Sound Sleep Guide

Archive for November, 2006

Frequent trips to the restroom at night can be caused by a number of things including pregnancy, diabetes, congestive heart failure, or an overactive bladder, among others. Getting up at night interferes with our sleep cycles. Are there any treatment methods to help those who suffer from nighttime wake up calls to get better sleep? Here we will delve deeper into the matter.

During the day, your kidneys clean your body by producing large amounts of urine. When you go to sleep at night, your brain makes lots of a hormone called ADH for short that shuts down your kidneys so you can sleep at night. As you age, the brain’s ADH production slows down so many older people have to get up at night to visit the restroom. Antidiuretic hormone nasal sprays or pills can help these people sleep through the night. Even men who have frequent night-time urination after prostate surgery have reduced levels of ADH and can be cured by taking that hormone at bedtime (1). A potential serious side effect is seizures from taking too much water with HDH (4). So, if you take a 400 mg ADH pill or a single ADH nasal spray at bedtime, do not drink fluids after 6 PM.

The common causes of frequent urination range from the overly simplistic explanation of excessive fluid intake to more complicated scenarios such as congestive heart failure, benign prostatic hyperplasia, diabetes, chronic or recurrent urinary tract infections, or drugs.

If you are pregnant, this can mean lots of trips to the bathroom especially in the first and last trimesters.

Pregnant women and mothers will testify that the quality of sleep in the third trimester is unbearable. Along with the normal discomforts of pregnancy such as heartburn, leg cramps, restless leg syndrome, and snoring, the bladder is under pressure. Like it was during the first trimester when the bathroom was a second home, the baby is positioned right on top of the mother’s pelvis. Pregnant women can reduce their nighttime potty breaks by limiting fluid intake in late afternoon and evening and also completely emptying the bladder every time they visit the toilet. You can cut down on nighttime trips to the bathroom by drinking plenty of fluids during the day but limiting your intake in the hours before you go to bed. Stay away from coffee and tea late in the day.

An overactive bladder may make you feel like you have to get to a bathroom immediately because the bladder muscles act inappropriately and contract involuntarily. You may be experiencing symptoms of an overactive bladder if you get up 8 or more times in a 24-hour period to go to the restroom, if you get up two or more times at night, if you have sudden urges to urinate, and/or if you have wetting accidents. You can try cutting back on liquids, and wear pads or liners to protect your clothing but there are other ways to deal with this condition and get back to a normal night’s sleep. Consult with your physician about medical treatment. In the meantime, try some Behavioral therapy such as Kegel exercises to help strengthen your pelvic muscles. Try to retrain your bladder by lengthening the time between visits to the bathroom. Add fifteen minutes to the time between the times you would normally go to the bathroom. If you go every two hours, wait two hours and fifteen minutes the next time and slowly get your bladder trained to make less visits to the bathroom.

Biofeedback is also an option which can teach you how to contract the levator muscle and track when your bladder and urethral muscles contract involuntarily. Drug therapy will help block bladder contractions by relaxing your bladder muscles. Occlusive devices are another option for women, which are urethral inserts and urine seals that help to obstruct urine flow and manage leakage. Surgery is recommended only as a last resort when drug therapy and bladder retraining have failed. You can also modify your diet to help you get some shut-eye. Avoid or limit foods that contain caffeine, chocolate, and alcohol that make your body produce more urine. Also stay away from foods and beverages that may irritate your bladder such as coffee, tea, chocolate, alcohol, citrus fruits, juices, and high-spice foods. Drink six to eight glasses of water spread out evenly through the day. If you have problems with constipation or have gained too much weight, this can worsen the symptoms of an overactive bladder. Smoking has been show to aggravate the bladder so if you’re a smoker, try quitting for the sake of your health and your overactive bladder.

Check with your physician or urologist for treatment options and get back to a good night’s sleep.

How to Treat this Condition

Gastro esophageal reflux, or heartburn, is recognized by burning chest pain. Another typical symptom is a sensation of food coming back into the mouth with a bitter, acidic taste. This disorder can also be accompanied by asthmatic breathing, coughing and hoarseness. Occasionally, gastro esophageal reflux can mimic the symptoms of a heart attack, and is often mistaken for one. This disorder is caused by acid “backing up” into the esophagus during sleep. This is easily treatable with medication.

Most people can control heartburn by making a few changes in their lifestyle and habits. It’s especially important to cut back on things such as chocolate, alcohol, coffee, fried foods, and other items that have a tendency to weaken the seal between the stomach and the esophagus. You can also ease some of your pain by avoiding foods that irritate an already inflamed esophagus, such as tomato sauces, citrus fruits and juices, peppers and spicy foods. If you’re a smoker, you should consider quitting. It would be the healthiest thing to do at this time. And if you’re overweight, loosing a few pounds can save you a lot of unnecessary pain.

If heartburn tends to strike you at night, try raising the head of your bed by four to six inches. One way to do this is to place blocks under the frame at the head of the bed. Some stores such as “Bed, Bath, and Beyond” sell bed raisers to do just this. This will make physics work for you. Gravity will help keep acid in your stomach. For the same reason, you should also wait at least two to three hours after dinner before lying down to bed. This is a good thing do to help you loose weight as well. If your food is digested, there is nothing to go back into the esophagus.

Over-the-counter antacids such as Rolaids, Tums, or Maalox can provide quick relief from heartburn. You can push off future attacks by taking one of several drugstore remedies that slow down the flow of acid, including Tagamet, Zantac, Pepcid, and Axid. If heartburn is a recurring problem, talk to your doctor. He can help you find the remedy that’s right for you. You want something that will work long term, not just when it happens. You want to avoid it from happening to begin with.

If your attacks are strong, you may need stronger medicine. Your doctor may want to give you prescription-strength doses of over-the-counter medicine, or a powerful dose of acid-fighters known as proton pump inhibitors. These drugs, including Nexium, Protonix, and many others, shut down acid production in the stomach and can bring dramatic relief.

If medications and lifestyle changes aren’t enough to control your heartburn, you may need an operation — called fundoplication. This operation bolsters the barrier between the stomach and the esophagus. The surgery is considered a last resort, but it cures up to 90% of cases. The operation can now be performed through a tiny incision. The procedure causes relatively little pain and doesn’t require a long hospital stay.

Other treatments may also be available. Several procedures are being used and researched for the treatment of gastro esophageal reflux disease (GERD). One of these procedures uses radio waves to tighten the muscular valve between the esophagus and stomach and reduce symptoms of GERD.

For quick treatment of heartburn or other stomach acid problems, try drinking a glass of milk. You can also eat a piece of bread. This will help either absorb the excess acid or neutralize it. This does not work for everyone, but it may be the quick fix you need to get to sleep. If this technique works for you, it could save you hundreds of dollars a year on medicines and doctor visits.

Proper treatment of heartburn and other related problems can help you avoid outbreaks in the future. Heartburn when you are trying to sleep can be one of the most unpleasant things. It can ruin your whole night. You will wake up feeling nauseated, tired, grouchy, and sick. This is not good. Take care of this problem now and it will save you a lot of pain and sleep in the future.

Maybe you’ve heard of your ‘body clock,’ but have never quite understood what it is. When people refer to their inner body clock, they are making reference to their circadian rhythm. Your circadian rhythm is in charge of coordinating your daily sleep-wake cycle. Your body actually has hundreds of circadian rhythms. These cycles control and coordinate your body’s varying temperature, heart rate, blood pressure, hormone levels, and numerous other factors that allow you to move about comfortably every day. Your circadian rhythm operates on a 24-hour cycle. Your brain relies on outside influences (called zeitgebers) such as daylight to set your circadian rhythm each day. Our bodies depend on these external cues to set our internal body clocks. Any time that your circadian rhythm becomes interrupted-for instance, if you experience several nights of sleep deprivation-your circadian rhythm is thrown out of sync.

Unfortunately, many people are unable to keep a steady circadian rhythm because of their employment. People who work at night are particularly vulnerable to this danger. People who work during the nighttime hours interrupt the body’s natural biological and psychological rhythms. Many of these individuals may eventually suffer from a circadian rhythm disorder. Other people who are vulnerable to developing a circadian rhythm disorder are people who keep very irregular sleep schedules, those who travel frequently and experience jet lag, and people who simply do not get enough sleep due to insomnia or other sleep disorders.

What happens when your circadian rhythm is disrupted? Not only does your ability to get a restful night’s sleep become compromised, your immune system is also compromised, making you more vulnerable to getting colds and flu’s. Your body becomes more susceptible to weight gain, you are more vulnerable to develop mood swings, and your body’s digestive system may be thrown out of whack. How does your circadian rhythm affect your ability to get a good night’s sleep? A disruption of your circadian rhythm may cause you to become sleepy and fatigued during work hours, and you are more likely to develop chronic insomnia. It is usually much more difficult to achieve restful sleep during the day. There are far more interruptions and environmental factors that negate the amount of sleep you can achieve during the day. Short-term disruptions to your circadian rhythm can also cause fuzzy thinking and an overall lack of clarity. This can result in an increase of workplace accidents caused by fatigue.

The long-term effects of an interrupted circadian system can leave you vulnerable to any number of illnesses and diseases, including diabetes, heart disease, and strokes. You may also be more vulnerable to psychological, mental, and emotional disturbances.

If you are a nighttime shift worker, what can you do to reduce the adverse effects that such work might have on your circadian rhythm? First, you must be proactive in maintaining good sleep hygiene. Good sleep hygiene means that you keep a regular sleep schedule, waking and retiring at roughly the same time each night. You should strive always to sleep in a dark, quiet room. If you sleep during the day, you can make or purchase special blackout curtains that will allow you to pattern the effects of nighttime in your room. Turn off phones, timers, cell phones, and any other reminders that it is not really night time. You can use a white noise device or a fan to drown out any noise you may be exposed to while trying to fall asleep.

Once you have established an environment conducive to getting a good night’s rest, you should strive to establish other healthy lifestyle habits that can help you achieve restful sleep. Getting regular exercise can help you maintain a steady circadian rhythm. Ideally, you should exercise at roughly the same time each day. You should also strive to eat small, frequent and healthful meals, and to stay well hydrated throughout your work shift.

If you are a nighttime worker, you should avoid overexposing yourself to natural light after your shift is done. The light will signal to your brain that it is time to ‘wake up.’ Wear sunglasses, or try to get home before absorbing excessive daylight. This will make it much easier for you to fall asleep once you get home. Also, after awaking from your daytime sleep, you may want to expose yourself to 30 minutes or so of artificial light. This will help signal to your brain that its time to wake up.