Getting the right amount of sleep is becoming more difficult in today’s 24/7 world. It seems there just isn’t enough time to accomplish everything life has to offer, or demands. We are expected to work longer and harder than ever before, family demands have increased with all the activities and, of course, who wants to miss the latest video, television show or “surfing the web”.
Unfortunately, we are paying a price for giving up sleep to accomplish more. Experts tell us that we are becoming, as a society, so chronically sleep deprived that we don’t even realize that we are functioning at a lesser level. Irritability is affecting our relationships, fatigue affects our productivity and ability to think clearly and creatively and, importantly, our immune system is negatively impacted by lack of sleep. Even our children, and especially our adolescents, are suffering from our collective “workaholism.” We are teaching ourselves negative sleep habits that may, unfortunately, impact every aspect of our lives.
So, what do we do? First we acknowledge the problem. Then we begin to develop strategies to manage our sleep and our lives. What priority is our health? Must work and play always come first? How do we prioritize so that we maintain our careers and also manage to enjoy life while maintaining health? The purpose of this booklet is to assist you in developing strategies and priorities for a healthy sleep life. Of course, everyone is unique and everyone’s situation is different. Therefore, take the following advice and use it to your advantage. Craft it to fit your needs and situation. Remember the goal is to prioritize your life such that you remain healthy enough to enjoy it.
This booklet will address three critical concerns that prevent healthy sleep: insomnia, sleep disorders and lifestyle.
The first issue that needs to be addressed is Insomnia. Insomnia affects almost everyone at sometime. In fact, insomnia affects approximately 35% of Americans during the course of a year. Insomnia can be the result of other sleep disorders, medical conditions, mental disorders or some other form of stress. Insomnia can be of three types:
Most people experience some form of transient insomnia, usually related to stress or other short-term life issues. Practicing good sleep hygiene will assist a return to more normal sleep patterns. Those experiencing the more chronic forms of insomnia should visit their physician and specifically describe their sleep difficulties. Prior to the physician visit one should be prepared to describe all aspects of the problem and perhaps maintain a sleep diary for about two weeks prior to the visit. Sleep diaries can be obtained through the National Sleep Foundation at www.sleepfoundation.org. Or you can create your own from the example shown in this booklet.
If the insomnia is not caused by another medical condition, the best way to manage the problem is through behavioral methods. Medication may be prescribed; however, this is usually a short-term solution. The behavioral change methods on the following pages represent more lasting solutions to insomnia.
Used with all forms of insomnia these 13 tips should be the first response to the onset of insomnia. Indeed, these should be the primary tools in dealing with transient insomnia and as a way of preventing insomnia in general.
In addition to these 13 tips, there are other techniques that can be valuable to healthy sleep and general stress reduction. Find a program that works for you and use it automatically. Relaxation tapes, meditation, prayer, are among the many relaxation options for reducing stress and enhancing sleep.
Stimulus Control — For many, the suffering from insomnia is due to stimuli surrounding sleep that causes tension and arousal. The following rules are designed to help re-establish the ability to fall asleep quickly:
Other Methods — If you are still unable to overcome insomnia, it is important to know there are additional steps you can take. However, the following methods should involve the supervision of a health professional:
The second topic that needs to be addressed is the diagnosis and treatment of sleep disorders. Sleep disorders are serious medical conditions that require professional diagnosis and treatment. Since there are approximately 80 different sleep disorders, referral to a specialist is often warranted. Sleep apnea, for example, may affect over 18 million Americans and may exacerbate other conditions such as hypertension and cardiovascular disease.
How are these disorders managed? There are a number of treatments depending, of course, on the disorder and its severity. In each instance, however, good lifestyle habits and proper sleep hygiene are helpful. Also, with sleep apnea for example, behavioral changes such as weight management, smoking cessation and alcohol moderation are positive treatment options. Other options include behavioral therapy, medication, Continuous Positive Airway Pressure (CPAP) devices, surgery and even dental appliances. The first action, of course, is a visit to your physician. Be sure and describe all symptoms and bring a sleep diary, if possible. An example is provided for you on the following page. Also, information provided by bed partners may be useful in diagnosing a problem.
“Sleep is the golden chain that ties our health and bodies together.”—Thomas Dekker, 1572-1632
Primarily, tissue structure problems in the breathing passage, or airway, result in sleep apnea. When muscles at the base of the tongue and uvula (u-view-la) relax and sag, the airway is blocked. (The uvula is that small piece of tissue hanging down at the back of your mouth). Apnea also can occur in overweight people when excess neck tissue narrows the airway. The sleeper has to work harder to breathe, and these efforts cause snoring and periods of no breathing.
These stopped-breathing episodes occur when the sleeper is unable to breathe in oxy-gen and exhale carbon dioxide, resulting in lowered levels of oxygen in the blood and higher levels of carbon dioxide. This alerts the brain to order the upper airway to reopen, an action known as an “arousal.” Then the sleeper, thrashing about and sometimes choking, struggles back to regular breathing. Throughout, the sleeper is unaware of what’s happening. But he or she certainly feels the consequences the next day, with effects such as general tiredness, loss of concentration, impaired work performance, and even falling asleep on the job or while driving.
It's estimated that 18 million Americans are affected by sleep apnea. It is most common in males who are middle-aged and overweight. If you or someone in your family has trouble getting a good night's rest, check out this list of sleep apnea indicators:
The first two are the most significant. Excessive sleepiness shows that something is in-terrupting your sleep, and chronic snoring—especially the loud, explosive kind—also points strongly to sleep apnea, although not everyone who snores is affected. (By the way, if your spouse complains about your snoring, there could be good reason: Snoring noise may be as high as 65 decibels, which is louder than OSHA allows in the workplace!)
Yes, indeed. If you or your spouse suspects that you might have the condition, see a doctor for an evaluation. You may be referred to a specialist who can use certain tests to either establish the diagnosis or rule out sleep apnea.
There are effective treatments, including changes in behavior such as losing weight. A weight loss of just 10 percent can reduce the number of apnea events for most patients. It’s also wise to avoid use of alcohol, tobacco, and sleeping pills.
The most widely used effective treatment is Continuous Positive Airway Pressure (CPAP). In this procedure, the patient wears a mask during sleep, and an attached device forces air through the nose. Just enough pressure is used to keep throat tissue from collapsing. Thousands of patients who use CPAP therapy say it has given them their first good night’s sleep in years. There also are surgical treatments available, such as removal of excess tissue from the uvula or other areas. The key thing to remember is if you have symptoms of sleep apnea, check with your doctor without delay.
For more information concerning sleep apnea, be sure to check out The American Sleep Apnea Association’s website. The ASAA is a 501(c)(3) organization dedicated to reducing injury, disability, and death from sleep apnea and to enhancing the well-being of those affected by this common disorder. The ASAA promotes education and awareness, the ASAA A.W.A.K.E. Network of voluntary mutual support groups, research, and continuous improvement of care. As part of its endeavors to increase understanding of sleep apnea, the ASAA fulfills thousands of requests for information from the public each year and answers a multitude of questions about diagnosis and treatment options.
As previously mentioned, society puts considerable demands on our time. Unfortunately, many people are forced to choose between these demands and sufficient sleep. Moreover, if you are a shiftworker you are even more at risk. What can be done to ensure that proper and healthy sleep are a part of our lives? The following tips may be useful:
Living in today’s complex, fast-paced society presents real challenges to our physical and mental health. Sleep just doesn’t seem to be a priority. However, the paradox is that healthy sleep better equips us for the mental and physical challenges of living in today’s society. To see how well you’re functioning on a daily basis, take the sleep knowledge quiz found on the next page.
“Laugh and the world laughs with you, snore and you sleep alone.”—Anthony Burgess, 1917-1993
In managing fatigue and staying alert, good sleep habits are essential. The following 10 recommended sleep habits are suggested.
Much of the information contained in this guide was submitted by Dr. Dennis Holland at Union Pacific Railroad and used by permission. All content is based on the best health information available and has been reviewed for accuracy. It is not intended to replace the advice of your healthcare provider. If you have any questions about managing your own health and/or seeking medical care, please contact a medical professional.
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