A Good Snooze
News and Information about Sleep
A minor sleep problem can be made much worse if you have inaccurate beliefs and attitudes about sleep. The following statements represent 10 myths that insomnia sufferers commonly believe. You may be more likely to struggle with insomnia if you strongly agree with many of these statements:
10. I should spend more time in bed to get more sleep.
You should go to bed only when you are sleepy. If you are not asleep in 20 minutes, then you should get back out of bed. Leave the bedroom and do something relaxing. Once you are sleepy, return to bed and go to sleep.
9. I should try harder when having sleep problems.
Many people with insomnia try too hard to sleep. It is important to help your mind and body relax at bedtime. Take a warm bath, eat a light snack or read for a few minutes before going to bed.
8. I need 8 hours of sleep to function during the day.
Most adults do need an average of 7 to 8 hours of sleep each night. But a poor night of sleep does not have to ruin your day. Most people with insomnia continue to function well after a sleepless night.
7. I can’t predict how I’m going to sleep.
Your body tends to sleep in a cycle. This makes sleep fairly predictable. Your body sleeps best when you go to bed and wake up at the same times every day.
6. A bad night of sleep always follows a good night of sleep.
A good night of sleep usually helps you sleep well again the next night. You will feel better and more relaxed. You also will be less worried about your sleep.
5. I have no control over my racing mind.
You can learn how to relax your mind and your body when you are in bed. Part of this process involves setting aside time to reflect on the day’s events and plan for what lies ahead.
4. Insomnia prevents me from enjoying life.
Most people with insomnia have normal, enjoyable lives. Insomnia is a challenge for you to overcome. But it is not a barrier that keeps you from enjoying life.
3. I am better off taking sleeping pills.
Sleeping pills can provide short-term relief for a sleep problem. But they may cause side effects. Other treatment options may be safer and more effective for you. You should discuss all your options with a doctor.
2. Insomnia seriously affects health.
Insomnia is unlikely to cause severe health problems. But it may be related to other medical problems that can affect your health. Many people with insomnia also suffer from depression.
1. My sleep is getting worse and no one can help.
Insomnia can be treated with a very high rate of success. There are doctors near you who specialize in helping people who have sleep problems. A sleep specialist can decide which treatment option will work best for you.
Discuss your sleep problems with your primary care doctor. Let him or her know if your sleep problem is causing you distress or affecting you during the day. Your doctor may refer you to a sleep specialist for more help.
Some sleep specialists are certified in behavioral sleep medicine (BSM). They specialize in treatment methods that help you change habits or thoughts that keep you from sleeping well.
Source: U.S. National Institutes of Health
Obstructive sleep apnea can be very serious. However, following an effective treatment plan can often improve your quality of life quite a bit.
Treatment can improve your sleep and relieve daytime tiredness. It also may make you less likely to develop high blood pressure, heart disease, and other health problems linked to sleep apnea.
Treatment may improve your overall health and happiness as well as your quality of sleep (and possibly your family’s quality of sleep).
Ongoing Health Care Needs
Follow up with your doctor regularly to make sure your treatment is working. Tell him or her if the treatment is causing side effects that you can’t handle.
This ongoing care is especially important if you’re getting continuous positive airway pressure (CPAP) treatment. It may take a while before you adjust to using CPAP.
If you aren’t comfortable with your CPAP device or it doesn’t seem to be working, let your doctor know. You may need to switch to a different device or mask. Or, you may need treatment to relieve CPAP side effects.
Try not to gain weight. Weight gain can worsen sleep apnea and require adjustments to your CPAP device. In contrast, weight loss may relieve your sleep apnea.
Until your sleep apnea is properly treated, know the dangers of driving or operating heavy machinery while sleepy.
If you’re having any type of surgery that requires medicine to put you to sleep, let your surgeon and doctors know you have sleep apnea. They might have to take extra steps to make sure your airway stays open during the surgery.
How Can Family Members Help?
Often, people with sleep apnea don’t know they have it. They’re not aware that their breathing stops and starts many times while they’re sleeping. Family members or bed partners usually are the first to notice signs of sleep apnea.
Family members can do many things to help a loved one who has sleep apnea.
• Let the person know if he or she snores loudly during sleep or has breathing stops and starts.
• Encourage the person to get medical help.
• Help the person follow the doctor’s treatment plan, including CPAP.
• Provide emotional support.
Source: U.S. National Institutes of Health
The four key signs of restless legs syndrome (RLS) are:
• A strong urge to move your legs. This urge often, but not always, occurs with unpleasant feelings in your legs. When the disorder is severe, you also may have the urge to move your arms.
• Symptoms that start or get worse when you’re inactive. The urge to move increases when you’re sitting still or lying down and resting.
• Relief from moving. Movement, especially walking, helps relieve the unpleasant feelings.
• Symptoms that start or get worse in the evening or at night.
You must have all four of these signs to be diagnosed with RLS.
The Urge To Move
RLS gets its name from the urge to move the legs when sitting or lying down. This movement relieves the unpleasant feelings that RLS sometimes causes. Typical movements are:
• Pacing and walking
• Jiggling the legs
• Stretching and flexing
• Tossing and turning
• Rubbing the legs
Unpleasant Feelings
People who have RLS describe the unpleasant feelings in their limbs as creeping, crawling, pulling, itching, tingling, burning, aching, or electric shocks. More severe RLS symptoms may cause painful feelings. However, the pain usually is more of an ache than a sharp, stabbing pain.
Children may describe RLS symptoms differently than adults. Sometimes children with RLS are misdiagnosed as having ADHD.
The unpleasant feelings from RLS often occur in the lower legs (calves). But the feelings can occur at any place in the legs or feet. They also can occur in the arms.
The feelings seem to come from deep within the limbs, rather than from the surface. You usually will have the feelings in both legs. However, the feelings can occur in one leg, move from one leg to the other, or affect one leg more than the other.
People who have mild symptoms may only notice them when they’re still or awake for a long time, such as on a long airplane trip or when watching TV. If they fall asleep quickly, they may not have symptoms when lying down at night.
The unpleasant feelings from RLS aren’t the same as the leg cramps many people get at night. Leg cramps often are limited to certain muscle groups in the leg, which you can feel tightening. Leg cramps cause more severe pain and require stretching the affected muscle for relief.
Sometimes arthritis or peripheral arterial disease (PAD) can cause pain or discomfort in the legs. Moving the limbs usually worsens the discomfort instead of relieving it.
Periodic Limb Movement in Sleep
Most people who have RLS also have a condition called periodic limb movement in sleep (PLMS). PLMS causes your legs or arms to twitch or jerk about every 10 to 60 seconds during sleep. These movements cause you to wake up often and get less sleep.
PLMS usually affects the legs, but it also can affect the arms. Not everyone who has PLMS also has RLS.
Related Sleep Problems
The symptoms of RLS can make it hard to fall or stay asleep. If RLS disturbs your sleep, you may feel very tired during the day.
Lack of sleep may make it hard for you to concentrate at school or work. Not enough sleep also can cause depression, mood swings, or other health problems such as diabetes or high blood pressure.
Source: U.S. National Institutes of Health
Your insomnia is more than just occasionally being unable to get a good night’s sleep. It’s a serious disorder, and until now, there were few safe, effective insomnia treatments.
Your insomnia may be caused by one or more underlying problems. You may have restless legs syndrome, sleep apnea or a serious medical condition that keeps you from getting restful sleep. And like a large number of people who have insomnia — 42 million by some estimates — you may have turned to sleeping pills for insomnia treatment.
What’s so good about a good night’s sleep?
Sleep is essential for your physical and mental well-being. When you’re sleep-deprived, recovery from stress takes longer, and you’re more likely to develop infections, high blood pressure, cardiovascular disease and diabetes. You may have problems with learning and memory, may be depressed and irritable, and apt to make mistakes on the job. You also have a higher risk of being in a motor vehicle crash — people with insomnia have twice as many car accidents as does the general population.
Natural sleep is best. It’s physically restorative, and it usually provides enough dreaming time (REM sleep) to improve learning, memory and mood. But most sleep experts agree that there are times when sleeping pills, especially the relatively new class of drugs that includes zolpidem (Ambien), eszopiclone (Lunesta) and zaleplon (Sonata), may be of help.
Such times include periods of pain or grief, or when sleep loss affects your job performance. But though sleeping pills are a temporary aid and shouldn’t be taken for more than a few days to a few weeks, some people take these drugs far longer — often every night for months. And some users may increase their dosage as the pills become less effective.
Especially when taken for long periods or in higher than normal doses, sleeping pills can cause serious problems that far outweigh their benefits. Among other side effects, sleeping pills can:
• Mask the real causes of poor sleep, such as depression, heart trouble,
asthma and Parkinson’s disease, and delay treatment of these disorders
• Interact with other medications or alcohol, often with serious, even deadly,results
• Cause next-day grogginess or rebound insomnia — an inability to sleep that’s worse than the original problem
• Lead to high blood pressure, dizziness, weakness, nausea, confusion, short-term amnesia and bizarre behavior that goes far beyond traditional sleepwalking to include “sleep binge eating,” “sleep shoplifting” and “sleep driving” — none of which the person remembers
Cognitive behavioral therapy: A new tool for treating insomnia
For years, people who spent their nights tossing and turning didn’t have many choices. But now there is an insomnia treatment that’s an alternative to pills, even for people with severe or chronic sleep problems. Called cognitive behavioral therapy (CBT), this relatively simple, short-term treatment has long been used to treat a range of problems, including depression, panic attacks, eating disorders and substance abuse. Now, it has also proved effective against insomnia. So effective, in fact, that for most people it works better than sleeping pills — with no side effects.
CBT can benefit nearly everyone, including older adults who have been taking sleep medications for years, people with physical problems such as restless legs syndrome, and those with primary insomnia, an intractable, lifelong inability to get enough rest. What’s more, the effects seem to last — a year after CBT, most people still sleep soundly.
How does it work?
CBT is based on the idea that how you think affects the way you feel and behave. By changing your thought processes (cognition), the theory goes, your behavior also changes. When used as an insomnia treatment, CBT, which usually requires four to eight 30-minute sessions with a trained sleep therapist, works on two levels. First, it teaches you to recognize and change false beliefs that affect your ability to sleep — the idea that you need exactly eight hours of sleep every night, for instance, or that one restless night will make you sick. CBT also deals with misperceptions about the amount of time you actually spend sleeping. People with insomnia often sleep more than they realize. In therapy, you learn how much sleep you really need and how to plan for it.
The second part of CBT insomnia treatment deals with behavior, or what sleep experts call “sleep hygiene.” This helps reprogram the part of the brain that governs the sleep-wake cycle. In CBT you learn to:
• Get up at approximately the same time every day, even on holidays and weekends.
• Get as much natural light as possible during the day, and limit light when you want to sleep.
• Go to bed only when you think you can fall asleep. If you haven’t dozed off within 20 to 30 minutes, get out of bed and do something else until you feel drowsy. Limiting the amount of time you spend in bed when you’re not actually sleeping increases your desire to sleep.
• Avoid napping during the day.
• Avoid caffeine, nicotine and alcohol, especially late in the day.
• Get regular exercise. Whether exercise close to bedtime disturbs sleep remains unclear and may vary from person to person.
• Start winding down an hour or two before bedtime. Turn down the lights. Stop watching television and using the computer. Take a warm bath.
Finding help
CBT for treatment of insomnia isn’t available everywhere, and you may have to do some searching to find a trained practitioner. If you can’t find a practitioner near you, you may be able to locate a therapist who offers phone consultations. CBT books and tapes also are available. Once you’ve been through the program, you can usually solve future sleep problems yourself. And that’s what makes CBT such a valuable insomnia treatment. It’s a safe, highly effective and can be lasting solution for sleep problems.
Source: U.S. National Institutes of Health
The main symptom of insomnia is trouble falling and/or staying asleep, which leads to lack of sleep. The lack of sleep can cause others symptoms, such as:
• Waking up feeling tired or not well rested
• Feeling tired or very sleepy during the day
• Having trouble focusing on tasks
• Feeling anxious, depressed, or irritable
Source: U.S. National Institutes of Health
