Sound Sleep Guide

Archive for October, 2006

Almost everyone has battled with at least a short-term case of insomnia. Some people may be more prone to either transient or long-term, chronic insomnia. Here are the top five conditions that can cause insomnia.

1. Stress, anxiety, and depression. The undisputed number one cause of insomnia is excessive stress, anxiety, and depression. Almost everyone has experienced transient insomnia the night before a job interview, big presentation, wedding, or other significant personal event. Transient insomnia usually passes after the stress-inducing event has been overcome. Chronic insomnia is more serious because it can affect an individual for an extended period of time. Persistent stress at work or home can lead to chronic insomnia. Anxiety and depressive disorders are another major source for chronic insomnia.

2. Sleep apnea, narcolepsy, night leg disorders, and other sleep disorders. One of the most common causes of chronic insomnia is the presence of one or more sleep disorders. Sleep disorders can severely disrupt sleep patterns and interfere with an individual’s quality of life.

Sleep apnea is one of the most common sleep disorders (after excessive snoring and chronic insomnia). A person with sleep apnea will stop breathing several times during the course of a night’s sleep. The pauses in breathing last about ten seconds, and can occur up to 30 times a night. A person with sleep apnea may not be aware of their condition. But the cumulative effect of waking up several times a night can cause them to lose sleep, leading many sleep apnea patients to conclude they are suffering from chronic insomnia.

Restless leg syndrome is another sleep disorder that can cause severe chronic insomnia. Individuals with restless leg syndrome will experience crawling sensations on their limbs, especially their calves and ankles. The symptoms of restless leg syndrome become magnified during long periods of inactivity, so sufferers will usually experience the majority of symptoms during the night. Individuals with restless leg syndrome can have a difficult time falling and staying asleep, and may experience significant discomfort. People with restless leg syndrome often experience involuntary jerking of their legs during the course of the night. It’s no surprise that restless leg syndrome often causes chronic insomnia and daytime fatigue.

3. Environmental disturbances. Environmental factors such as light, noise, temperature, and partner’s sleep habits can severely disrupt the quantity and quality of sleep. Excessive light at night has been shown to disrupt sleep. Very bright artificial light should be avoided, and sensitive sleepers should even avoid dim artificial lighting. Insomnia has also been linked to lack of sufficient light during the day. Studies have shown that individuals who expose themselves to bright daylight may suffer from significantly less sleep disturbances than those who do not get bright daylight.

Noise can obviously also adversely affect a person’s ability to get restful sleep. People who live near busy city streets or next to noisy businesses or neighbors may have difficulty achieving a good night’s rest. Temperature-too cool or too warm-is another common cause of insomnia. It is recommended that individuals suffering from chronic insomnia experiment with the temperature of their sleeping area until they find the most comfortable sleep setting.

Another common environmental factor that can lead to insomnia has to do with the sleeping arrangements and sleeping partners. A partner’s sleeping habits can have a detrimental effect on their bedmates ability to achieve a restful night’s sleep. Loud snoring, tossing, and other nighttime habits can alter significantly the amount and quality of a person’s sleep. For instance, if one person enjoys watching television in bed or reading before bed, the other person’s ability to fall asleep easily and to remain asleep may become compromised.

4. Overuse of alcohol, stimulants, and sleeping aids. The consumption of alcohol, stimulants, and overuse of sleeping aids has been linked insomnia. Alcohol should be avoided several hours before bedtime. Stimulants such as caffeine and cigarettes should also be avoided. Research has shown that the overuse of sleeping pills can also compromise their ability to be effective, and lead to chronic insomnia.

5. The presence of a chronic medical condition, such as arthritis, kidney problems, Alzheimer’s disease, and Parkinson’s disease. Many medical conditions have been shown to cause insomnia. Medical conditions that cause pain, such as arthritis and kidney disorders, usually cause insomnia. Alzheimer’s and Parkinson’s disease have also been linked to insomnia. Many times, insomnia may be triggered by medications used to control the medical condition.

There are six common causes of disruptive sleep in children and these include sleep deprivation, night waking, sleep-onset associations, separation issues, resistance to sleep/settling problems and parasomnias. Let’s take a brief look at each one of these.

Any sleep disorder can lead to sleep deprivation which can affect a child’s physical and mental health as well as his/her performance in school and in other social activities. Sleep deprivation among children is becoming more and more commonplace in our society, to its detriment as it has many debilitating effects on an otherwise healthy child’s life.

Night waking refers to times when a child sleeps lightly and/or wakes up without an obvious reason such as discomfort or a loud noise. This is normal if it happens occasionally, as, just like adults, children cannot remain in deep sleep every hour of the night. However when night waking starts becoming the norm or the child consistently has problems falling asleep then treatment is needed.

Sleep-onset associations refer to what children associate with drifting off to sleep (such as being rocked to sleep by a parent or sucking on a soother) and what they also need if they should awaken suddenly in the night. The most positive sleep-onset associations are the ones that don’t include parents or anyone else for that matter. To encourage a good night’s sleep for your child, put them to bed when they are sleepy but not completely asleep yet. By putting your child in his/her bed when they are drowsy but still technically awake, they are learning to become independent by going to sleep by themselves. This helps to foster self-confidence in children and a sense of accomplishment. Children with moody or temperamental dispositions generally need the comfort of sleep-onset associations even more so than other children do. The most common problem for disruptive sleep in children is sleep-onset associations.

Separation issues (or separation anxiety) occur most often in children under the age of three. By the time a child reaches eight or nine months old, he/she has come to understand that mom and dad are still around even if they can’t see them at that precise moment in time. However it takes a couple more years for their confidence to build about being alone. As a parent you will know that separation anxiety is the cause of your child’s sleeping disorder if they quickly drift back to sleep once you have calmed their fears. Some parents experience separation anxiety from their children and find themselves looking in on them frequently throughout the night.

Sometimes children have a resistance to what is known as “sleep/settling.” Basically this means a child who for one reason or another does not want to go to bed and demonstrates this by throwing a tantrum complete with screaming and feet stamping, or consistently thinks of excuses for why he or she is not ready for bed just yet. This can also be seen by kids who simply say to their mothers, “I’m not going to bed because I don’t want to.”

Parasomnias are sleep-related problems that interrupt proper sleep patterns and include such things as night terrors, nightmares, teeth grinding (bruxism) and bed wetting. If not kept in check, any one of these problems can develop into more serious concerns for both parent and child.

There are other reasons why children have disrupted sleep. Some are very simple and easy to remedy while others are more serious and would require a visit to their doctor. Some children wake up during the night because they are wearing a pair of uncomfortable pajamas and/or are wearing nightwear that has scratchy tags that are irritating their skin; others wake up because of itching from pinworms and discomfort wakes up some children, whether it be in the form of the child having wet their bed, being too cold, too hot, thirsty, hungry or they have to use the toilet. Yet other reasons include a noise that wakes the child; an allergy or food insensitivity; gastro-esophageal reflux (GER); a bladder infection causing pain and/or a constant need to urinate; allergens in the air and finally, pain from an earache, stomach ache or teeth growing in. Never discount any of these problems but address them as soon as they occur so they don’t develop into something worse.

Narcolepsy is one of the most unusual and least common of all sleep disorders. Narcolepsy is a medical condition and sleep disorder that causes chronic and uncontrollable instances of daytime sleepiness. A person with narcolepsy can experience the sudden onset of sleepiness and fall asleep at a moment’s notice. They may drop whatever they happen to be holding, become limp, and fall to the floor in sleep. Narcolepsy is classified as a chronic neurological disorder. It is thought that narcolepsy is caused by the brain’s inability to adjust normal sleep-wake cycles. The cause for this irregularity remains unknown.

In addition to the sudden onset of uncontrollable sleepiness, individuals who suffer from narcolepsy may also experience three distinct symptoms. The first is cataplexy, which refers to bouts of irregular muscle weakness or paralysis that occurs without loss of consciousness. The second symptoms are hypnopompic and hypnogogic hallucinations, which refer to hallucinations experienced while waking up or falling asleep. The third symptom related to narcolepsy is sleep paralysis. With the frequent disruptions of sleep patterns, narcolepsy can wreak havoc on an individual’s quality of life. Narcolepsy patients complain of feeling consistently fatigued and irritable.

Narcoleptic “sleep attacks” can occur several times a day, with each attack lasting anywhere from a few seconds to almost an hour. Most bouts of sudden sleepiness occur during long meetings and lectures. Most individuals that suffer from narcolepsy report feeling refreshed and revived upon reawakening. Some narcolepsy patients also report that the narcoleptic attacks can be strongly hallucinogenic, or simply slightly irritating.

It is estimated that 25 people out of every 100,000 people in the United States suffer from narcolepsy, with an estimated 125,000 individuals diagnosed with the disorder. The disorder is thought to strike individuals with a genetic predisposition, since it is most commonly repeated in certain families. Usually, narcolepsy develops during adolescence, with most individuals diagnosed between ages ten and twenty. However, some individuals are diagnosed in early childhood, and some elderly may experience the sudden onset of sleep attacks as well. Some studies indicate that the effects of narcolepsy wane with age, although this remains in dispute.

Narcolepsy is usually diagnosed through a description of symptoms and by reviewing the results of an electroencephalogram (EEG). In many cases, a medical professional will advise the patient be examined during a sleep lab. Unfortunately, there is no “cure” for narcolepsy. The primary treatment for narcolepsy involves making several lifestyle adjustments, including getting regular exercise, avoiding stimulants, and incorporating regular naps into the individual’s daytime schedule. Indeed, taking two to three short naps (15 to 20 minutes in length) have been shown to help individuals control excessive daytime sleepiness. Individuals with narcolepsy may need to negotiate with their employers to allow for regular naps during the regular workday.

Individuals with narcolepsy can also greatly benefit from maintaining a daily exercise regime. Just exercising for 20 minutes a day can help control sleep attacks, improve the quality of nighttime sleep, and help control a healthy weight (excessive weight may contribute to the severity of narcoleptic symptoms). Getting regular sleep during the normal nighttime hours is also important in controlling the effects of narcolepsy. Stimulants should be avoided for several hours before bedtimes, including alcohol, caffeine, and cigarettes.

Drugs commonly prescribed to individuals with narcolepsy include stimulants such as ephedrine or amphetamines. Antidepressant drugs, such as migraine, are sometimes also used to control the cataplexic attacks that often accompany bouts of daytime sleepiness. Over the counter drugs and caffeine are not shown to prove effective in combating the drowsiness caused by narcoleptic sleep attacks. In 1999, a new drug was approved by the FDA to treat excessive daytime sleepiness. The drug, Modafinil, has proved effective in suppressing excessive daytime sleepiness, but it does not treat the cataplexy, paralysis, or hallucinations caused by narcolepsy.

While narcolepsy itself does not cause any medical problems or risks, sudden bouts of severe daytime sleepiness pose the danger of causing accidents. Narcolepsy can interfere with the performance of everyday tasks, reduce overall productivity, and disrupt with normal nighttime sleep patterns. Also, recent research indicates that narcolepsy may be linked to blood pressure and depression. Narcolepsy patients can greatly improve their quality of life by maintaining normal and healthy sleep schedules, and by taking medications to combat the effects of cataplexy and excessive drowsiness.