A good night of sleep – seems like the simplest thing, yes? Almost a right – shouldn’t everyone sleep like a baby?
While this appears to be true, we know that even babies don’t always sleep well. And for some, a full evening of rest is an elusive thing. According to a study conducted by the Center for Disease Control, nearly 9 million Americans have used prescription sleep aides in the last month.1 That study also found that more women than men use them, and their use is greater in the 50 and older age group.
Sleep disorders can significantly impact one’s work and home life – and your health. Snoring and sleep apnea are the Number One medical cause of relationship and marriage break-ups. Prolonged sleep apnea can lead to hypertension, diabetes, obesity, depression, heart attack, and stroke. Chronic fatigue that results from sleep issues can keep one from being at their best and contributes to poor work performance.
Is Your Sleep Disturbance Chronic or Acute?
Sleep can be disordered for a number of reasons. Some can’t fall asleep or stay asleep – this is known as insomnia. Everyone at sometime in their life will not sleep due to an acute condition – a problematic day at work, racing mind, or maybe just too much coffee close to bedtime. These times are short and self-limited. Chronic insomnia is defined as having difficulty falling asleep 3 nights a week, for 3 months or longer. Insomnia can be “co-morbid” – due to a medical condition that is known to cause sleep issues. Both psychiatric and medical conditions can cause this to happen, as can a host of medications.
So, no, it’s not all in your head, and as you well know, if you’ve ever had trouble sleeping – wishing it away won’t work. While there is no definitive test for insomnia, the diagnosis usually involves an inventory of sleep-related medical questions, a sleep log, and blood work or sleep testing. Thus, visiting a sleep professional is essential to getting the right diagnosis and proper help.
Do You Have Sleep Apnea?
For some, falling asleep easily is actually the sign of a sleep issue. Long-standing fatigue can make one fall asleep inappropriately – as a passenger in a car, in the theatre, or at your desk when it’s expected you will be alert and productive. In this case, the problem is poor quality sleep. It could be that you are frequently awakened by something known as “apnea.”
An apnea is a cessation or pause in the breath – the cause for this is either in the central nervous system, or because the airway is unable to stay open enough to allow you to sleep. The body reflexively awakens you when your airway closes off – a protective response that wakes us up enough to breathe. Humans of all ages have some degree of apnea during sleep – and it is usually a combination of “central” and “obstructive.” But., when it becomes excessive and sleep becomes fragmented, there is a bigger problem.
Despite common belief, you don’t have to be obese to have obstructive sleep apnea (OSA). In fact, OSA in and of itself can lead to insulin resistance and cause or promote obesity. OSA occurs in up to 10% of children of various weights and sizes and is the most common sleep disorder in children. We often observe that if we get children to breathe better at night, they gain weight, become more productive at school, and behavior and learning issues sometimes disappear.
There are definitive tests for apnea. While going to a sleep lab was once the gold-standard way to diagnose obstructive sleep apnea, most insurance companies now prefer in home sleep testing. A doctor who is familiar with the diagnosis and treatment of sleep can easily order such testing. It has to be interpreted by a sleep specialist, and recommendations are made how best to get treated. CPAP (continuous positive airway pressure) is one way to treat obstructive apnea, and continues to be recommended for the most severe cases. But there are an array of other treatments, which the doctor will discuss with you when reviewing the results.
What You Can Do to Help Yourself, Your Child or Loved One Sleep Better
Try to get enough of sleep every night — The American Sleep Foundation recommends at least 7 hours of sleep nightly.
Establish a consistent bedtime and stick to it — The body does respond to a circadian rhythm that once broken is difficult to re-establish. That is as true of shift workers as it is of children. Try to go to sleep and awaken at about the same time every day.
Exercise consistently, but not close to bedtime — Exercise is important for sleep as it decreases arousal, anxiety and depressive symptoms all of which are beneficial for sleeping. There is also a drop in body temperature after exercise – which helps you get sleepy. Vigorous activity too close to bedtime will cause arousal, though, so make sure you have a gap of at least a few hours between activity and lights out.
Maintain good sleep hygiene – Limit screen time close to bedtime and give your body a period of time to wind down. Also don’t pick up your mobile or turn on your computer should you awaken in the middle of the night. This is not the time for catching up on your emails! Make sure your little ones don’t take their iPads and cellphones to bed. Make their rooms a sleep-only zone, so that homework and other activities occur outside of the sleeping space.
Be sure to have a comfortable bed and sleep position — Don’t expect your body to adapt to the wrong mattress and pillow. This will only worsen aberrant musculoskeletal feedback to the central nervous system – and make your sleep less restful.
Supplements for Better Sleep
In addition to the behavioral techniques, there are herbal remedies and supplements that can naturally help you get better sleep. It’s hard to know which one your body will respond to, and we recommend trying each one for 2-3 weeks before giving up and moving on to the next one.
Magnesium – This is one of the most important minerals for your sleep, muscle relaxation and mental health. Clinical studies have shown that magnesium improves insomnia, sleep efficiency, sleep time and sleep onset. Can be taken by mouth, put into a warm bath (Epsom Salts), or rubbed on the skin as a cream or oil. We recommend an absorbable form of magnesium, like magnesium glycinate, instead of magnesium citrate which can cause loose stool (and in fact is used to treat constipation).
Melatonin – This hormone is produced by your body in response to light to help regulate your sleep-wake cycle. Melatonin can also help reflux – a condition that often occurs alongside obstructive sleep apnea. It should be used in small amounts, starting with 1 mg and perhaps increasing to 2, then 3 mg over a few weeks if you don’t feel it’s helping. Take it about an hour prior to bedtime.
Valerian –This amino acid increases the neurotransmitter GABA in the brain. As such, it does what prescribed sleep aids like Xanax and Valium do – only without the associated risks. We love blends of valerian, passionflower and lemon balm, all combined. At Blum Center we use Myocalm PM.
L-Theanine – Well known as an anxiolytic, L-Theanine not only helps produce a state of calm, but has been shown to aid overall sleep quality.
Live in our area and want to sleep better? Join Dr. Gereau and special guest Dr. Brad Gilden for their FREE community talk, Sleep: The Essential Pathway to Optimum Health on Monday, September 25th at 7pm. The discussion and demonstration will include sleep position, posture, the importance of nasal breathing and stress management. You will walk away with 7 strategies to improve your sleep immediately. Join Us! Sign Up
Meet Dr. Gereau: Sezelle Gereau, MD, is an integrative ENT/Allergist with more than 20 years of experience. She uses an integrative and functional medicine approach to conditions such as sleep apnea, headaches, allergies and chronic sinusitis.
The Blum Center is teaming up with Elite Health Services to provide patients suffering from sleep disturbances with a natural and holistic solution to improving breathing and sleep-related problems. Elite Health Services located in Greenwich and Westport CT provides hands on manual physical therapy to improve postural and mechanical limitations that may be depriving you of a restful night sleep. Elite’s team of physical therapists and performance specialists are at the forefront of collaborating with your medical team to solve your sleep dilemma.
NCHS Data Brief. 2013 Aug;(127):1-8.