rhythm to a later hour. Patients can also be treated with one medicine that puts them to sleep earlier in the evening and another medicine that helps wake them up in the morning, but this form of treatment is usually used only in extreme cases.