Guest column | Dr. Rao Musunuru

Doctor offers tips on putting sleep disorders to rest

An irritable and hyperactive child, a poorly performing student, a college student in a car crash, an exhausted employee, a prematurely dead superstar, a snoring grandma and a grandpa with restless legs. What might all of them have in common?

Sleep deprivation or a sleep disorder. As many as 70 million Americans are estimated to be affected by chronic sleep loss or one of more than 70 sleep disorders. Many times, the reason for sleep deprivation is improper lifestyle or inadequate understanding.

Sleep is a very important activity, as essential for survival as breathing and eating. So important that we are supposed to spend one-third of our lifetime doing it. The brain is hard at work throughout sleep, forming or reinforcing the pathways necessary for learning and creating memories and new insights, not only during infancy and childhood but throughout life.

It is well established that lack of sleep increases the risk not only for mood disorders, but also obesity, diabetes, cardiovascular disease and infections, through a complex interplay of elaborate biological mechanisms, affecting production of various chemicals, especially hormones.

Most people falsely believe that they can function very well with a few hours of daily sleep. They will quickly realize how much more efficient, effective, energetic, quick and creative they can be during waking hours if only they allow themselves to enjoy a little more needed sleep the night before.

Adults need at least seven to eight hours of sleep each night to be well rested and restored and to feel energetic during the day. Newborns need 16 to 18 hours a day, preschool children 10 to 12 hours, school-age children and adolescents nine hours or more. Contrary to the popular belief, older people do not need less sleep than middle-aged.

Even though we may put off going to sleep in order to squeeze more activities into our day, the built-in biological need for sleep keeps accumulating to the point that we fall asleep when we don't want to, like while driving or working. As we keep fighting sleep, the functional efficiency progressively declines. Ultimately, we have to pay off the sleep debt. If we don't, we end up paying the penalty in the form of irritability, poor concentration, fatigue, confusion, malaise, forgetfulness, depression and slow reaction time. People with sleep deprivation drive as poorly as people who are drunk.

Unlike adults, children who do not get enough sleep at night typically become more active than normal during the day to the extent of resembling attention deficit hyperactivity.

People who necessarily have to work night shifts are at odds with the natural wake-and-sleep cycles and end up paying a hefty price in terms of physical and emotional health unless they take a lot of precautions.

Several precautions can help to get a good night's sleep. Avoid exercising for about five hours before bedtime; large meals and beverages late at night; naps after 3 p.m.; disturbing late-night news or movies; computer and television in the bedroom; noises and background light; an uncomfortable bed; alcoholic drinks before bed; caffeine for about eight hours before bedtime; nicotine; and, if possible, medicines that delay or disturb sleep.

Take a hot bath before bed. Keep room temperature lower. Relax (unwind) before bed. Stick to a sleep schedule. Sleeping later on weekends won't fully make up for the lack of sleep during the week and also will not make up for impaired performance during the week. It will also further disturb your biological clock.

At least 30 minutes of exposure to natural sunlight during the day will help you sleep better at night by helping the biological clock. Gratification through good deeds and satisfaction from sincere service will help more than any pill to enjoy sound sleep. Also, properly performed yoga and meditation may work better than any medication. Pleasure helps, pressure doesn't.

Losing sleep temporarily over a stressful life situation or experience is normal and expected. If you are not sure what you may be doing wrong to cause your chronic sleep problem, try to sleep on it. If you don't wake up fresh with the right reason or solution, you may have a sleep disorder. You need to seek proper medical help. You may lose more than sleep if you get addicted to the wrong sedatives and hypnotics.

Dr. Rao Musunuru, a cardiologist at Regional Medical Center Bayonet Point, is a current member of the Advisory Council for National Heart, Lung and Blood Institute at the National Institute of Health.

Doctor offers tips on putting sleep disorders to rest 07/30/09 [Last modified: Thursday, July 30, 2009 6:38pm]

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