Wednesday, April 28, 2004

Looking for a good sleep?

We all want sleep. We all need sleep. But many of us never get enough at night, and we complain about it all day.

Richard Mikilitus, M.D., board certified neurologist and medical director of the West Georgia Sleep Disorders Center, says that lack of sleep is so upsetting because without it, you simply cannot function.

What is a good sleep? It varies greatly from person to person; some need only four to six hours to feel refreshed, while others are unhappy without at least seven to nine hours of sleep. The length of time you sleep is important but not as important as the way you sleep, says Dr. Mikilitus. In order to feel refreshed you must go through the stages of sleep.

Sleep is comprised of two major categories: dreamless sleep, known as non-rapid eye movement (NREM) sleep, and dream sleep,commonly known as rapid eye movement (REM) sleep. During NREM sleep the body moves through four stages of sleep, stage one being the lightest, stage four being the deepest. Unfortunately, the amount of deep sleep decreases as we age, says Dr. Mikilitus.

During REM sleep, where most dreaming occurs, the body is in a paralyzed state and the eyes move rapidly, as if watching a dream. Deep sleep, stages three and four, are what’s needed to restore bodily functions, while REM sleep is needed to restore brain function. “We need to have dreams,” says Dr. Mikilitus, “and they should happen 3 to 5 times a night.”

No one really knows what dreams are; some experts say dreams represent our wishes while others contend that they merely replay experiences. Twenty percent of the night, however, should be spent dreaming in REM sleep in order to feel satisfied or refreshed the following day.

Most of us complain about a bad night’s sleep now and then. Others say they feel pulled into snoozing once in a while during the day. Both of those feelings happen often enough and to enough people to be considered normal. However, if you feel constantly sleepy or think you never can get to sleep at all, your sleep patterns made need expert observation. Any drastic change in your sleeping habits that continue for more than three weeks can be your subconscious signaling for help. You may not even be the one to notice the change.

The examples of sleep disorders are numerous. Even common snoring can be a clue to abnormal sleep patterns. People do come to sleep disorders centers to be treated for snoring. Their long-suffering spouses also need help to overcome the insomnia that comes from putting up with a noisy bed partner.

It is not uncommon to find a couple with a lot of bitterness and a marriage on the rocks when they finally seek help, according to Dr. Mikilitus. Think of how you feel when you do not get one good night’s sleep and multiply that by years.

Excessive snoring can be a sign of obstructive sleep apnea, a disorder during which snorers stop breathing for at least 10 seconds. “They sometimes stop breathing several hundred times a night and never know it,” says Dr. Mikilitus.

Patients with sleep apnea may also experience dangerous drops in oxygen levels. These nighttime disturbances often result in symptoms of daytime sleepiness, personality changes, memory impairment, difficulty concentrating, lowered libido, increased blood pressure and other medical problems. If left untreated, this disorder could be fatal. A patient suspected of having obstructive sleep apnea may undergo one to two nights of polysomnogram. This is a sleep study performed in a sleep evaluation lab that monitors brain waves, eye movements, airflow from the nose and mouth, blood oxygen level, leg movements and other bodily functions during sleep.

Other sleep disorders may not be as loud as snoring but their effects can be just as debilitating. People suffering from excessive daytime sleepiness can be fired for sleeping on the job, or may feel they cannot adequately care for themselves or their families. If you are falling asleep several times during the day, you are probably having more than just a mid-day slump. There is a big difference between normal fatigue and being overcome by sleepiness, says Dr. Mikilitus. Those who are just tired during the day are typically not sure if they could lie down and fall asleep. For those who are truly sleepy during the day actually fight to stay awake.

The purpose of a sleep disorders center is to evaluate an individual’s sleep complaint and provide various solutions for help. But many of us with mild sleep disturbances may want to first try a few home remedies before seeking professional help:

• Don’t go to bed starving, but do not eat a heavy meal close to bed time either. A late night snack is acceptable as long as it does not contain sources of caffeine. Spicy foods can often disturb sleep; however, Mother’s suggestion of milk and cookies can help sleep. For those that do not like milk, cheese and crackers is an option that contains carbohydrates and tryptophan, two ingredients known to promote sleep.

• Short-term use of sleep medications are an effective treatment for insomnia. In contrast though, long-term use can have a reverse effect.

• Avoid daytime napping. Most adults suffer at night if they allow themselves to sleep during the day. Napping upsets your body clock, the natural rhythm of your body and may interfere with good sound nighttime sleep.

• Don’t give your mind and body a workout close to bedtime. If you read before dozing off, keep the reading material light and cheerful. Regular daytime exercise helps promote sleep but it should not be done close to bedtime. A guideline is to allow a four-hour window between exercise and bedtime.

• Avoid alcohol in the evening. Alcohol may relax you into sleep but will disrupt the quality of your sleep further into the night, often causing awakenings. As a result you could feel tired the next day.

• Avoid the urge to sleep in on weekends. Make every attempt each day to go to bed at the same time and to wake up at the same time.

Maintaining a consistent sleep/wake schedule is probably the single most important remedy for disturbed sleep complaints, says Dr. Mikilitus. This is the best way to keep your body clock synchronized. Remember that if you sleep in Sunday, you will feel rotten Monday.

For more information on sleep disorders, contact the National Sleep Foundation or go to www.sleepfoundation.org.

— Gail McBride-Vest

(Gail McBride-Vest is credentialed in both respiratory therapy and sleep disorders technology and holds a master’s degree in healthcare policy and administration. She’s been active in the field of sleep disorders for 22 years and is director of development for the West Georgia Sleep Disorders Center. You can reach Gail at 770-631-4600.)