Sleep is something that we all want to improve. No one seems to be getting enough sleep, yet it is so vital to our well-being. There are many sleep disorders out there, but there is hope! There are also a lot of ways to treat problems with sleep. Let’s cover two of the most common sleep problems.
Insomnia is the general term for difficulty sleeping. It is the most common sleep disorder, affecting up to 1/3 of the population. Insomnia can mean problems falling asleep, staying asleep, or both. Insomnia can have psychological causes such as anxiety, depression, or stress, or physiological causes such as COPD, arthritis, renal failure, or certain GI conditions. Also, older adults are prone to have less deep sleep and experience changes to their circadian rhythms.
There are several ways to treat insomnia. Some are things that you can do on your own to improve your sleep (called sleep hygiene):
- Avoid coffee or other caffeinated beverages after noon
- Exercise regularly in the morning
- Limit television or cellphone use for 1 hour before bed
- Avoid scary/stressful television shows or movies close to bedtime
- Stay on a regular schedule
- Make your bedroom comfortable by keeping the temperature cool, the lighting low, and masking disruptive noises
Medications are another option for treating insomnia. There are over-the-counter medications such as melatonin that may be helpful. Otherwise, your doctor can prescribe medication to improve your sleep. Some of these, like valium or Ambien, can be habit-forming and can also cause drowsiness in the morning. Other medications like trazadone or mirtazapine can be helpful without causing dependence. A new class of medications called orexin inhibitors is showing promise. These work by blocking a chemical called orexin that is involved in alertness. These drugs are not yet available but show good results in studies.
Cognitive Behavioral Therapy (CBT) is also a good way to address insomnia. This is a therapy that teaches you how to change your associations with sleep as well as relaxation techniques. Studies have shown this to be more effective for a longer time than medications. The downside is that it is time consuming to learn the techniques.
Sleep apnea is when a person stops breathing for short amounts of time in their sleep. They also usually snore loudly, gasp, or make choking sounds while they sleep. This is a very common problem, affecting about 5-20% of the population. Obviously, not breathing is not ideal because your brain is not getting the oxygen it needs. Our bodies respond by waking you up so that you breathe. Patients with sleep apnea can wake up hundreds of times per night. As a result, you are not getting good, restful sleep. This can lead to daytime sleepiness (and accidents), irritability, mood disorders, as well as high blood pressure, diabetes, heart attack, and stroke.
Sleep apnea is more common in men, women who have gone through menopause, and older adults. Other risk factors include obesity (particularly carrying the weight in the trunk and neck), large tongue or tonsils, small chin, large overbite, or using sedatives at night.
Treatment for sleep apnea is using a device called a Continuous Positive Airway Pressure (CPAP) machine. This machine continuously moves air into your nose (and sometimes mouth) using a mask that you wear at night. It takes some getting used to, but there are a lot of options for types of masks. Your doctor can help you get the right kind for you. Sometimes other types of devices or surgeries can help treat sleep apnea.
If someone tells you that you snore or stop breathing at night, please tell your primary care doctor. They will refer you to a sleep specialist who will perform a sleep study. This involves being monitored while you sleep for your oxygen levels, snoring, and how often you wake up. This will determine if you need a CPAP machine. Once you start using your CPAP regularly, you will likely notice great improvement in your sleep, ability to concentrate, and mood.
Managing sleep disorders properly will greatly improve your well-being and your health. Healthy sleeping habits contribute not just to feeling good, but also protect your body and your mind from disease. If you have problems sleeping, which most of us will from time to time, try some of these suggestions mentioned here. Don’t hesitate to talk to your doctor about sleep issues. Sleep tight!
For more reading on sleep and mental health, check out “What Do Our Dreams Reveal About Mental Health?”
Peter Hauri, PhD and the National Sleep Foundation. (2013). The Sleep Disorders. http://sleepdisorders.sleepfoundation.org/contents/
National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health-topics/sleep-apnea