The illusive good night’s sleep. According to the National Center for Sleep Disorders Research at the National Institutes of Health, it’s a national problem. Between stress, problems with your sleeping environment and any number of disorders, 30 to 40 percent of the U.S. adult population reports experiencing symptoms of insomnia each year.
We talked to Marcy Guido-Posey, registered polysomnographic technologist and registered sleep technologist who is a coordinator at Holy Spirit Sleep Centers, and Beverly Azemar, certified nurse practitioner at Penn State Hershey Sleep Research and Treatment Center in Hummelstown, to get the skinny on what’s keeping you from a blissful eight hours.
Insomnia
“Insomnia is defined as the inability to fall asleep, stay asleep or both,” Guido-Posey said. It can lead to impaired daytime functioning.
“When people have trouble sleeping it’s insomnia, which is a symptom and not a disease,” Azemar said. Insomnia symptoms fall into three categories:
• Transient: lasting less than one week
• Short-term: lasting one to three weeks
• Chronic: lasting one month or longer
Sleep apnea
“Sleep apnea is a decrease or total cessation of airflow during sleep,” Guido-Posey said. “Often you will hear loud, rhythmic snoring, followed by a period of silence that ends with a loud snort or gasp as breathing resumes, then stops again. This pattern repeats itself over and over.”
According to the American Sleep Apnea Association, sleep apnea occurs most frequently in men, particularly African Americans and Hispanics. It affects more than 18 million Americans. The three types of sleep apnea are:
• Obstructive sleep apnea: caused by a blockage in the airways
• Central sleep apnea: “That is when the airway is not blocked, but the brain fails to signal the respiratory muscles to breathe,” Azemar said.
• Mixed: a combination of obstructive and central sleep apnea
Narcolepsy
Narcolepsy is the chronic neurological disorder often depicted in movies by characters falling asleep suddenly during daily activities, which isn’t far from the truth. Excessive daytime sleepiness is the main symptom of narcolepsy and happens because the brain isn’t able to regulate the body’s sleep-wake cycle.
It is estimated that up to 200,000 Americans suffer from narcolepsy. It affects men and women equally. While there is no cure, treatment can involve stimulants, antidepressants and other types of prescription medication. Symptoms include:
• Cataplexy: a sudden loss of muscle control
• Sleep paralysis: the brief inability to talk or move while falling asleep or when waking up
• Hypnagogic hallucinations: scary dreams when falling asleep
• Automatic behavior: performing routine tasks without awareness, or even memory, of performing them
Restless Legs Syndrome
Willis-Ekbom disease, or restless legs syndrome, is a neurological disorder. Its hallmark is a tingling sensation in the legs or arms that results in an irresistible urge to move. The sensation varies from person to person with patients describing a creeping, crawling, or electric feeling, according to the National Sleep Foundation.
RLS is estimated to affect 7 to 10 percent of Americans. Treatments include dopaminergic agents or anticonvulsants combined with behavioral techniques.
Periodic Limb Movement Disorder
PLMD is basically RLS while you’re asleep, explained Guido-Posey. The disorder is characterized by repetitive movements such as twitching or jerking every 20 to 40 seconds. Like sleep apnea, it is often recognized first by bed partners.
PLMD isn’t considered to be a serious medical condition, but it can be a contributing factor in insomnia. The NSF recommends seeking treatment for PLMD when it’s accompanied by RLS and/or daytime sleepiness.
Symptom management with medication
Insomnia sufferers do have over-the-counter and prescription medication options to consider that may help them get a better night’s sleep. OTC drugs such as Benadryl and Tylenol PM can help with occasional sleeplessness, but the Mayo Clinic warns that they aren’t intended for long-term use.
Another issue with OTC sleep aids is the day-after hangover. “Many over-the-counter aids are antihistamines and they can also cause residual daytime drowsiness the next day,” Azemar said. She also warns that while they are fairly safe to use because they are over-the-counter, they can be abused.
Doctors can prescribe medication for their sleep-lacking patients. Common prescription brands of sleeping pills include the sedatives Ambien and Lunesta. These drugs work by relaxing patients and helping them fall asleep and stay asleep.
“When patients are prescribed a sleep aid, they are usually used for 1-2 weeks, but then again some patients need them longer. They just need to be followed and monitored to make sure they are effective and they’re getting the appropriate results,” Azemar said. Some prescription sleep aids help you fall asleep while others can be taken in the middle of the night to help you get back to sleep.
Patients are cautioned that use of prescription sleep aids can come with risks. Side effects can include dizziness, prolonged daytime sleepiness and weight gain. Use can also lead to an increased risk in nighttime falls in older adults.
Sleep hygiene
One of the most important factors in a good night’s sleep is your hygiene. Sleep hygiene is the collection of practices necessary to developing a healthy sleep schedule.
Factors in sleep hygiene include:
• Creating a sleep-promoting environment
• Maintaining a regular sleep schedule
• Sticking to healthy eating habits
• Lowering your stress level
If you are maintaining healthy sleep hygiene and still experiencing insomnia or symptoms of a sleep disorder, talk to your doctor about scheduling a sleep study and treatment options.
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