Sleepless in Santa Monica? That’s not surprising because we live in a sleep-deprived society.
According to the National Sleep Foundation, which conducts annual “Sleep in America” polls, approximately 70 million Americans are affected by a sleep problem. Moreover, 40 million Americans suffer from a chronic sleep disorder and an additional 20 to 30 million people experience intermittent sleep-related problems. Unfortunately, the vast majority of these disorders remain undiagnosed and untreated.
Most people need eight hours of sleep daily for good health, safety, and optimum performance. But few actually get the recommended shuteye. In fact, nearly one-third of all Americans say they sleep less than seven hours each weeknight.
When is “trouble sleeping” considered a sleep disorder? Generally, when the problem lasts at least two weeks and/or affects daytime functioning. Once a person has trouble sleeping, anxiety about the difficulty may contribute to “anticipatory insomnia,” which can become a vicious cycle and make the original problem worse.
The following suggestions may help prevent sleep problems, particularly insomnia, defined as a “chronic inability to fall asleep or remain asleep for a length of time”:
• Have regular sleeping and waking times for both weekdays and weekends.
• Establish a regular, relaxing pre-bedtime routine, such as soaking in a bath or hot tub, reading a book, or listening to soothing music.
• Create a sleep-conducive environment that is dark, quiet, and without distractions.
• Remove work materials, computers, PDAs, and televisions from your bedroom.
• Finish eating at least 2 to 3 hours before your regular bedtime.
• Get outdoor light or intense artificial light for 30 to 90 minutes every day to help reset your biological clock.
• Exercise regularly and complete your workouts at least a few hours before bedtime.
• Avoid excessive alcohol, caffeine, nicotine, or sugary foods close to bedtime.
Insomnia may be treated with cognitive behavior therapy, relaxation training and prescription medications. However, some prescription sleep aids can become ineffective over time and result in “rebound insomnia” when discontinued. Many over-the-counter medications for insomnia contain diphenhydramine, which can cause unpleasant side effects, including dry mouth.
Discuss chronic sleep problems with your primary-care physician, who may refer you to a sleep specialist for evaluation. In addition to its effects on health, sleep deprivation causes a major public safety issue: drowsy driving. More than half of adults reported driving while drowsy at least once during the past year and almost a third reported doing so at least once per month.
Sleep apnea, a problem characterized by breathing interruptions during sleep, and other severe sleep disorders should be evaluated by a board-certified sleep specialist at an accredited facility. Treatment should be tailored to the patient’s specific needs.
Dr. Frisca Yan-Go is director of the UCLA Sleep Disorders Center in Santa Monica and a clinical professor of neurology at the David Geffen School of Medicine at UCLA.