Sleep Disorders, Sleep Deprivation Sleeping Pills and Sleep Aids
Each year, there are about 40 million people in America who suffer from sleeping disorders. An additional 20 million have occasional sleeping problems.
Research has shown that it takes a toll on us both mentally and physically. While we sleep, our bodies secrete hormones that affect our mood, energy, memory, and concentration. Sleep deprivation and fatigue have long been issues for professions that have traditionally held long work hours. Pilots have federal regulations that limit their work hours to eight hours of flying time within a 24-hour period. Truck drivers can't drive more than 10 hours without a mandatory eight-hour break.
Recent research suggests that if sleep deprivation is long-term--whether because of lifestyle choices or sleep disorders--it may increase the severity of age-related chronic disorders such as diabetes and high blood pressure.
Short-term insomnia lasts only a few days and is usually not a cause for concern. For example, with jet lag, your internal body clock will readjust itself within several days. It's wise to read labels carefully and check with your doctor before using over-the-counter (OTC) sleeping pills or sleep aids for short-term insomnia. These sleep aids use sedating antihistamines to make you drowsy. Examples include Nytol (diphenhydramine) and Unisom Nighttime (doxylamine). While, some use other methods e.g. Melatonin.
What are the causes for sleep deprivation or disorders?
Sleep Deprivation due to Lifestyles People who work nights, for example, probably never completely adapt because our bodies want to be awake during the day and asleep at night. We are governed by the circadian rhythm, an internal clock that regulates sleep and wake cycles. Sleep deprivation can also result when people choose to skimp on sleep in favor of work, parties or late-night television.
Can't Fall Asleep--Can't Stay Asleep Most people experience short-term insomnia at some time. Insomnia includes having trouble falling asleep, having trouble getting back to sleep, and waking up too early. Insomnia is more common in females, people with a history of depression, and in people older than 60.
Noise and Stressful Events Temporary insomnia can be caused by noise or a stressful event like the loss of a job or a death in the family.
Medications, Large meal before bedtime and Alcohol Certain medications could keep you awake, particularly those that treat colds and allergies, heart disease, high blood pressure, and pain. And some of us practice bad habits that sabotage our sleep. This includes drinking alcohol and eating too close to bedtime.
Alcohol works as a sedative, but it's also metabolized quickly. You may sleep soundly for the first couple of hours, then you wake up. And large meals in the two hours before bedtime could cause indigestion or even heartburn.
Sickness People with breathing problems, glaucoma, or chronic bronchitis, pregnant or nursing women, and people who have difficulty urinating due to an enlarged prostate should not use these medicines. People with sleep apnea shouldn't take sleep-promoting medicine because it could suppress their respiratory drive, making it harder to wake up when they experience an episode of interrupted breathing.
Insomnia is considered chronic when it lasts most nights for a few weeks or more. This longer-term condition deserves professional attention.
SLEEP AIDS AND TREATMENTS About 85 percent of people who have insomnia can be helped with a combination of behavioral therapy and medicine.
Prescription hypnotic drugs act in areas of the brain to help promote sleep. There have been advances with the development of more short-acting drugs to decrease drowsy spillover effects in the morning. Sonata (zaleplon), for example, is a drug designed to help you fall asleep faster, but not for keeping you asleep. Ambien (zolpidem) is an example of a drug indicated for both getting to sleep and staying asleep.
Insomnia has traditionally been viewed as a symptom of an underlying medical or psychiatric illness, and drugs to treat insomnia are approved for short-term use only, until the primary condition can be treated.
Hypnotic drugs are potentially addictive. Generally, their use is limited to 10 days or less. However, most people with this chronic condition may need long-term treatment. About 20 percent of people with chronic insomnia have a primary form of it, which means it's not associated with another medical condition. As with any prescription medication, it's important to not increase doses or stop taking hypnotic drugs without consulting a doctor. No drugs that promote sleep should be taken with alcohol. And because of the sedating effects, caution must be used when getting out of bed, driving, or operating other machinery.
Sleepy During the Day
Feeling tired every now and then during the day is normal. But it's not normal for sleepiness to interfere with your routine activities. For example, you shouldn't be dozing off while reading the newspaper, during business meetings, or while sitting at a red light. Slowed thinking, trouble paying attention, heavy eyelids, and feeling irritable are other warning signs.
If you're feeling sleepy frequently during the day, you might simply need to make more time to sleep.
Most adults need at least eight hours of sleep every night to be well rested, but this varies from person to person. The bottom line is that you should sleep for the number of hours it takes for you to feel rested, refreshed, and fully alert the next day. If you've had a good sleep, you shouldn't feel drowsy during the day.
Naps before 3 p.m. and for no longer than an hour can be good, so that it doesn't interfere with falling asleep at night.
If you are sleeping an adequate amount and you still feel drowsy going about your day-to-day routine, or if adjusting your sleeping habits hasn't helped, then you should talk with your health-care provider.
SLEEP DISORDERS AND SLEEP PILLS OR AIDS Overwhelming daytime sleepiness could be due to a number of sleep disorders.
Narcolepsy People with narcolepsy experience excessive sleepiness even after a full night's sleep. Some people may be able to sleep, but the sleep quality is no good, If you look at the brain as a rechargeable flashlight, some people don't hold the charge very well. They may have sleep attacks, sometimes at very inappropriate times such as while eating or talking. But not all cases present this way. Provigil (modafinil) may be helpful for this type of sleep disorder. The drug is approved by the FDA to improve wakefulness in people with narcolepsy. Potential side effects include headaches and nausea.
Some people with narcolepsy experience episodes of cataplexy, a condition characterized by weak or paralyzed muscles such as buckling knees. In July 2002, the FDA approved Xyrem (sodium oxybate or gamma hydroxybutyrate, also known as GHB) to treat this condition.
Snoring Snoring is noisy breathing during sleep that occurs when relaxed structures in the throat vibrate and make noise. Most snoring is harmless, though it can be a nuisance that interferes with the sleep of others. Some snoring can be stopped with lifestyle changes, particularly losing weight, cutting down on smoking and alcohol, and changing sleeping positions. This generally means keeping snorers off their backs and on their sides as a way to keep the airway more open during sleep. There are over-the-counter nasal strips that are placed over the nose to widen the space in the nose and make breathing easier. Read labels carefully because these strips are only intended to treat snoring. The labels point out certain symptoms that require a doctor's care.
The trick is figuring out the cause of snoring. It could be related to allergies or structural abnormalities such as nasal polyps or enlarged adenoids, which are lymphoid tissue behind the nose.
Sleep Apnea If your snoring is loud and frequent and you also have excessive daytime sleepiness, you could have sleep apnea. People with sleep apnea tend to also be overweight, and it's more common among men than women. When a person with sleep apnea tries to breathe in air, it creates suction that collapses the windpipe and blocks the flow of air. Blood oxygen levels fall and the brain awakens the person, who then snorts or gasps for air and then resumes snoring. This cycle is typically repeated many times during the night. It results in frequent awakenings that prevent people from reaching the deepest stages of sleep, which leaves them sleepy during the day.
Sleep apnea has been linked to heart disease, high blood pressure, and stroke. Recognizing the signs of sleep apnea in children is a challenge because unlike adults, kids push through daytime sleepiness and keep going. Kids with sleep apnea may do poorly in school."
Doctors use an all-night sleep study to make a definitive diagnosis of sleep apnea. During the test, sensors are attached to the head, face, chest, abdomen, and legs. The sensors transmit data on how many times the person being tested wakes up, as well as changes in breathing and in blood oxygen levels.
Medications generally aren't effective for sleep apnea. There are about 20 FDA-approved devices available by prescription for snoring and obstructive sleep apnea. Most devices pull the tongue or jaw forward to open the airway. There are no similar over-the-counter devices approved by the FDA. Potential side effects include damage to the teeth and jaw joint.
The most common treatment for sleep apnea is continuous positive airway pressure (CPAP) with a device that pushes air through the airway at sufficient pressure to keep the airway open while sleeping. Radzikowski says using CPAP makes her feel rested during the day. It involves wearing a mask over the nose while sleeping. A blower attached to the mask pushes air through her nasal passages.
Surgery also is an option to treat snoring and sleep apnea. This may include removal of the tonsils or adenoids. To treat snoring, a laser-assisted procedure called uvulopalatoplasty is used to enlarge the airway by reshaping the palate and the uvula, making them less likely to vibrate. For sleep apnea, a laser procedure called uvulopalatopharyngoplasty is used to remove excessive tissue at the back of the throat.
If you're troubled by sleep problems, ask your health-care provider about how your problem should be evaluated and which treatments may be appropriate for you.
Tips for Better Sleep 1. Keep a regular sleep-wake cycle. Try to go to bed and wake up at the same time every day. 2. Avoid caffeine, alcohol, and nicotine in the four to six hours before bedtime. 3. Don't exercise within two hours of bedtime. 4. Don't eat large meals within two hours of bedtime. 5. Don't nap later than 3 p.m. 6. Sleep in a dark, quiet room with a comfortable temperature. 7. If you can't fall asleep within 20 minutes, do a quiet activity 8. Perform relaxing pre-sleep ritual -warm bath, soft music, or reading. 9. Lose weight if you are overweight. 10. Take antacid if you have heartburn.
THIS ARTICLE IS FOR INFORMATION ONLY. CONSULT WITH YOUR DOCTOR FOR YOUR QUESTIONS. ALL RIGHTS RESERVED SOURCE FDA Consumer Magazine November-December 2002 Issue Pub No. FDA03-1325C