>Who's At Risk?

>Hazards of Sleeplessness

>Improving Sleep Hygiene

>Sidebar: Defining Insomnia

>Sidebar: Signs of Inadequate Sleep

>Sidebar: Insomnia and Age

Printable version

Email article

Hazards of Sleeplessness

Many chronic insomniacs live with their condition for years, unaware of how the lack of refreshing sleep aversely affects their minds and bodies.

"We all know the common effects of transient insomnia, such as feeling lethargic, tired and lacking in energy," says Jack Edinger, PhD., senior psychologist at the VA Medical Center in Durham, N.C., and a clinical professor in the Department of Psychiatry and Behavioral Sciences at Duke University. "To some degree it can also affect concentration, attention and work performance.

"But if someone has chronic insomnia that persists for months or years, we can see more serious effects. For example, even if they have no other mental disorder or medical disease, people with chronic insomnia are more prone to engage in medical utilization Insomnia also appears to be a risk factor for a variety of mental disorders, including clinical depression, if there is no intervention."

Recent studies also have shown that chronic insomniacs are at greater risk of traffic and occupational accidents, are less productive at work and experience higher absenteeism, Edinger says.

Now that you understand how chronic insomnia can influence you mentally and physically, what should you do about it?

Many people turn to prescription and over-the-counter sleep aids to help them fall asleep at night. Of the two, say sleep experts, prescription drugs such as Ambien, Sonata and Estorra are the most effective and are commonly prescribed as part of a short-term regimen to help establish more normal sleep patterns.

"I don't recommend over-the-counter sleep aids at all," states Walsleben. "Most are simply antihistamines so you're actually using the side-effect of sedation. But antihistamines can dry you up and affect many other body systems. If someone believes they need a sleep medication, I prefer they talk to their physician and get a prescription for one of the newer short-acting drugs and use it sensibly. That way, you know the drug is producing only sleep and no other side effects in the brain."

Improving Sleep Hygiene

Changes in what experts call "sleep hygiene" also can help you get a better night's sleep. This includes what you do immediately prior to going to bed, as well as the environment in which you sleep. It's an important consideration, yet something few of us ever think about.

"Sleep hygiene is very important in the treatment of insomnia," confirms Dr. Zafarlotfi, a self-professed sound sleeper who listens to soft music before bedtime.

If you're having trouble sleeping, take a moment to evaluate your sleep environment. Sleep comes more easily in a dark, quiet, comfortable bedroom, so you might want to add soundproofing or blackout curtains if street noise or outside light is interrupting your slumber. Machines that make soothing ambient noise such as rain, a babbling brook or crashing ocean waves also might help you fall asleep.

Once your bedroom is conducive to sleep, it's time to think about your bed. This is perhaps the most important factor in getting a good night's sleep, say sleep researchers, yet many people spend years tossing and turning on a bed that is too hard or too soft. As a rule of thumb, if your bed is more than 10 years old, it's probably time to find a more comfortable replacement.

Maintaining a regular sleep schedule is also key to sleeping well. "It's very important to go to bed and wake up at the same time every day," Zafarlotfi notes. "A half-hour difference won't matter much, but if you sleep in for an extra two hours on weekends, you won't feel as rested. It's almost like a form of jet lag."

A few other helpful tips:

* Don't try to recoup lost sleep by napping during the day. This will only make it more difficult for you to get to sleep at night.

* Avoid using your bedroom as an office or entertainment center. "Don't eat, watch TV or read a book in bed," advises Zafarlotfi. "Your bed should be used only for sleeping and making love."

* Refrain from eating a heavy meal immediately before retiring. If you're hungry, nosh on a light snack such as non-citrus fruit or crackers and cheese a half hour before bedtime. "I've had patients who eat half a chicken before going to bed and then are surprised they can't fall asleep," laughs Zafarlotfi.

* Avoid caffeine after 2 p.m. It stays in your system longer than you think.

* If work or other problems are troubling you, take a moment in the early evening to write them down—along with possible solutions. Once you've addressed your worries, they should no longer keep you awake.

* Avoid emotionally stimulating movies or news programs before bedtime—they cause an adrenalin rush that can make sleep difficult.

* If you find yourself unable to sleep, get out of bed and read until you start to feel drowsy. Lying in bed trying to force yourself to go to sleep will only make your insomnia worse.

* Consider sleeping in another room if your partner's snoring or body movements interrupt your sleep.

* Most importantly, seek help if your sleep difficulties last longer than two weeks. "People have to make sleep a priority," concludes Walsleben. "No one should go through life with insomnia."

For more information about insomnia and sleep disorders, visit the National Sleep Foundation website at www.sleepfoundation.org.