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Sleepless in America

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What's Keeping You Up All Night?

It’s estimated that 60-80 million Americans nearly 40% of women and 30% of men suffer from an inability to fall asleep or stay asleep when they want to.  Only 32% of Americans get the recommended eight hours of sleep.

What keeps us up?

  • Environmental factors
  • Temperature
  • Noise
  • Light
  • Discomfort
  • Family members
  • Pets

To get the best sleep, you should be in a comfortable, dark, quiet place. You may need a sleep mask, earplugs, a fan or a heater. You may need to change your bed’s location, your mattress or the blinds on your windows. You may need to talk with your partner about his or her snoring, sleep/wake times or other sleep habits that affect you. You may need to re-train a pet who likes to sleep in your bed or make noise at night.

Keep trying new things until you find a sleeping arrangement that works for everyone in the family. Being well-rested can help everyone get more from life.

Physical factors

  • Illness
  • Pain
  • Medication
  • Sleep apnea
  • Restless legs syndrome
  • Periodic limb movement disorder
  • Sleepwalking
  • Delayed/advanced sleep phase syndrome
  • Aging
  • Hormones
  • Circadian rhythm disruptions
  • Narcolepsy
  • REM sleep behavior disorder
  • Stress

Many illnesses can cause disturbances in sleep, including asthma, heart trouble, high blood pressure, depression or bipolar disorder. Pain from arthritis, migraines, heartburn, irritable bowel syndrome, injuries, back trouble or other illnesses can also keep you awake.

The medications for these and other illnesses may also disrupt your sleep. Check the side effects of your medications to see if they can make you drowsy or restless. Talk with your doctor about changing your dosage, medications, or the times you take them.

Sleep apnea affects about 18 million Americans. It occurs when breathing stops during sleep and wakes a person up. This can leave the person un-rested, fatigued and irritable. In mild cases, losing weight and not sleeping on one’s back can help. For more serious cases, medication, surgery or special devices to wear during sleep may be needed.

Restless legs syndrome (RLS) affects approximately 12 million Americans, causing crawling, prickling, or tingling sensations in the legs and feet. People with RLS often need to move their legs to feel relief, which may interfere with sleep. In some cases, it may be linked to other conditions such as anemia or diabetes. Some vitamin and mineral supplements may help with RLS. Other treatments work on the brain chemical dopamine.

Periodic limb movement disorder (nocturnal myoclonus) is a series of repetitive, involuntary movements (usually of the legs or arms) during sleep. It can be a problem if it wakes or injures the person or the person’s partner.

Sleepwalking occurs during deep sleep phases prior to REM sleep. A person will get up from bed and move around the home. He or she may appear to be awake, or talk without making sense. People who sleepwalk should avoid alcohol, illegal drugs, sleeping pills and pain medications. They should follow a regular sleep-wake schedule. They should also have a medical exam to find out if their sleepwalking is caused by other brain conditions. It may also be helpful to anticipate the time a person might sleepwalk and wake him or her up before it happens. The person should be awakened and kept awake for five minutes every night for a week. This may prevent sleepwalking by interrupting the person’s sleep pattern.

Delayed/advanced sleep phase syndrome causes some people to fall asleep and wake up later or earlier. People with these syndromes can still get enough sleep if they are able to change their schedules to accommodate it. Once they fall asleep, they sleep normally.

Aging causes chemical changes in the brain that may make older adults less able to sleep continuously and deeply. They may awaken six times as often as younger people. They are likely to be more sensitive to noise and prone to other medical conditions that keep them awake, including Alzheimer’s or Parkinson’s diseases. Decreased physical activity can also affect older adults’ ability to sleep. Older adults may go to sleep earlier, wake more often, and nap during the day.

Hormones such as progesterone can help a person sleep. So when a woman’s progesterone levels drop during menstruation and rise during ovulation, her sleep can be affected. Pregnancy or birth control pills can also disrupt normal sleep.

Circadian rhythm disruptions occur when a person travels across time zones, and are commonly known as “jet lag”. Jet lag is usually temporary. A person should get as much daylight as possible. Staying indoors will worsen jet lag.

To help make jet lag less severe, a person may want to begin going to bed and waking up earlier several days before the trip for eastbound trips; later for westbound trips. Caffeine and heavy meals should be avoided if possible.

Narcolepsy is a disorder that causes a person to fall asleep without warning at random times. Studies have shown that people with narcolepsy lack hypocretin, a brain chemical that helps people stay awake. Researchers believe that at least 250,000 Americans have narcolepsy but 50-80% are undiagnosed.

Before a “sleep attack,” a person often experiences muscle weakness throughout the body. Muscle weakness may be triggered by increased emotion such as laughter, anger or excitement. Some people with narcolepsy may perform automatic behaviors while sleeping, and may appear to be awake but “out of it.” Narcolepsy can be effectively treated with medication.

REM sleep behavior disorder occurs when people physically act out their dreams, which disrupts their sleep. People in normal REM sleep have relaxed muscles, while people with REM sleep behavior disorder may twitch, yell, or take hold of things. People with REM sleep behavior disorder may need to be evaluated for other disorders of the brain.

Stress has caused sleep loss for almost everyone at one time or another. Anything that increases a person’s emotional response can interfere with sleep. In most cases, stress-induced sleep loss is temporary. A doctor may prescribe a tranquilizer or sleeping pill for a short time.

In one study, 47% of people with sleep problems reported mental stress. Many people lie awake thinking about problems or trying to solve them. It might seem that the harder you try to sleep, the less success you have. It’s true, looking at the clock can make you anxious.

If your sleep problem is mild, things such as journaling, relaxation exercises, guided imagery and meditation can help you. Find a method that works for you.

If your sleep problems last more than two weeks and interfere with other parts of your life, or if you stay up for days and don’t miss sleep, you might benefit from treatment for depression or bipolar disorder.

Click here to learn more about depression and bipolar disorder.