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A good night's sleep eludes many

Sleep disturbances trouble everyone at some point.

Little children wake up frightened and have trouble getting back to sleep.

Teenagers may sleep until noon, but the journal Sleep found that nearly 14 percent of teens have at least one symptom of insomnia.

Parents frequently have their sleep disrupted by their children.

Menopause can bring hot flashes, heart palpitations and other enemies of a good night's sleep.

Then there's aging itself, which causes people to sleep less and wake more often during the night.

"Sleep becomes more fragile with age, and the architecture of sleep changes," said Selim R. Benbadis, a doctor and professor of neurology at the University of Florida. "Typically it takes longer to fall asleep, there's early arousal, more time in bed awake, all kinds of insomnia.''

So just about everyone has sleeping problems sometimes, but what can be done about it?

For starters, we should recognize that modern life has altered human sleep in a fundamental way.

In his book, The Head Trip: Adventures on the Wheel of Consciousness, Jeff Warren points out that until the advent of cheap, widespread, artificial lighting, most humans went to bed at sunset. They experienced two distinct sleep cycles separated by a period of waking known as "the watch."

During that period, people would wake into a relaxed, contemplative state that might last an hour or more, and then fall into a "second sleep" of several hours.

Today, people who experience such an interruption may think they are suffering from insomnia and, in turn, reach for one of the many sleep aids to render them unconscious for the night.

These sleep aids, a class of drugs known as hypnotics, do work, according to Benbadis, who is also a neurologist at Tampa General Hospital. But he cautions they should be reserved for short-term bouts of insomnia brought about by life events such as grief or temporary anxiety.

"Until about 10 years ago, all we had were strong sedatives in the Valium class," Benbadis said. "Now we have this new class that includes Ambien, Sonata and Rozerem, which you hear advertised . . .

"These new drugs are better than the old because they don't carry the same side effects, such as a hung-over feeling the next day, respiratory depression and dependence. But we don't recommend them for long-term treatment."

People who have chronic trouble sleeping, he said, should try to get at the root of the problem.

"When insomnia becomes chronic the main problem is usually psychological — stress, bad sleep habits, things like that — and I always recommend psychotherapy," he said. "Behavior modification for chronic insomnia is the treatment of choice."

Other sleep problems emerge with age, such as:

• Depression, which tends to be more common among the elderly.

• Chronic pain caused by arthritis and other age-related ailments.

• Breathing difficulties that cause sleep apnea, a condition more common among the obese (and people tend to gain weight as they age). Sleep apnea causes people to stop breathing temporarily, which rouses them from sleep.

• A need to get up to urinate during the night.

• An increased sensitivity to caffeine and alcohol, which can both disrupt sleep.

• A sedentary lifestyle, which denies people the sleep-inducing effects of exercise.

• The use of prescription medications that can disrupt sleep in a variety of ways.

Another problem getting more attention these days is restless leg syndrome.

"That's a real disorder, and treatable," said Benbadis. "It's caused by a neurological problem involving receptors in the brain."

Benbadis recommends combating sleep disorders by following the basic rules of "sleep hygiene." That means paying attention to four areas crucial to a good night's sleep:

The circadian rhythm: This is the 24-hour cycle of changes in our bodies.

A regular rhythm contributes to sleep, but that rhythm can be altered by a nap, exposure to light, jet lag and other routine activities. You can help your circadian rhythm by turning down the lights in the evening, going to bed at a regular time, and avoiding stimulants late in the day.

Psychological stress: This can be triggered by events such as a work crisis or marital conflict.

Cognitive therapy, which involves revising what you tell yourself about your performance and your predicament, can help alleviate such stress. Meditation, relaxation exercises or even a hot bath before bedtime can help too.

Drugs: Whether prescription or recreational (including alcohol, nicotine and caffeine), drugs can affect quality of sleep. Alcohol may make you sleepy, but too much may cause you to wake during the night and also make it more difficult to go back to sleep.

Aging: You can't make yourself younger, but you can try to accommodate the age-related changes that disrupt sleep.

For example, if you get up to urinate, keep lights dim, because light can make your brain think it's morning. If you suspect you have sleep apnea, get tested at a sleep center. If pain wakes you, try to ease it with analgesics like ibuprofen or acetaminophen.

And learn how to deal with those middle-of-the-night awakenings. Some people pick up a book and read for an hour or two until they get drowsy again.

"A lot of the changes that disrupt sleep are benign, part of normal aging," Benbadis said. "With age there's less slow-wave sleep, less REM sleep. We don't know why, but even in healthy people this is true."

Freelancer Tom Valeo writes about medical and health issues. Write to him in care of Pulse, St. Petersburg Times, P.O. Box 1121, St. Petersburg, FL 33731, or e-mail
features@sptimes.com.

.FAST FACTS

Don't be sheepish

The Centers for Disease Control and Prevention estimate that 50-million to 79-million Americans suffer from a chronic sleep disorder. Risk factors that can contribute to these problems include cigarette smoking, lack of exercise, drinking too much alcohol, shift work, watching TV at night and too much caffeine.

• To hear about the sleep problems of others — and to report your own — go to www.
talkaboutsleep.com.

• The number of accredited sleep centers offering help with sleep apnea, insomnia and other problems has tripled in the past decade to more than 1,000, according to the American Academy of Sleep Medicine.

• According to a recent study in the American Journal of Medicine, more than half of all Americans have trouble getting the sleep they feel they need.

For sleep tips, visit:

www.helpguide.org; search "sleep"

www.sleepeducation.com

www.umm.edu/sleep

www.sleepfoundation.org

Bedroom magazine is aimed at "sleep retailers" that sell products to promote better sleep. Online: bedroom-mag.com

A good night's sleep eludes many 04/14/08 [Last modified: Tuesday, April 15, 2008 11:34am]
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