CBS 2’s "Sleep Wreckers" are a few of the common-sense insomnia culprits

On day 2 of WCBS New York City’s “Sleep Week,” health reporter introduced viewers to their so-called “Sleep Wreckers.”

Most elements in their list should be familiar for regular blog readers.

- Pets in bed
-Alcohol before bedtime
-Supplements like B6, B12 or Ginseng in the evening
-Sleep disorders like sleep apnea or restless leg syndrome
-Pain or discomfort while sleeping
-Stress

The report only scratches the surface for behaviors that contribute to sleeplessness. Some are more obvious than others.

-Caffeine after lunch
-Eating before bed
-Exposure to bright light before bedtime
-Heavy evening exercise
-Nicotine before bedtime
-Lengthy naps
-Irregular sleeping patterns
-Using your bed for activities other than sleep
-Uncomfortable sleeping environment

The author of the WCBS article recommends prescription sleep drugs for treating short-term insomnia. The AASM recognizes medications such as Ambien or Lunesta as an effective temporary fix. However, we first suggest improving sleep hygiene and eliminating these “Sleep Wreckers.” Some people may need the assistance of a sleep professional. Cognitive Behavioral Therapy is the treatment of choice for insomnia. Patients work with behavioral sleep experts to change the thoughts and actions that contributed to difficulty sleeping.

Learn more about Cognitive Behavioral Therapy on Sleepeducation.com.

“The Nation of Walking Zombies” – Sleep Deprivation in America

In the first of a four-part series, “The Science of Sleep,” New York 1 reports that sleep deprivation, exhaustion and insomnia are common problems in New York and across America.

Many people think that their addiction to caffeine is normal, but if you constantly wake up feeling unrefreshed and are excessively sleepy throughout the day, you are probably not getting the sleep you need.

Last month, Prevention and msn listed five signs that you might be sleep deprived. These signs also may indicate that you have a sleep disorder.

More than 70 million people in the U.S. have a sleep disorder. According to AASM member Dr. Carl Bazil, sleep disorders often go unnoticed by patients and doctors: “Sleep problems are the most underdiagnosed of any medical illness.”

The International Classification of Sleep Disorders, Second Edition documents 81 sleep disorders. Common sleep problems include insomnia, obstructive sleep apnea and restless legs syndrome. Sleep disorders can have a negative impact on physical and mental health if left untreated.

There are steps you can take to improve your sleep on your own:

• Wake up at the same time each day, even on weekends.
• Avoid naps if you can during the day.
• Don’t drink caffeine in the afternoon.
• Don’t read, write, eat, watch TV, talk on the phone, or surf the web in bed.
• Make your bedroom quiet, dark, and a little bit cool.

Find more tips about good sleep hygiene at Sleep Education.com. Contact an AASM-accredited sleep disorders center if improvements in your sleep habits do not resolve your sleep problem.

Dr. Oz: Rejuvenate While you Sleep

According to Dr. Oz, making small changes to your bedtime routine can help you maintain or restore your youth while you sleep.

Dr. Oz notes that everyone has some sort of bedtime routine they follow each night. By adding some of the steps below, you might be able to slow or even reverse the effects of aging.

1. Wash your face with gentle soap that hydrates and exfoliates.

2. Use a moisturizer that contains vitamin A to avoid and erase wrinkles.

3. Use a humidifier to keep your skin well-hydrated.

4. Keep a glass of water next to your bed so you don’t have to get up if you are thirsty.

5. Take half of your vitamins in the morning and half at night so they stay in your system all day.

Taking the time to enhance your sleep routine and nighttime habits may increase the quality and quantity of your sleep.

Many Americans place sleep at the bottom of their priority list, and practice poor sleep hygiene.

Earlier this month, the Sleep Education Blog reported that making small changes to your bedroom and your bedtime routine can help improve your sleep.

AASM member Dr. Charles Czeisler recently told ABC News that "You need to set aside the time for sleep. You need a few hours to unwind before. It takes time for the brain to wind down."

Consult a board-certified sleep expert at an AASM-accredited sleep center if your problems continue after you have improved your sleep environment and bedtime routine.

Chronic Pain: Cognitive Behavioral Therapy Improves Sleep

A new study found that cognitive behavioral therapy (CBT) can significantly improve sleep for people with chronic neck or back pain.

Many people living with chronic pain have poor sleep hygiene. Common mistakes include sleeping when they are not tired, sleeping in places other than the bedroom and watching TV in bed. These habits may lead to insomnia.

People taking medicine for their pain may be unwilling or unable to use sleep aids to treat their sleep problems. CBT provides a safe and effective alternative.

The study involved 28 people who experience chronic pain. Participants received eight weeks of therapy from a trained nurse therapist.

Therapy sessions established a set number of hours in bed, focused on negative thoughts about sleep and addressed unhealthy sleep behavior. Sleep diaries were used to track sleep. Pain and mood were measured throughout the study. Patients were followed for six months after treatment.

Patients who are interested in CBT but have limited access to face-to-face sessions can receive treatment online. Last year the Sleep Education Blog reported that online CBT programs have the potential to provide long-lasting effects for people who suffer from chronic insomnia.

The AASM recommends CBT as an effective treatment for chronic insomnia in adults. Consult a board-certified sleep expert at an AASM-accredited sleep center if you are suffering from an ongoing sleep problem.

Changes in Bedtime Routine and Sleep Environment Can Improve Your Sleep

According to a recent blog post, making small changes in her night time habits and bedroom have helped Glamour Magazine’s Cindi Leive improve her sleep during Sleep Challenge 2010.

Leive said that since she began the sleep challenge, her awareness of her sleep has increased, and that has made a positive impact. She notes that the small changes she made to her night time habits and bedroom have increased the quality and quantity of her sleep. Some of the changes include buying a new pillow, creating a bedtime routine, making her bedroom darker and keeping electronics out of her room. Leive has also given herself a bedtime.

After speaking with several sleep experts, including AASM member Dr. Michael Breus, Leive and Huffington have focused on the factors that were keeping them from getting the sleep they need. They are currently in the process of making lifestyle changes that will allow sleep to be included as a major priority.

Last year, the Sleep Education Blog reported that following a nightly bedtime routine can reduce daytime sleepiness. Research showed that the most effective strategies to feel less sleepy were taking a bath and going to bed at the same time every night.

In order to improve your sleep the AASM also recommends that you:

• Wake up at the same time each day, even on weekends.
• Avoid naps if you can during the day.
• Don’t drink caffeine in the afternoon.
• Don’t read, write, eat, watch TV, talk on the phone, or play cards in bed.
• Make your bedroom quiet, dark, and a little bit cool.

Find more tips about good sleep hygiene at Sleep Education.com.Contact an AASM-accredited sleep disorders center if you have an ongoing sleep problem.

Image courtesy of Glamour Magazine

Does Childhood Insomnia Exist?

As children begin to attend school regularly, many become involved in extracurricular and social activities that cut into their sleep time, which may result in insufficient sleep. Although children at any age can have anxiety that affects their ability to sleep, U.S. News & World Report notes that school-age children can develop what may be thought of as "pseudo-insomnia."

Parents may worry if their child is having a hard time falling asleep; however, it may be a problem that is fixed simply by adjusting bedtime. For instance, parents may set a bedtime that allows for 12 hours of sleep for a 7 to 8 eight year old child, who only needs 10 to 11 hours of nightly sleep. Pushing bedtime back by an hour may eliminate the child’s inability to fall asleep.

According to the American Academy of Sleep Medicine, children’s nightly sleep requirements vary by age. Suggested nightly sleep needs for children are:

• Infants (3 to 11 months): 14 to 15 hours
• Toddlers: 12 to 14 hours
• Preschoolers: 11 to 13 hours
• School-age children: 10 to 11 hours

Parents should help children build healthy sleep hygiene habits, which include avoiding TV in bed, preparing for bed with a routine, avoiding going to bed until sleepy enough for sleep, and waking at the same time each morning—including weekends.

Older children often develop a problematic sleep pattern called delayed sleep phase disorder. By waking late on weekends relative to weekdays, they shift their body clocks late and then have trouble with sleep onset on Sunday to Thursday nights. They may lie in bed and worry about their ability to fall asleep, which compounds the problem for them. This latter difficulty is often termed psychophysiological insomnia and is a common cause of adulthood insomnia as well.

Insomnia symptoms include difficulty falling or staying asleep, waking up too early or poor quality sleep.

Learn more about behavioral insomnia of childhood on SleepEducation.com.

How to Help Your Child Sleep Better

A new study confirmed that poor “sleep hygiene” has a negative effect on the sleep patterns of young children.

The study analyzed data from a national poll of 1,473 parents and caregivers; their children ranged in age from newborns to 10-year-olds. The poll included questions on sleep habits and sleep patterns.

Having a late bedtime after 9 p.m. was associated with sleep problems across all ages. Children who went to bed late took longer to fall asleep; they also had a shorter total sleep time.

Having a parent present when the child falls asleep also affected all age groups; these children woke up more often during the night.

Children 3 years of age and older had a shorter total sleep time if they had a TV in the bedroom; they also obtained less sleep if they had no consistent bedtime routine.

Children 5 years of age and older slept less if they regularly consumed caffeine.

The authors concluded that good sleep hygiene helps young children sleep better. Basic tips that parents should put into practice include:

- Letting children fall asleep independently
- Putting children to bed before 9 p.m.
- Establishing a bedtime routine that includes reading
- Helping children avoid caffeine
- Keeping a TV out of the bedroom

In May the Sleep Education Blog reported that a simple, four-step nightly routine helps children sleep better. Children fell asleep faster, and they had fewer and shorter night wakings.

In March the blog reported on TV, children and bedtime. Studies indicate that watching TV can have a negative effect on children’s sleep.

Learn more about sleep and children on SleepEducation.com.

Michael Jackson’s Struggle with Insomnia

The Associated Press reports today that Michael Jackson struggled with severe and chronic insomnia. A nurse told the AP that he wanted to obtain the drug propofol - also known as Diprivan - to help him sleep.

Diprivan is a powerful sedative that is injected into a vein. It is given to patients before an operation or medical test.



Jackson’s insomnia may have had a variety of causes.

The AP reports that the 50-year-old singer was rehearsing hard for his upcoming “This Is It” tour. This may have caused adjustment insomnia. This type of insomnia results from a source of stress.

His concern about being unable to sleep may have developed into psychophysiological insomnia. People with this sleep disorder worry too much about insomnia and about being tired the next day. As a result, they learn to become tense and anxious as bedtime approaches.

The AP article notes that Jackson would sleep with a computer on the bed. This is a sign that he may have developed bad habits that prevented him from sleeping well. This is called inadequate sleep hygiene.

The AP also reports that Jackson often was in pain. Painful medical problems often cause insomnia due to medical condition.

Jackson may have been taking a variety of prescription medications. Many medications can suppress or disrupt sleep. Insomnia due to drug or substance may result.

His insomnia also may have been related to a mental health problem. The AASM reports that insomnia due to mental disorder is the most common disorder in people who seek help from a sleep center for ongoing insomnia. Often it is related to depression or anxiety.

Do you struggle with insomnia? You can get help at an AASM-accredited sleep center near you.

Update - July 28, 2009: The AP reported today that authorities believe the drug propofol caused Jackson's heart to stop.

Update - Aug. 6, 2009: The Wall Street Journal reports that the abuse of propofol is a growing problem among medical professionals.

Update - Aug. 29, 2009: The AP reports that the Los Angeles County coroner's office determined the cause of death was "acute propofol intoxication."

Image by LainerJeanTater

Insomnia: When Should You Get Help?

Insomnia is the most common sleep complaint; everyone has trouble sleeping at times. So how do you know when your insomnia is severe enough that you should seek help?

This is what sleep specialist Dr. Donna Arand told the AASM:

“You should seek help when these three statements all describe your insomnia:
1. The insomnia has lasted more than three weeks.
2. It is not improving.
3. It is interfering with your ability to function during the day.”

“Insomnia is often a typical response to a stressful situation. It should disappear as the stress decreases. But bad sleep habits can develop during the period of stress. This prolongs and establishes the insomnia. It is easier for you to re-establish good sleep if you eliminate these habits early.”

Get more insomnia advice from Dr. Arand on SleepEducation.com.

Get help for insomnia at an AASM-accredited sleep center near you.

Tension Headaches, Naps and Insomnia

Maybe it’s not such a good idea to take a nap when you have a headache.

A new study in the Journal of Clinical Sleep Medicine shows there may be a link between headaches, naps and insomnia.

The study involved 32 women who have tension headaches. Their average age was about 22 years. Ninety-four percent of the women reported that stress was a trigger of their headaches.

Eighty-one percent of the women reported using sleep as a coping strategy for headaches. This made sleep the number one self-management strategy.

Sleep also was rated as the most effective intervention. Other common self-treatment methods were:

• Medications
• Relaxation
• Distraction
• Hot or cold compress

So is sleep the best treatment for tension headaches? Not exactly. Fifty-six percent of the women also reported that sleep problems are a trigger of their headaches.

“Insomnia is a common complaint among headache sufferers,” said principal investigator Jason C. Ong, PhD. “While napping may relieve pain, it may also result in poor sleep hygiene, thus triggering sleep disturbance or perpetuating an insomnia episode.”

So taking a nap may provide immediate headache relief. But the daytime sleep may cause you to be more alert that night.

This may lead to an episode of insomnia. Then the insomnia could trigger another tension headache the following day. To break this cycle, practice good sleep hygiene and limit the use of naps as a headache treatment.

The NINDS recommends other treatment options. These include therapies that help you manage stress or relax your muscles. You may want to take a hot shower or apply moist heat to the back of the neck. A massage or gentle neck exercises also may be helpful.

Sleep & Relationships: Practical Tips to Help a Sleep Stealer

Yesterday we looked at some signs that you or your bed partner may be a sleep stealer. Today let’s discuss three ways to put an end to sleep stealing.

First, seek medical help for an ongoing sleep disorder. Meet with a board-certified sleep specialist at an AASM-accredited sleep center near you.

Many sleep disorders can be disruptive to your bed partner’s sleep. These include snoring, obstructive sleep apnea, restless legs syndrome and grinding teeth – also called bruxism.

Or you may have one of the disturbing sleep disorders that are classified as a type of parasomnia. If so, you can follow these ten tips for preventing parasomnias.

The need for medical help is most urgent if you suspect that you may have sleep apnea. It can increase your risk for other health problems such as heart disease and stroke.

Loud and erratic snoring is a key warning sign for sleep apnea. Another sign is when silent pauses during sleep are followed by gasping or choking sounds.

Second, you and your bed partner should both commit to “sleep for seven” – to get at least seven hours of sleep every night. Then practice the healthy habits of good sleep hygiene.

Third, you can take some practical steps to prevent sleep stealing. We asked sleep specialist Donna Arand, PhD, for some tips.

“Couples can purchase two twin mattresses and put them on a king frame and box spring so that body movements are not conducted to the sleeping partner,” she said. “It is also useful to have separate blankets or other top bed covers for each side of the bed to minimize disruption.”

Arand also recommends that couples keep the bedroom door ajar and use a dim night light in the bedroom or hallway. This will allow one of you to move quietly in and out of the room without disturbing the other. Arand also suggests using a “white noise” sound machine to drown out bothersome noises.

Have you found any useful ways to prevent sleep stealing?

The Phelps Plan: Get on a Schedule

Five months after the Beijing Olympics, Michael Phelps is back on a schedule. In the pool. In the weight room. And in bed by 10:30 p.m.

“I can get to sleep earlier,” Phelps told the Associated Press. “I have no problem falling asleep now. I was completely worn out my first day back. After two hours or so of working out, I was absolutely dead. I had no problems falling asleep at 10 or 10:30 that night. It feels good to add some scheduling back to my life.”

His experience highlights one key for curing sleepless nights: You need to get on a schedule.

Your body functions best when you keep to a regular schedule. This includes going to bed and waking up at the same times every day. Yes, even on weekends.

Regular meal times should be another part of your schedule. You also should try to get some exercise at a scheduled time. It doesn’t have to be a Phelpsian workout. Even some light exercise will help.

These routine events act as “timing cues” for your body. They are signals that let your body know what time of day it is.

Another important timing cue is daylight. Letting your eyes see the bright morning light alerts your body that it is time to get moving. In contrast, the dim evening light is a signal that it is time to wind down.

Following a daily routine is one way to help you fall asleep easier at night.

To Go to Sleep, Get Out of Bed

For some people with insomnia, the key to falling asleep is their bed. They need to get out of it.

And sleep on the floor? No, they can still sleep in the bed. They just need to stop spending so much time in it.

This has to do with psychophysiological insomnia: psycho = mental, physio = physical, logical = study or science of. It occurs when the mind and body interact in a way that keeps you awake.

With this form of insomnia, you may learn to associate your bed with frustration. You toss and turn, unable to fall asleep. So getting into your bed causes feelings of anxiety.

This explains why you may sleep better away from home. You’re in a new bed and in a new environment. The negative associations are absent. So you are able to fall asleep quickly.

What can you do when you suffer from this type of insomnia? One step you can take at home is to practice "stimulus control." This is a form of cognitive behavioral therapy.

First, you should learn to associate your bed only with sleep. Don’t read, watch TV or talk on the phone in bed.

Second, you should go to bed only when you are sleepy. One of the worst things you can do is get into bed when you feel alert. That is a recipe for frustration.

Third, give yourself about 20 minutes to fall asleep. Then if you are still awake, get out of bed. Do something relaxing. Once you feel sleepy, go back to bed again.

You also should practice the healthy habits of good sleep hygiene. Create a relaxing bedtime routine. Try to wake up at the same time every day.

A medication also may help you with sleepless nights. Talk to your doctor before trying to treat insomnia on your own.

Are You in a Sleep Recession?

It was no shock when economists finally determined that the U.S. economy is in recession. Our wallets and investments have been taking a pounding. So has our sleep.

Surveys by groups such as Amway Global Wellness Index, Compass Bank and ComPsych Corporation have all reported the same trend: The economy is keeping people awake at night.

A new study in the Jan. 1 issue of the journal Sleep takes a closer look. The study of 370 women links financial strain to decreased sleep quality and lower "sleep efficiency."

Women reporting financial strain had more sleep complaints. They also spent a greater percentage of time awake while in bed. "Financial strain" meant the women had trouble paying for basics like food, housing and medical care.

Economists expect things to get worse in 2009. So how can you fight insomnia during difficult times?

First you need to give yourself a break from the bad news. Turn off the TV and the radio, and get away from the computer. Spend some time relaxing and doing something that you enjoy.

Make sure you follow the principles of good sleep hygiene. Avoid caffeine and alcohol late in the day. Try to go to bed and wake up at the same times every day.

When problems persist, seek help at an AASM-accredited sleep center. A board-certified sleep specialist will determine the best treatment option for you.

One option is cognitive behavioral therapy. It helps you develop habits and a mindset that promotes good sleep. Your doctor also may prescribe a medication that can help you break the cycle of sleepless nights.

How about you? Are your worries about the economy keeping you awake at night?