When Sleep's a Problem

Bonnie hill knows what it means to be tired. In her 30s, she noticed she wasn’t sleeping well at night and would feel fatigued during the day. Years went by and the problem got worse. Her husband told her she was snoring heavily, almost violently. She had no energy, even in the morning, and had trouble staying awake to drive home from work. “I put off doing anything about it for a very long time,” Hill says.

Now in her early 50s, she finally spoke to her physician about her problems. In July 2009, she was sent to Lee Memorial’s Sleep Disorders Centers to determine what was going on. The diagnosis: a common case of sleep apnea, repeatedly cutting off her breathing at night and partially or completely waking her up. This prevented Hill from getting the deep sleep her body required.

According to the National Sleep Foundation, some 50 million Americans have some sort of sleep problem. A 2008 study by the foundation found that nearly 30 percent of people had fallen asleep or become sleepy at work, and 12 percent were late to work because of sleepiness. Even more frightening, 36 percent admitted to nodding off while driving.

“Studies show that habitually getting inadequate sleep—less than seven or eight hours of sleep each night—creates long-lasting changes to one’s ability to think and function well during the day,” reports Thomas J. Balkin, a vice chairman of the NSF. “These negative effects can accrue slowly over weeks, months and even years of inadequate sleep habits and cannot simply be reversed by a few nights of good sleep.”

I hate to admit it, but as someone who battles bouts of insomnia, I would have answered “yes” to those study questions. The truth is there is a wide variety of sleep problems that impact people’s lives. It’s also true that many of these problems have relatively simple solutions—if only people would wake up and admit they need to take action.

To get an idea of the latest findings on sleep issues and solutions, I turned to Alan Cunningham, the system director overseeing Lee Memorial’s Sleep Disorders Centers. He helped open the region’s first sleep lab in the mid-1980s.

PROBLEM: Sleep Apnea
This is by far one of the most common problems Cunningham’s patients face. A smooth muscle in the back of the throat can relax
too much and close off the sleeper’s airway. “Sometimes it will wake you up. Other times you don’t wake up. Regardless, it disturbs your sleep,” he says. “People will say, ‘Jeez, I got eight hours of sleep, and I feel tired.’ They don’t realize that they stopped breathing 600 times a night.”
SOLUTION: Weight loss often offers relief, as does a CPAP machine, which uses a stream of air to keep the sleeper’s airway open. More
serious cases may need surgery.

PROBLEM: Hormones
As women go through life’s changes, their hormones can fluctuate, leading to disrupted sleep patterns, often waking them up many times at night. “Sometimes they will develop restless leg syndrome, and that also will rouse them to where they are not allowed to go through all their phases of sleep,” Cunningham says.
SOLUTION: Women should talk to their OB/GYN. Changes in diet and medications can help, as can simple hormone therapy.

PROBLEM: Food and Beverages
People with sleep issues should obviously avoid anything with caffeine in it. This includes sodas and chocolates. Alcohol also is bad for sleep despite the relaxed, drowsy feeling a few drinks can create. “At first, alcohol will give you a sense of peacefulness, but it reverses on you after you go to sleep,” Cunningham says. “You might pass out the first couple of hours, but at two in the morning, you will be wide awake. It reverts into a stimulant.”
SOLUTION: Cunningham generally recommends stopping all eating and drinking at least three hours before bedtime.

PROBLEM: Hunger
While going to sleep on an empty stomach can help you get a good night’s sleep, Cunningham says some people who are sensitive may be awakened by hunger pains or a grumbling stomach.
SOLUTION: If hunger strikes in the middle of the night, your stomach wants something in it. Drink water or milk. “Don’t eat an apple or crackers or cheese because now your stomach is going to have to start digesting food while the rest of the body is at rest,” Cunningham says.

PROBLEM: Allergies
Some individuals have allergies to the tremendous amount of dust, dander and mites found in bedrooms. “For the average person, it probably doesn’t bother them. But have you ever seen light streaking into a room, and suddenly you can see all the stuff in the air?” asks Cunningham. Allergies can cause sleep problems when noses plug up and sinuses become inflamed.
SOLUTION: Vacuum your mattresses on a regular basis. Using a steam cleaner occasionally may also help. Change your linens frequently to keep them dust- and dander-free. Some sleep patients find relief from running HEPA
air filters in the bedroom.

The need for a good night’s sleep is paramount. Cunningham says it’s as important as diet and exercise. It’s the time that your body is resetting itself, taking short-term memory and putting it into long-term memory. Fatigue can keep you from exercising and sap the willpower from your diet. Lack of sleep can impact the immune system, leading to more illnesses. It may even shorten your lifespan.

The simple solution for Bonnie Hill’s sleep apnea was a CPAP machine to keep her airway open and let her truly sleep. “It has absolutely changed my life,” she says. “I am not dragged down all day. I feel more energetic. I accomplish more. After the work day, instead of collapsing into a chair, I get things done.”

HEALTH BRIEFS