Is it hard for you to fall asleep or stay asleep though the night? Do you wake up feeling tired or feel very sleepy during the day, even if you have had enough sleep? You might have a sleep disorder. Our resident sleep expert and bioscientific investigator at the Henry Ford Hospital Sleep Disorders and Research Center, Dr. Christopher Drake, explains six kinds of sleep disorders:

1. Chronic Insomnia – The most common sleep disorder is a condition known as chronic insomnia that affects at least ten percent of the American population. It is a condition in which patients have severe difficulty in falling asleep or staying asleep.

Dr. Drake added that while the underlying physiological causes of chronic insomnia are unknown, there are known triggers. Psychosocial factors like the loss of a job, divorce, and other severe life stressors can produce insomnia. Medical conditions like diabetes, heart disease, depression or anxiety, can also contribute to the development of insomnia. Insomnia also has a genetic component so that some individuals are more susceptible to sleep disturbance from these triggers than others.

Unfortunately, chronic insomnia can be extremely treatment resistant. Treatments come in various forms, including doctor-prescribed behavioral treatments, self-help books, music relaxation, and prescribed and over-the counter medications. Some patients find success using medical treatments, while others find success with drug-free programs. Dr. Drake recommends making a strong commitment to whatever treatment program is chosen. Treating insomnia early may prevent the development of other negative effects. “There is a great deal of evidence that insomnia may lead to depression over prolonged periods of time”, explains Dr. Drake.

2. Sleep Apnea – Between five and twenty percent of the U.S. population suffer from sleep apnea. It is a condition that often occurs in the older demographic and is often related to significant weight gain or a narrow/crowded airway. Sleep apnea is literally the collapsing of your airway during sleep and can happen hundreds of times per night in some severely affected individuals, remarked Dr. Drake. Sufferers stop breathing sparking many brief awakenings leading to fragmented and non-restorative sleep. In severe cases, patients stop breathing episodes can happen for minutes at a time.

The symptoms of sleep apnea usually involve feeling excessively sleepy or fatigued and may be accompanied by morning headaches, dry mouth, and frequent urination during the night. Unlike holding your breath while awake, when you stop breathing during sleep, the amount of oxygen in your blood is reduced and this can lead to significant medical complications including elevated blood pressure. Left untreated, patients have an increased risk for mortality from of cardiovascular disorders like heart disease. The excessive sleepiness caused by the frequent stop breathing episodes also increases the risk for motor vehicle accidents and can significantly reduce one’s quality of life.

Individuals who suffer from sleepiness/fatigue, hypertension, and snoring, should speak to their doctor about the possibility that they may have a sleep disorder such as sleep apnea. Treatment can be extremely effective for this disorder and it has been shown to reduce the risk of developing cardiovascular and other negative consequences. Dr. Drake outlines three types of treatments for Obstructive Sleep Apnea or OSA:

1. CPAP – Using a continuous positive airway pressure (CPAP) machine is an effective way to treat sleep apnea, says Dr. Drake. A CPAP machine involves a mask that is worn over the nose and mouth at night. It forces air into the airway, keeping it from collapsing.

2. Surgery – If you have a crowded airway or enlarged tonsils, tongue or uvula, surgery may be needed to correct sleep apnea.

3. Dental – A dental device is an option for those suffering from mild sleep apnea. A specially made dental apparatus can be designed to pull the bottom jaw forward to keep the airway open.

Although not everyone with sleep apnea is overweight, weight reduction can also be effective in individuals with obesity as a contributing factor.

3. Restless Leg Syndrome – The syndrome known as RLS, affects about ten percent of the population. Patients describe it as a “creepy, crawling sensation” in the legs sometimes described by patients like bugs crawling under the skin. The uncontrollable movements of RLS sufferers during the night keep them from getting a good night’s sleep. 

Dr. Drake recommends massaging the legs or walking around as a means of temporary relief. For more permanent relief contact your doctor to learn more about available drug treatments.

4-6. Other uncommon disorders include narcolepsy, sleepwalking, sleep talking, and REM behavior disorder, explains Dr. Drake. 

Narcolepsy is a sleep disorder that causes excessive sleepiness due to a loss of specific cells (hypocretin) in an area of the brain called the hypothalamus. It is very difficult for patients with narcolepsy to stay awake during the day, said Dr. Drake. Episodes of cataplexy sometimes occur due to the intrusion of rapid eye movement (REM) sleep into the daytime. These episodes involve loss of muscle tone to the body and can range in severity from mild to almost full body paralysis. An extremely rare disorder – much less than one percent of the population suffer from narcolepsy – it can be treated with medications.

Parasomnias are disruptive sleep-related disorders that include sleepwalking and sleep talking. Common in kids, safety is important. Be sure to keep them safe so they do not fall down steps at night. While treatments are available, Dr. Drake notes that parasomnias typically go away over time, particularly in children. 

Rapid eye movement behavior disorder (RBD) is a disorder in which patients act out dreams during the REM stage of sleep. Typically the body is paralyzed during REM, however patients with RBD do not experience paralysis and act out their dreams, often with serious consequences including injury. This can be very scary for the bed partner, Dr. Drake explained. Luckily RBD is treatable.  

For more information on any of these sleep disorders, Dr. Drake recommends contacting your doctor.

Related posts:

1. Night Terrors Can be Hazardous to Your Health
2. U.S. News & World Reports Seven Ways to Make Sleep Apnea Worse
3. Dr. Drake Answer: Is it Night Terrors or Recurrent Sleep Paralysis?

Are you always traveling for business? Do you find yourself exhausted after that last tradeshow? Feeling overwhelmed, irritable, exhausted, and forgetful are just a few symptoms of a burnt out business traveler.
 
The Miami Herald offered tips for professionals to fight burnout:
 
Sleep – Getting enough sleep is something that many entrepreneurs decide they can do without but it is one of the most important defenses against burnout. Our sleep expert Dr. Drake recommends adults get 7-8 hours of sleep.

Exercise – Physical activity helps reduce stress, so experts recommend a relaxing walk or bicycle ride, or a meditative yoga session.

Schedule a Timeout – It’s hard for many small-business owners to stop working, but scheduling some down time like watching TV for half an hour or reading a book can help keep burnout at bay.
 
Travelers who are constantly on the road can experience negative effects on their work but with a little effort, and sleep, experts say small business owners can alleviate the impacts of business traveling.
 
Related Links:

Avoid burnout by remembering to eat, sleep, stay social
Everything you need to know about the body’s internal clock
Exercise: Rev up your routine to reduce stress

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When someone regularly spends more money than they bring in, they end up in debt. The same goes for people who regularly sleep fewer hours than their body requires. “Sleep debt” is an actual phenomenon according to some experts and studies have shown that those who consistently get less than their ideal amount of sleep, actually perform increasingly poorly on tests of motor skills and problem solving the longer their sleep debt goes on.

Each individual has a “set point” of sleeping hours their bodies and minds need. Sadly, unlike money, you can’t save up sleep for use later on. So, the theory goes, if you stay up just one hour later than usual five nights in a row, you will be five hours in debt by the weekend. The only way to make up for a sleep deficit is to sleep, so you may find yourself napping and sleeping later than usual on your days off.

How do you know you’re in sleep debt? Drowsiness is a sure sign, but it can also be very dangerous. In the U.S. alone, drowsy driving causes more than 100,000 crashes a year, resulting in 40,000 injuries and more than 1,500 deaths according to the National Highway Transportation Safety Administration.

As always, the best way to stay out of debt – whether you’re talking about money or sleep – is to live within your means.

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3. Keeping Your Eyes Open and on the Road

Have you ever considered popping a sleeping pill after trouble getting to sleep? Do you want to learn more about prescription and over-the-counter sleep aids? If so, read on…

While risks can be minimal when taken as directed, says our resident sleep expert Dr. Drake, you should understand the benefits and risks associated with any medication you take.

Benefits

Better Sleep – Simply put sleeping pills can help you sleep better specifically when severe stress, travel across time zones or other significant disruptions produce chronic (a month or more) difficult falling asleep, staying asleep or non-restorative sleep. If used appropriately sleep medications can benefit sleep in a safe and effective manner, says Dr. Drake.

Risks

Misuse – Risks can be high when used at inappropriate times. Sleep-inducing medication should not be used for naps, during the day, or at higher than recommended doses.

Other Effective Treatments – If you have chronic insomnia, an alternative but effective approach may be to utilize better sleep habits and specific behavioral techniques with the help of a behavioral sleep specialist, says Dr. Drake. Behavioral treatments offer long lasting improvements, but there are limitations to behavioral treatments as well and combined medication and behavioral therapy can also be considered with your doctor.

Short Term Relief – Over the counter preparations like NyQuil and Tylenol PM may only offer short-term relief. These medications that contain diphenhydramine can lose their effectiveness after just 5 days.

Residual Effects – When taking very long acting medications to help sleep some patients may experience side effects such as daytime sleepiness or other impairments during the day. Dr. Drake recommends being cautious about driving or performing other critical activities until you know how the medication will affect you. Fortunately, most FDA approved sleep medications are less likely to cause those effects when taken as instructed by your physician. Another medication option is herbal preparations although they have the least amount of scientific evidence demonstrating their safety and effectiveness.

Alcohol and Other Threats – Drinking alcohol can increase the risk of side effects when used with sleep medications and although it may seem to improve the ability to fall asleep, alcohol disrupts sleep particularly during the second half of the night and this sometimes goes unnoticed by patients. Expecting mothers with sleep disturbance should carefully consider the risk/benefits of medications with their doctor as problems with sleep can often be the sign of another underlying sleep disorder that may need a different form of treatment (see article of pregnancy).

Dr. Drake shares one final piece of advice: Always make sure to follow the instructions when taking any medication and to consult your doctor.

Additional Resources

Prescription Sleeping Pills (Mayo Clinic)
Over-The-Counter Sleep Aids and Supplements (Mayo Clinic)
When to take a sleeping pill (CNN)
Diphenhydramine (MedlinePlus)

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Do you usually get a little sleepy after lunchtime? Ever wonder why that is? It is likely because of a natural force — your body’s clock — that determines when you’re alert or when you’re drowsy.

The human body has a natural dozy time during the day, a time when you are sleepy from around 1 or 2 in the afternoon. Dr. Drake recommends taking a short nap if you can although it should not last more than 30 minutes or an hour at most.

Other countries, like Spain and Greece, have incorporated their circadian rhythms into their lifestyles. Both cultures take naps after lunch.

See our past post for more on Circadian Rhythms.

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To ensure your best sleep possible, it is important to sleep and wake according to your body’s rhythm.

What is your best sleep possible? Our resident sleep expert Dr. Christopher Drake recommends sleeping and waking according to your body’s clock. This means falling asleep around 10:oo or 11:00 at night and rising around 7:00 or 8:00 in the morning. Not only is this in sync with your circadian rhythm, but also it ensures the recommended 7-8 hours of sleep.

Located in the Hypothalamus part of the brain, your body’s circadian rhythm is a cycle of biological processes that include among other things, body temperature, hormonal function and gastric activity.

“Your body’s clock is a little longer than 24 hours,” said our sleep expert Dr. Christopher Drake. You can keep it on track with light in the morning and lack of light in the evening. Too much nighttime light can disturb Melatonin secretion, the chemical the body releases to make you sleepy.

While you can not significantly change your sleep and wake schedule, it is a cycle that can be influenced by outside factors, such as jet lag, stress, hormones, pregnancy or overnight shift work. If such disruptions become chronic, they can eventually impair your memory, reduce your ability to concentrate, and possibly affect your overall health.

If you find yourself out of sync, your goal should be to establish sleep-wake patterns that will “reset” your body’s biological clock. For example, if you work nights, you will need to trick your body into thinking it is nighttime when you go to bed. Heavy curtains, a sleep mask and settling down to sleep at regular times each day will help. If the problem becomes ongoing, you may want to seek help from a sleep specialist.

The Henry Ford Health System offers sleep tips for shift workers and the Center for Circadian Medicine offers advice on how to gauge your body clock.

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Excitement over presents and family visits takes its toll. Just over 25 hours of sleep are lost by children due to a lack of time in bed caused by the excitement of the holiday season, says one study of 1,023 British parents released this week. Parents also lose out on an average of three hours’ sleep a night.

According to the National Sleep Foundation, there are basic daily sleep requirements for children, adolescents, pre-teens and teens. They recommend preschoolers get 11-13 hours, elementary school students get 10-12 hours, pre-teens get 9 – 11 hours, and teenagers get 8.5 – 9 hours of sleep each night.

To help kids sleep while away from home our sleep expert, Dr. Christopher Drake, offers parents the following sleep tips:
- Make time for kids to nap before or after being away from home for the night
- Bring your kids’ own pillows
- Make sure there are suitable sleep arrangements wherever your child is headed
- Pack comforting, familiar items such as night lights or books
- Have a light, healthy snack on hand in case your child gets hungry before bed or during the night

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Does getting proper sleep help you stay at a healthy weight? That seems to be a distinct possibility based on a study released earlier this year.

Researchers at the Walter Reed Army Medical Center in Washington, D.C., studied the sleep, activity and energy output of fourteen nurses who had volunteered to participate in a heart-health program at the hospital. The program, which included nutritional counseling, exercise training and other lifestyle counseling, also required the nurses to wear actigraphy armbands that measured their activities, including sleep and rest periods.

After the data came in, researchers split the group into “short sleepers” and “long sleepers” and found that the short sleepers had a much higher Body Mass Index (BMI) than those who slept longer. Lead investigator Arn Eliasson, M.D. also noted that short sleepers tended to sleep less efficiently and had a harder time falling and staying asleep.

Dr. Eliasson theorizes that insufficient sleep may disrupt the body’s hormone balance, causing the short sleepers to eat more and subsequently weigh more. He also added that the stress caused by a lack of sleep may also be a factor in their weight gain.

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1. Moderate Aerobic Exercise Before Bed Eases Insomnia
2. Reuters Health Reports Insomnia boosts short sleepers’ hypertension risk
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Before your reach for that extra glass of eggnog or Christmas wine this holiday season, you may want to hold off especially if it’s getting close to your bedtime. While alcohol can initially cause you to feel sleepy, it actually can have a negative affect on the quality of your sleep as the night progresses.

This is because sleep actually has several stages that you cycle through during the night and alcohol interferes with the latter stage, particularly the rapid eye movement or REM stage of sleep—this is the stage in which you dream. At this point during your sleep, any alcohol you ingest will interfere with the neurotransmitters in your brain that control your body’s ability to sleep. As a result, you’ll likely find yourself easily awakened and tossing restlessly until morning.

In addition, researchers advise against drinking alcohol altogether if you have chronic sleep problems such as insomnia or sleep apnea because alcohol tends to exaggerate those problems. The combination of lack of sleep and alcohol is particularly dangerous for those with sleep apnea: a recent study found that even moderate amounts of alcohol severely degraded the driving abilities of those who suffered from sleep apnea, making them more likely to have automobile accidents.

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We all know smoking is dangerous to your health, but research has shown it can also be dangerous to your sleep.

In a study released last year, researchers at Johns Hopkins University School of Medicine compared the sleep of 40 smokers against that of 40 non-smokers. Researchers specifically sought out smokers who did not have other health conditions that could mar the results of the study. As participants slept, they underwent polysomnography— a reading of the body’s biophysical changes, such as eye and body movement, heart rhythm and brain activity.

The results were surprising: researchers found that smokers were four times more likely to report waking up feeling less rested than their non-smoking counterparts, and that smokers spent less time in deep sleep than non-smokers. They also discovered smokers’ sleep patterns were vastly different from non-smokers’ during the early stages of sleep.

Researchers suspect that, in the early stages of sleep, smokers are still under the stimulating influence of nicotine, but as the night wears on, nicotine withdrawal kicks in, keeping smokers from achieving adequate periods of deep sleep.

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