Sleep is absolutely essential to good physical and mental health, and most adults need seven to nine hours every night. Sleep deprivation — caused by insufficient sleep or poor quality of sleep — impairs the body’s immune system, physical reflexes, emotional stability and cognitive functions, such as memory, decision-making, the capacity to focus one’s attention and the ability to complete complex creative activities or mathematical calculations. Severe sleep deprivation may lead to weight gain, an increase in muscle, joint and nerve pain, depression and even hallucinations. Sleep disorders can also be symptomatic of more serious illness, such as clinical depression and/or heart disease, meaning that it’s essential to talk with your doctor if you are having problems falling, or staying, asleep.
If you or your doctor think you might have a sleep disorder, a first step in further evaluation is to answer the eight questions on the Epworth Sleepiness Scale. If your score is equal to or higher than 10, the results should be discussed with your doctor. Depending upon your symptoms, your physician may determine that you are a candidate for a sleep study.
Another step is to begin keeping a sleep diary that documents your daily activities, including your sleep activities (i.e. tossing and turning, waking in the middle of the night, sleep walking, grinding teeth, etc.). Take careful note of the times you actually get good sleep versus the times you don’t. If you’re attempting to heal from an acute injury or a chronic illness, your treatment program will be greatly enhanced by your commitment to proper sleep hygiene.
Commonly-Diagnosed Sleep Problems
There are a large variety of sleep disorders. Some are caused by physical problems, such as an airway obstruction that leads to sleep apnea, or chronic pain or indigestion/reflux sufficient enough to cause insomnia. Sleep problems can also occur as a side effect of taking certain medications or supplements, or because of emotional difficulties including depression, post-traumatic stress disorders and/or anxiety about life situations. In many cases, there can be several factors contributing to the sleep disturbance, including anxiety about the sleep deprivation itself. Some commonly-diagnosed sleep disorders include:
? Insomnia: Inability to fall asleep within 15 to 20 minutes.
? Dyssomnia: Frequent awakenings throughout the night and/or early-morning awakenings.
? Restless leg syndrome: When lying in bed, unpleasant “crawling” sensations in the legs that create an irresistible and sleep-disruptive urge to move one’s legs.
? Sleepwalking: Walking during sleep or engaging in other activities, like eating, that are normally associated with wakefulness.
? Sleep apnea: Obstruction of airway during sleep, causing breathing irregularities that interrupt and interfere with sleep. Sufferers are at higher risk of developing high blood pressure, heart disease and stroke. Snoring may be a sign or symptom of sleep apnea, so it’s something you should mention to your doctor. (The National Institutes of Health offer more information about sleep apnea, including an animated illustration of the disorder.)
Treatment of Sleep Disorders
There are a wide range of over-the-counter and prescription medications advertised as sleep aids. All of them — including nutritional supplements, Chinese herbs, non-prescription-medications and prescribed-medications — may have side effects or cause drug interactions; for example, long-term use of Benadryl or Tylenol PM may increase your risk for developing Alzheimer’s. Please talk with your doctor before taking any sleep aids.
Alternative Treatments
? Calcium (1,500 to 2,000 mg daily, taken after meals — 500 mg per meal — and 500 mg at bedtime). Calcium is a nutritional supplement that helps relax the body’s muscles.
? Magnesium (1,000 mg daily). A nutritional supplement that helps to calm the body’s nervous system and relax the muscles.
? Cortisol Manager (One tablet daily). Cortisol Manager reduces cortisol levels for all-day stress reduction and restful sleep. It’s safe for use every night.
? Valerian (1,000 mg daily). Valerian is an American herb that has been found effective in helping to induce the onset of sleep.
? Phosphatidylserine (PS 100; take one to two at bedtime). Phosphatidylserine is a phospholipid nutritional supplement that stops hyperactive production of cortisol in the body, allowing unhealthy, elevated cortisol levels to decrease, and consequently, more restful sleep to occur.
? Melatonin (1 to 3 mg daily, but consult with your doctor before using, especially if you’re taking an antidepressant). Melatonin is a hormone that helps induce and maintain sleep. It can be useful in helping people recover from jet lag by reorganizing the sleep cycle (assisting the body in adjusting to time-zone changes).
? L-Tryptophan (1,000 to 3,000 mg, 30 to 40 minutes before going to bed). L-Tryptophan is a serotonin-precursor, amino-acid nutritional supplement that can help initiate sleep and can be used to reduce chronic pain and depression.
? Chinese herbs. These can be very helpful in treating and resolving sleep problems, but need to be prescribed by a physician or licensed acupuncturist trained in Chinese herbal medicine.
? Acupuncture. Talk with your doctor about the frequency of treatments that might be helpful for you.
? Meditation. Twenty minutes daily.
? Aerobic exercise. Three to four times a week, completed at least three hours prior to bedtime.
Immediate Steps You Can Take to Help Ensure You Get the Rest You Need
? Plan your daily schedule to allow seven to nine hours for sleeping every night.
? Keep a consistent sleep pattern, even on weekends.
? Eliminate caffeine from your diet or reduce your consumption to one cup of coffee or tea, or one soda per day. Caffeine is a stimulant, and it takes six hours or more for your body to metabolize.
? After 3 p.m., drink only non-caffeinated beverages.
? Take B-vitamins and ginseng in the morning, not before bedtime.
? Get regular physical exercise (three to four times a week).
? Create a bedtime-relaxation routine, which might include:
— Getting ready for and going to bed at the same time each night.
— Taking a hot shower or bath before bed.
— Enjoying a cup of chamomile tea before sleep.
— Reading a book rather than watching TV once in bed. (Instead of having a relaxing effect, watching television before bed actually stimulates the mind.)
— Journaling — as a way of getting problems “off your mind” and onto paper — so they can be dealt with in an orderly way in the future.
Also:
? Avoid drinking alcohol near bedtime (although alcohol may cause drowsiness initially, alcohol inhibits sleep continuation).
? Make sure sleeping conditions are comfortable (proper temperature and darkness).
Overall, try to remain consistent with your sleep routine — even on weekends and holidays.
Good night!
Dr. Gary Kaplan, D.O., a pioneer of integrative medicine, is one of just 19 physicians board certified in both family medicine and pain medicine and practices in McLean, Virginia. A clinical associate professor at Georgetown University and director of the Kaplan Center for Integrative Medicine, he has also served as a consultant to the NIH and, in October 2013, was appointed to the Chronic Fatigue Syndrome Advisory Committee at Health and Human Services. He’s the author of “ Total Recovery: A Revolutionary New Approach to Breaking the Cycle of Pain and Depression.” Dr. Kaplan has discussed his work on Good Morning America, BBC, NPR, NBC News and CBS News, as well as in The New York Times, The Washington Post, Wall Street Journal, TIME, Prevention, Everyday Health and US News & World Report. He resides in Falls Church, Virginia. Connect wit him o n YouTube , Facebook and Twitter.
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