Health Leader, Tired of Counting Sheep?

STORY BY

Wendy Cederberg

For some of us, a good night’s sleep is plain hard to get.

The harsh reality is that you can’t make yourself go to sleep. The harder you try, the tougher it is to get to sleep. You can’t buy, beg or borrow those restful “40 winks” we all need.

If you toss and turn on your way to dreamland, it may give you comfort to know that 62 percent of adult Americans suffer from some form of sleep disorder, with insomnia the most common.

Insomnia is a symptom, not a disease. It refers to the inability to easily get to sleep several nights a week. Most individuals can manage insomnia without any medications by making a few simple lifestyle changes.

Dr. Richard J. Castriotta, professor of medicine at the University of Texas Medical School at Houston and medical director of Memorial Hermann Hospital’s Sleep Disorder Center, offers reassurance.

“Fortunately, most insomnia management is based on common sense and attention to ordinary details,” he says. “We don’t really know why people need sleep,” he adds.

Most adults require 7-8 hours of sleep a night, but from 6-9 hours is still normal. The average child requires a little more than nine hours of sleep per night and this need extends through high school.

Unfortunately, many patients don’t bother to tell their doctors about sleep difficulties and many physicians do not routinely ask questions about sleep patterns.

Therefore, it is not surprising that insomnia may be undiagnosed in older and younger individuals. Older adults often are not in sync with society’s schedule and may go to bed at 6 p.m. and wake up at 3 a.m. Teens often have a delayed sleep phase and may not be ready to go to sleep until 3 a.m. and then sleep until noon.

How’s Your Sleep Hygiene?

Sleep hygiene refers to the conditions surrounding sleep that make it either a healthy environment or a disturbing one and the sad truth is that many of us have poor sleep hygiene.

So, plump up your pillow and follow these common-sense tips to help you get to sleep—and stay asleep.

Do not sleep too much. Sleep only as much as you need to feel refreshed.
Limit the amount of time spent in bed. Your bed is not the place for your laptop, tax forms or TV watching. Nor is it the place to host your marital spats or have the stern parent-child talk. Take that to the table.

Our minds become programmed that our bed is not for sleeping, so reserve that place only for sleeping and sexual relations.
A regular sleep routine is important. Get up at the same time and go to sleep at the same time.
Exercise is invigorating, so work out in the morning or during the daytime, but not in the evening.
Keep your bedroom quiet; loud noises can disturb your sleep, even if you don’t awaken.
It’s okay to have a light snack before bed, but avoid a heavy meal.
Keep your bedroom temperature cool. Our body temperatures cool off as we go to sleep and we can’t sleep when our body gets too warm. (The phrase “sleepy little town” refers to the days when small Southern towns didn’t have air conditioning and the residents didn’t sleep well during hot summer months.)

“We train patients to manage insomnia by controlling or correcting the problem,” explains Castriotta. “People should be able to fall asleep on their own and not be dependent on chemical substances.”

You may not be a Rip Van Winkle— wannabe and sleep several decades, but beware of these common causes of insomnia:

Caffeine must be eliminated, including coffee, tea, green tea, chocolate and colas. Even decaffeinated beverages are a “no-no.”

Cigarettes or other forms of nicotine function as stimulants.

Alcohol has a sleeping phase that makes people drowsy and a stimulant phase that hits in the middle of the night and can disrupt sleep.

Some people are more sensitive to stimulants than other individuals. For some, even drinking coffee in the morning can keep them awake at night.

Organic causes of insomnia that require specific treatments include:

Restless leg: an odd feeling in your legs causing you to have to move or massage your legs.

Periodic limb movement disorder: you are not aware of a slow rhythmic movement of your limbs in the night. This may be caused by iron deficiency.

Sleep apnea: a periodic and repeated cessation of respiration, often accompanied by horrific snoring, is the most common cause of daytime sleepiness and it is often undiagnosed.

“Sleep problems are more common in people who are driven and want control,” concludes Dr. Castriotta. “We can’t control sleep, unlike other things in life, but the innate drive for rest will eventually overwhelm us and we will fall asleep.”

Night! Night!

Last Updated: 8-18-2003

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About Dr. Castriotta:

Dr. Richard Castriotta is director of the Division of Pulmonary, Critical Care and Sleep Medicine at UT Medical School.

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Health Tip:

Eating healthy
reverses metabolic syndrome

Dr. Tasnime Akbaraly of University College London and her colleagues were interested if healthy eating could actually turn-the-tide and reverse metabolic syndrome, which is having 3 or more of the following risk factors: excess abdominal fat; high triglycerides, hypertension, low levels of HDL the “good” cholesterol, or type 2 diabetes. Having metabolic syndrome doubles a persons’ risk of heart disease and greatly increases the odds of developing type 2 diabetes.

The researchers studied 339 British civil servants with metabolic syndrome, and how closely the adhered to the Alternative Healthy Eating Index (AHEI) to see if it could help reverse metabolic syndrome. The AHEI is a set of published nutritional guidelines by the Harvard School of Public Health in 2002 that emphasizes whole grains, fruits, vegetables and decreased red meat consumption.

Five years into the study, nearly 50% no longer had metabolic syndrome. People who followed the AHEI guidelines the closest were nearly twice as likely to have reversed their metabolic syndrome. The results of the study were published in Diabetes Care, online July 29, 2010.

Dr. Alice Lichtenstein, an expert on diet and heart health from Tufts University in Boston who was not involved in the study said, "It's not about focusing on individual components of the diet, it's really the whole package, and that becomes important because it means that if one of the components of a healthy diet is to eat more fruits and vegetables, just buying a pill saying that there's a concentrated extract of fruits and vegetables is probably not what's going to help you."

Call and make an appointment with Wellness Coach Sam Hester, CWC, CPT, LWMC, at 713-500-3327. It's confidential and free. For more information on the wellness services provided, visit UT Counseling and WorkLife Services.