How to get good sleep if you do shift work

This article explains why shift work can hurt your sleep and gives tips on what to do if you do shift work.

If you work a non-traditional shift like the night shift or rotating shifts, you may be missing out on more than daylight and watching your kids’ soccer games. You could be missing out on sleep and better health.

Night shift workers who have trouble sleeping may have a condition known as shift work sleep disorder.

“Working non-traditional shifts interferes with the body’s circadian rhythms,” says sleep expert Tina Waters, MD. “Most of us are awake during the day because our body’s internal clock is keeping us awake. So no matter how tired you are after working all night, your awakening signals will conflict with your desire tosleep.”

Fortunately, there are some lifestyle changes that can help. But first, let’s look at the problems this disorder can cause.

Why shift work sleep disorder can be hazardous to your health

Studies have shown that lack of sleep can lead to other health issues. Some people develop gastrointestinal distress or metabolic disorders, such as diabetes. Others may develop heart disease.

“There was also a large study done on nurses who worked the night shift in which they were found to have a higher prevalence of infertility and even cancer,” Dr. Waters says.

From a non-health perspective, working alternate shifts can make it difficult to lead a balanced life. “If you’re a spouse or a parent, there are things going on during the time you need to be sleeping,” Dr. Waters says.

Do you have shift work sleep disorder?

Not all shift workers will develop shift work sleep disorder.

If you’re having trouble sleeping and you think this disorder could be the culprit, expect your doctor to first run some tests to rule out other underlying sleep disorders, such as sleep apnea or narcolepsy.

“It’s also a good idea to keep a sleep diary of which shifts you worked and what hours you slept,” says Dr. Waters. A sleep diary can help your doctor identify the problem and monitor its progression over time.

What you can do to get a good ‘night’s’ sleep

Practice good sleep hygiene. If you’re diagnosed with shift work sleep disorder, one of the most important things you can do to make sure you are getting enough sleep is to practice ‘good sleep hygiene.’ which includes:

• Establishing a regular bedtime routine and sticking to it
• Making your environment conducive to sleep (e.g., keeping your bedroom dark, cool and quiet)

Go straight to bed after work. Dr. Waters also recommends going home and sleeping as soon as your shift is over. “One of the triggers that keeps people awake is light, so it helps to decrease your light exposure at least 30 minutes before trying to sleep,” she says. “One way you can do that is to wear sunglasses on your way home, even on a cloudy day.”

Cut back on caffeine. Another thing you can do to help you get a better ‘night’s’ sleep is to reduce yourcaffeine intake. “If you’re drinking caffeine to stay awake, try not to drink any within four hours of the end of your shift to give your body time to metabolize it,” Dr. Waters says.

Set boundaries. It’s also a good idea to let people know what hours you’re working and when you will be sleeping, so they know when to leave you alone.

Get help from your doctor if you need it. If behavioral techniques aren’t helping you sleep, your doctor may prescribe melatonin to induce sleep, medications to promote wakefulness, or prescription sleep aids.

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Five common sleep myths

This article busts five common myths about sleep.

Good sleep is a cornerstone of good health. Yet misunderstandings about sleep – and lack thereof – are common. Here experts shine a light on five popular myths about sleep.

1. Older people don't need as much sleep as they used to.

Fact: The amount of sleep adults need remains fairly stable from about age 20 onwards.

You've probably heard you'll need less sleep as you age. So when older people spend hours awake in the middle of night or wake before the sun comes up, it's often accepted as a normal part of ageing.

But while some aspects of sleep do change as you age, the amount of sleep you need remains fairly constant, says Professor David Hillman, chair of the Sleep Health Foundation.

"If people notice a change in their sleep requirements as they get older, such as spending longer in bed for less benefit, and waking up unrefreshed despite getting the same amount of sleep that used to refresh them, then that implies there's something wrong with sleep itself," he says. In this case, he advises seeing a sleep specialist who can help to diagnose any possible sleep disorder and once these are identified and treated, older adults can feel years younger.

You are also more likely to experience advanced sleep phase syndrome as you get older, which means you get sleepier earlier in the evening, Hillman says. So while you may still be sleeping for eight hours, you might find yourself awake before the birds.

Also, while your body is programmed to sleep at night, some of us find ourselves feeling sleepy in the afternoon. Given that older adults are less likely to be at work, they sometimes have an afternoon nap. But napping in the afternoon, especially later in the afternoon, will affect how well you sleep at night.

More: Do older adults need less sleep?

2. You can die from lack of sleep.

Fact: Possibly, but it's more likely due to an increased risk of accidental death.

While sleep is important to human health, there's no good evidence to show being sleep deprived has direct and profoundly deadly effects on your body, says Sydney sleep researcher Dr Nathaniel Marshall. But it can impair your judgement in potentially fatal ways.

"People are just more likely to do stupid things and put themselves in life threatening situations when they've not been sleeping," Marshall says.

American high school student Randy Gardner, who stayed awake for 11 days, is regarded as the record holder for the longest period going without sleep. He did not use stimulants, but rather kept himself awake by doing things he found fun, like playing basketball, Marshall says.

At the conclusion of the attempt, Gardner's health seemed good; he was able to speak, play games and do limited mental tasks. When he finally slept, he did so for just 14 hours and 40 minutes, awoke naturally, stayed awake 24 hours, then slept a normal eight hours.

"This kid showed that you can stay awake a long time and it's not fatal. I mean I'm not recommending it – he was a special case and he had experts supervising him – but it's not fatal. He just slept for 14 hours."

However Marshall points out the effect of Gardner's experience on his health was not examined in any detail in the experiment.

More: Can you die from lack of sleep?

3. If you're not a morning person, you never will be.

Fact: Your internal 'body clock' is not rigidly fixed but is influenced by your sleep routine.

Feel like you'd rather die than get up when your alarm goes off in the mornings?

The time we feel sleepy and the time we wake up is influenced to a large extent by an internal clock in the brain that varies from person to person. It's true that some of us are more 'early to bed and early to rise' people than others. But despite what many of us think, our internal body clocks are not rigidly fixed, says Sydney sleep physician and researcher Dr Keith Wong. They are partly determined by our genes but also by our sleep routine, he says.

If you want to become more of a 'morning person', he advises changing the time you get up, rather than the time you go to sleep, as this will have the most impact. Try pushing back your wake time a small amount each day and expose yourself to bright light soon after waking, to 'reset' your clock's 'programmed' wake time. (Daylight is best, as even the natural light on a cloudy morning is brighter than most artificial light.) Go to bed when you feel sleepy, and avoid bright light in the evening before bed. Once your body clock is set to your new routine, you'll need to stick to a regular schedule to maintain it.

If you cannot go to sleep until very late at night and lifestyle change doesn't help, you may have a condition known as Delayed Sleep Phase Syndrome, where the internal clock does not work properly. More complex treatment from a sleep specialist may be needed to treat this.

More: Does being an early riser make you healthier?

4. People who get up early are healthier.

Fact: Getting enough sleep is more important than the time you get up.

Getting up early has a lot going for it. The world tends to be quieter and less crowded, and the first rays of daylight can be golden and beautiful. But there's nothing inherently healthier about being an early riser, says Sydney sleep physician and researcher Dr Keith Wong.

A 1998 study of more than 1200 adults published in the British Medical Journal could find no health advantages in the 'early to bed, early to rise' habit. So if you're not someone who wants or needs to get up early, don't feel compelled to do so, Wong says.

But while when you sleep is not important, how much you sleep is. Not getting enough sleep can impair your reaction time, problem solving ability, mood and immune system. And it might lead to long term health problems, such as heart disease and diabetes.

Being an early riser could have health advantages if it means you're less likely to be forced to undersleep to fit in with the schedule you are expected to keep, for example, the hours you work or study. A standard nine to five business day for instance is more suited to someone who tends to wake when the sun comes up than someone who likes to sleep until mid morning or later. But being a late riser is probably better if you are a musician or chef who needs to work until later at night and still wants to be sure to get enough zeds.

More: Does being an early riser make you healthier?

5. Counting sheep will help you fall asleep.

Fact: Mental imagery can help induce sleep but the task has to be something you find pleasant and relaxing.

Counting sheep has long been touted as a way of combating insomnia; references to the practice in literature date back more than 150 years. But whether it works has never been tested in scientific studies.

It's known though mental imagery can help bring on sleep by serving as a distraction from stressful thoughts, says Sydney sleep psychologist Dianne Richards. But what works for some may not work for others. It needs to be something you find pleasant and relaxing and her experience is that many people find counting tasks somewhat stressful. Her hunch is that other methods will have broader appeal.

The idea behind distraction strategies is to stop your mind worrying, planning or problem solving as these are activities that lead to production of the stress hormone cortisol and interfere with sleep.

But if the alternative task you give your brain is too boring, or it simply doesn't appeal, you won't stick with it and your mind will drift back to the thoughts that produce cortisol.

"Ultimately, the task you choose has to be effective for you," she says.

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Sleep hygiene and children

This article explains how important having sleep hygiene is for children.

Getting kids ready for bed can have its challenges. Without good sleep hygiene, each night could be started with the odds stacked against you. Dr. Brian McGinley says 15-20 minutes is all it takes, on average, to fall asleep. Not getting those Z's can result in poor school performance, difficulty paying attention, weight gain, moodiness and inability to make decisions. In older children, it can result in an increased risk for depression, risk taking behavior and possible suicidal thoughts.

Getting the right amount of sleep can make all the difference, he said. McGinley, an associate professor of pediatric sleep medicine, says a 5-year-old, on average, needs about 10½ to 11 hours of sleep, a 10-year-old about 10 hours and adolescents between 9 and 9½ hours of sleep.

A poll by the National Sleep Foundation found that 75 percent of teens in America are getting less than eight hours of sleep. McGinley says electronic media have played a huge role in this. In fact, studies show the effects of TVs, computers, video games and phones are delaying bedtime even more. Interactive behaviors, such as pushing buttons or socializing online, stimulate the brain, and light signals it's time to be awake. “The commercials get loud, the car crashes and your brain is constantly responding to those things.”

McGinley says another sleep deterrent is caffeine. “Caffeine use can be used to delay the ability to fall asleep earlier and can be disruptive for sleep, and then you wake up and you’re tired and you feel the need for caffeine.” To help combat restlessness, McGinley suggests cutting off caffeine at noon.

For younger children, there’s something called behavior insomnia or the more familiar term, “curtain calls.” “Mom, I need a glass of water, it’s dark, can you read another story.” For those requests, McGinley says be consistent. “It might even be just a pat or a kiss on the forehead and then removing yourself from the room, encouraging them to go back to sleep. If the interaction is minimal and some of those requests are denied, they would likely fall asleep quickly.”

Allowing extracurricular activities or homework to be done up until bedtime does not give the brain enough time to wind down.

If sleep behavior doesn't seem to be the case, a child may be suffering from a biological disorder, which may require a trip to the doctor's office. “If you do get enough sleep but are having problems breathing during sleep, you have sleep apnea.” Signs of sleep apnea include snoring, pauses in breathing, gasping and restless sleep. Another sleep disturbance children face is insomnia. “Insomnia is the inability to fall asleep, stay asleep or wake up too early or any combination of those things.”

A study may also be needed for children who sleep just fine at night but have trouble staying awake the next day. “There’s a real biological process here that can be corrected with treatment.” If a child is believed to have sleep apnea, insomnia or other serious sleep disturbances, contact a physician to discuss the need for a sleep study.

When it comes to good sleep hygiene, McGinley says set a regular time for bed and be consistent. Turn off all electronic devices one to two hours before bed, allowing the brain time to wind down. Focus on activities that are more relaxing like reading, writing, painting or coloring. Create a comfortable sleep environment. Cooler temperatures at night are best and the room should be dark and quiet. “Your brain is very responsive to noise and especially changes in noise fluctuations.”

If noise is a problem, try listening to white noise like a fan, static or rain. Those who like to take a hot shower or bath at night, bump that up two hours before bedtime to give the body time to cool down. McGinley adds that it’s OK to eat a light snack before bed, “especially if they’re waking up and they’re hungry in the middle of the night.”

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Ways to treat insomnia

This article discusses insomnia and how to treat it.

Insomnia is difficulty getting to sleep or staying asleep for long enough for an individual to feel refreshed the next morning, even if one has had enough opportunity to sleep. Sleep is the natural state of unconsciousness that enables one’s body to rest. During such state, the body goes through various sleep stages in a cycle like drowsiness, light sleep, deep sleep and dreaming.  insomnia or in other word sleeplessness, is a sleep disorder which exhibits an inability to fall asleep or to stay asleep as long as desired.

Definition of normal sleep remains difficult since people differ on the basis of age, diet, environments and lifestyles – factors that play a role in determining the amount of sleep one need. Notably, insomnia is not the only sleep disorder although it is the most common sleep complaints; hence it at times becomes a symptom of another problem which differs from one person to another. insomnia can be classified as transient, acute or chronic.

Treatment of insomnia requires its cause for instance, if it is caused by an underlying medical condition or not.insomnia can be treated by the following means:

Ensuring good sleep hygiene

A general practitioner may assist you in knowing what to do in order to get sleep – also known as good sleep hygiene. Tips for good sleep hygiene include establishing set times for going to bed and waking up, making sure you relax before going to bed, ensuring a comfortable sleeping environment, avoiding a daytime nap, avoiding late night caffeine, nicotine and alcohol, avoiding exercise four hours to bedtime, avoiding eating a heavy meal late in the night, avoiding glancing at the clock all through the night and using the bedroom only when you want to sleep and sex.

If your insomnia lasts more than four weeks, your general practitioner may either recommend cognitive and behavioral treatments or short course of sleeping tablets for immediate relief.

Cognitive and behavioral treatments

This is aimed at changing unhelpful thoughts and behaviors that may be contributing to insomnia. This includes stimulus control therapy which helps remove factors that condition one’s mind to resist sleep, sleep restriction therapy – increasing the time one spends in bed by improving sleep, relaxation training to help you calm your mind and body through muscle relaxation, imagery and meditation, paradoxical intention which refers to letting go of any worry that keeps you awake and biofeedback – a method that allows the observation of biological signs like muscle tension and heart rate and shows you how to adjust them. CBT-I is at times performed by a specially trained general practitioner or a clinical psychologist.

Sleeping tablets

Sleeping tablets are drugs that promote sleep. They are usually used when you have a severe insomnia, to relieve short term insomnia and in case the above mentioned behavioral treatments prove ineffective. Doctors are mostly reluctant to administer sleeping tablets as they don’t treat the cause of insomnia and have side effects such as a feeling of hungover and daytime drowsiness. Examples of sleeping tablets are discussed below.

Benzodiazepines are tranquillizers that can lessen anxiety and encourage coolness, relaxation and sleep. This medicine should only be given to a person with severe insomnia or if it causes acute suffering as it makes that person sleepy and can also lead to dependency.

Z medicines are current kinds of medicines that work in a comparable way to benzodiazepines. Z medicines include zaleplon, zolpidem and zopiclone.

Zaleplon should be used in people with insomnia who have problem falling asleep and in lowest possible dose as it has side effects such as memory problems, painful periods in women, sleepiness, apathy, balance and coordination problems, concentration problems, changed sense of smell, dizziness and hallucinations.

Zolpidem is for unbearable insomnia causing severe stress. Its side effects are diarrhea, dizziness, nausea, vomiting, headaches, tiredness and sleep difficulty like sleep walking and stomach pains.

Zopiclone is for short-term treatment including waking up during the night, difficulty falling asleep causing severe distress. It should be used in its lowest possible dose as side effects include dry mouth, metallic taste in the mouth, sleepiness, dizziness, nausea, vomiting, drowsiness and headaches.

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Insufficient sleep epidemic

Insufficient sleep is a huge public health issue and is becoming an epidemic leading to negative health outcomes. This article tells you the possible negative health outcomes from insufficient sleep, how much sleep you should be getting, and general sleep hygiene tips.

Sleep is increasingly recognized as important to public health, with sleep insufficiency linked to motor vehicle crashes, industrial disasters and medical and other occupational errors. Unintentionally falling asleep, nodding off while driving, and having difficulty performing daily tasks because of sleepiness all may contribute to these hazardous outcomes. People experiencing sleep insufficiency also are more likely to suffer from chronic diseases such as hypertension, diabetes, depression and obesity, as well as from cancer, increased mortality and reduced quality of life and productivity. Sleep insufficiency may be caused by broad scale societal factors such as round-the-clock access to technology and work schedules, but sleep disorders such as insomnia or obstructive sleep apnea also play an important role. An estimated 50 to 70 million U.S. adults have sleep or wakefulness disorder. Notably, snoring is a major indicator of obstructive sleep apnea.

In recognition of the importance of sleep to the nation's health, Centers for Disease Control and Prevention surveillance of sleep-related behaviors has increased in recent years. Additionally, the Institute of Medicine encouraged collaboration between the CDC and the National Center on Sleep Disorders Research to support development and expansion of adequate surveillance of the U.S. population's sleep patterns and associated outcomes. Two new reports on the prevalence of unhealthy sleep behaviors and self-reported sleep-related difficulties among U.S. adults provide further evidence that insufficient sleep is an important public health concern.

Sleep-related unhealthy behaviors

The Behavioral Risk Factor Surveillance System survey included a core question regarding perceived insufficient rest or sleep in 2008 (included since 1995 on the Health Related Quality of Life module) and an optional module of four questions on sleep behavior in 2009. Data from the 2009 survey's Sleep module were used to assess the prevalence of unhealthy sleep behaviors by selected sociodemographic factors and geographic variations in 12 states. The analysis determined that among 74,571 adult respondents in 12 states, 35.3 percent reported fewer than seven hours of sleep during a typical 24-hour period, 48.0 percent reported snoring, 37.9 percent reported unintentionally falling asleep during the day at least once in the preceding month, and 4.7 percent reported nodding off or falling asleep while driving at least once in the preceding month. This is the first CDC surveillance report to include estimates of drowsy driving and unintentionally falling asleep during the day. The National Department of Transportation estimates drowsy driving to be responsible for 1,550 fatalities and 40,000 nonfatal injuries annually in the United States.

Self-reported sleep-related difficulties among adults

The National Health and Nutrition Examination Survey introduced the Sleep Disorders Questionnaire in 2005 for participants 16 years of age and older. This analysis was conducted using data from the last two survey cycles (2005 to 2006 and 2007 to 2008) to include 10,896 respondents aged older than or equal to 20 years. A short sleep duration was found to be more common among adults ages 20 to 39 years (37.0 percent) or 40 to 59 years (40.3 percent) than among adults aged older than or equal to 60 years (32.0 percent), and among non-Hispanic blacks (53.0 percent) compared to non-Hispanic whites (34.5 percent), Mexican-Americans (35.2 percent) or those of other race/ethnicity (41.7 percent). Adults who reported sleeping less than the recommended seven to nine hours per night were more likely to have difficulty performing many daily tasks.

How much sleep do we need? And how much sleep are we getting?

How much sleep we need varies among individuals but generally changes as we age. The National Institutes of Health suggests that school-age children need at least 10 hours of sleep daily, teens need nine to 10 hours, and adults need seven to eight hours. According to data from the National Health Interview Survey, nearly 30 percent of adults reported an average of less than or equal to six hours of sleep per day from 2005 to 2007. In 2009, only 31 percent of high school students reported getting at least eight hours of sleep on an average school night.

Sleep hygiene tips

The promotion of good sleep habits and regular sleep is known as sleep hygiene. The following sleep hygiene tips can be used to improve sleep:

* Go to bed at the same time each night and rise at the same time each morning.

* Avoid large meals before bedtime.

* Avoid caffeine and alcohol close to bedtime.

* Avoid nicotine.

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How caffeine disrupts your sleep

New research looks into the specifics of how late-in-the-day caffeine can disrupt your sleep at night.

You hear it all the time when it comes to sleep: Don't drink caffeine too late in the day. It's among the most common sleep tips -- and it's a good one. Caffeine, with its stimulant effects, is disruptive to good sleep. And these days, with the popularity of energy drinks and other caffeine-laden beverages and snacks, it's not difficult to wind up consuming caffeine throughout the day, even if you've set your coffee cup aside. The negative health consequences of too much caffeine also extend beyond sleep problems. Research shows that caffeine may contribute to cardiovascular problems. A recent large-scale study also suggeststhat heavy caffeine consumption -- more than four 8-ounce cups of coffee per day on a daily basis -- is linked to higher mortality rates in men and women.

But how late in the day is too late in the day to be consuming caffeine? Despite consensus about caffeine's sleep-disrupting effects, recommendations about the timing of caffeine consumption -- and when it's best to stop for the day -- can vary widely. Though an abundance of research has been conducted to establish caffeine's negative effects on sleep, very little attention has been paid to the specific timing of caffeine consumption relative to bedtime.

A new study attempts to fill in some of these important specifics about the effects of late-afternoon and early-evening caffeine consumption on nightly sleep. Researchers at Michigan's Henry Ford Hospital's Sleep Disorders & Research Center and Wayne State College of Medicine analyzed the sleep-disruptive effects of caffeine consumption at different lengths of time before bedtime. They found that caffeine consumed even six hours before bedtime resulted in significantly diminished sleep quality and sleep quantity. This is believed to be the first study to investigate directly the effects of caffeine at specific times before nightly sleep.

The study included 12 adult men and women, all of whom were healthy and were normal sleepers who in their regular lives were moderate consumers of caffeine. During the study period volunteers kept up their normal sleep routines, which included bedtimes between 9 p.m. and 1 a.m. and wake times between 6 a.m. and 9 a.m. Participants' total nightly sleep duration fell somewhere in the range of 6.5 to 9 hours per night, with no regular habit of napping during the day. Throughout the study researchers tracked sleep by having participants keep sleep diaries and by using at-home sleep monitors. Participants were given doses of caffeine in pill form as well as placebo pills, on a schedule that enabled researchers to measure the sleep-disruptive effects of caffeine taken at three different points: at bedtime, three hours before bedtime, and six hours before bed. They found significant disruptions to sleep as a result of caffeine taken at all three points:

• Caffeine consumed zero, three, and six hours before bedtime significantly reduced total sleep time. Even caffeine consumed six hours before bed reduced total nightly sleep amounts by more than one hour.
• Caffeine consumed at all three points diminished sleep quality. Caffeine taken three and six hours before bedtime, as well as caffeine consumed at bedtime, significantly increased the amount of time spent awake during the night.
• Disruptions to sleep as a result of caffeine were perceived by volunteers (as recorded in sleep diaries) for caffeine consumed at bedtime and three hours before bed, but were not reported for caffeine taken six hours before bed. However, sleep monitors measuring total sleep time, and sleep efficiency (time spent sleeping relative to total time spent in bed) showed that caffeine consumed six hours before bedtime had significant detrimental effects to both.

This last finding is especially important, because it suggests that people can't -- and shouldn't -- rely entirely on their own perceptions of how much or little caffeine affects their sleep, especially caffeine consumed in the afternoon. Even if you don't feel that late-afternoon cup of coffee has a negative impact on your sleep, this study suggests that it is likely to be interfering nonetheless. This is one reason that I have long recommended a 2 p.m. cut off time for caffeine consumption.

Remember, limiting caffeine doesn't mean removing it entirely from your daily routine. A moderate amount of caffeine, consumed at the right times, can be useful and evenhealthful, stimulating alertness and energy. These new findings provide us with some really important specifics about just how significantly late-in-the-day caffeine can undermine a good night's sleep. Want to enjoy your coffee without wrecking your sleep? Follow these basic suggestions for consuming caffeine in a sleep-friendly way:

Stick to a 2 o'clock cut off. As this current study shows, late-afternoon caffeine can cause problems for your sleep, even if you aren't aware of it. To avoid sleep disruption, restrict your caffeine consumption primarily to the morning hours. If you do have a midday cup of coffee, make sure to drink it before 2 p.m.

Taper caffeine as the day progresses. Start your day with your most highly caffeinated beverage and ease up on the caffeine as the morning goes on. First thing in the morning is likely when you'll crave caffeine the most, and when it can do you the most good in terms of boosting energy and shaking off the effects of a night's sleep. Switch over to tea or decaffeinated coffee as the morning continues, to keep overall daily caffeine amounts moderate and be comfortably caffeine-free by mid-afternoon.

Avoid jumbo drinks. These days, everything seems to be "super-sized" -- and caffeinated drinks are no exception. From a 20-plus-ounce latte or soda to a caffeine-packed energy drink, a lot of caffeine products deliver way more of the stimulant than is healthful. Stick to something much closer to the old-fashioned 8-ounce cup, and savor it.

Don't ignore your sleep problems. Being tired makes us more likely to feel the need for caffeine, and that extra consumption can in turn make sleep problems worse. Avoid this sleep-disruptive cycle by making sleep a daily priority. Practice good sleep hygiene and talk to your doctor about how you are sleeping, particularly about any problems that arise.

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Insomnia symptoms can raise risk of death

Both insomnia, and the symptoms of insomnia such as issues falling asleep or staying asleep, have been shown to risk a person's risk of death.

With our busy lives, it can be tempting to shrug off -- or ignore altogether -- difficulties with sleep. Trouble falling asleep, difficulty staying asleep throughout the night, waking feeling tired and unrefreshed: These are commonly experienced disruptions to sleep for millions of adults. Too often, these sleep problems aren't taken seriously, or are considered the less-than-ideal price to pay for living full and sometimes hectic lives.

Difficulty falling asleep, waking during the night, waking very early in the morning, and experiencing un-restorative sleep are all symptoms of insomnia, a serious sleep disorder. People may experience these symptoms all at once, or some of them and not others. They may experience them chronically or every so often. They are signs of disrupted, poor quality sleep and they should never be ignored.

New research indicates how high a price we may pay for overlooking signs of insomnia. Scientists at Massachusetts' Brigham & Women's Hospital have identified a link between insomnia symptoms and elevated risk of death. Their study, which included more than 23,000 men, found certain symptoms of insomnia associated with higher mortality risk from cardiovascular disease. The men were all participants in the Health Professionals' Follow-Up Study, a long-term, ongoing research endeavor that investigates issues related to men's health. In 2004, 23,447 men reported to researchers about their sleep and any insomnia symptoms. Researchers followed up with the men over a period of six years, during which time 2,025 of the men died. After adjusting for other mortality-influencing factors including age, lifestyle habits, and other health problems, researchers analyzed data on men's mortality as related to the presence of the following insomnia symptoms:

• Trouble falling asleep
• Difficulty maintaining sleep
• Waking in the early morning
• Experiencing non-restorative sleep

They found that several symptoms of insomnia were associated with higher rates of cardiovascular death among the men. In particular:

• Men who reported having difficulty falling asleep had a 55 percent increased risk of death from cardiovascular disease as compared to those men who did not experience this sleep difficulty.
• Men who reported experiencing un-refreshing sleep most of the time were at 32 percent higher risk for cardiovascular death than men who did not report this symptom.

Poor sleep is well understood to have a serious, negative impact on heart health. Not sleeping well, or enough, raises the risks for a number of cardiovascular problems, includinghigh blood pressure, heart attack, heart failure, and stroke. Protecting the quality of sleep as we age is a critical component of protecting long-term cardiovascular health.

This isn't the first scientific evidence of a link between poor sleep and increased mortality risk. But the news is particularly worrisome because these symptoms are quite common, particularly as we age. Estimates suggest that 30 percent or more of American adults experience some insomnia symptoms at least periodically, and for 10-15 percent, insomnia is chronic. Insomnia grows increasingly common with age: More than half of adults over the age of 65 experience symptoms of insomnia. Women are at higher risk than men for insomnia, due in part to hormonal cycles during childbearing years and to the hormonal changes associated with menopause. This current study included only men, but other research has shown higher risks of mortality associated with poor sleep in both men and women:

• In a number of studies that included both men and women, sleeping fewer than six hours and more than eight hours per night has been associated with increased mortality risk.
• Obstructive sleep apnea in men and in women is linked to significantly highercardiovascular and overall mortality risks. Studies have shown that mortality risksfrom cardiovascular problems are two or more times greater for adults with obstructive sleep apnea. The more severe the obstructive sleep apnea, the greater the mortality risks.
• Research has also linked use of sleeping pills to increased mortality risk. The link between higher rates of mortality and sleeping pill use exists even after factoring out other possible contributors to death risk, including health problems, age, and gender.

Ready for some good news? While sleep problems left untreated may shorten longevity, improving sleep can have powerful positive health benefits. A study conducted recently in the Netherlands found that a regular routine of 7-8 hours of sleep may have as significant an impact on risk for cardiovascular death as not smoking.Regular, sufficient amounts of high-quality sleep have also been linked to reduced risk for Type 2 diabetes, largely because of the positive effect that sleep can have on improving insulin sensitivity.

If you have symptoms of insomnia, don't ignore them. Share them with your doctor. Make an honest assessment of your sleep habits and make a commitment to taking simple steps to improve your sleep routine and your overall sleep hygiene. Taking steps to improve the quality and quantity of your sleep is one important way to protect your cardiovascular and overall health for the duration of your life. And sleeping well may actually help you extend that duration.

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Sleeping more on the weekends can make you more tired

This article claims that sleeping more on the weekends and catching up on sleep can make a person more tired.

A few extra hours of sleep in the weekend to make up for lost sleep during the work week isn’t going to help you reverse the effects of sleep deprivation, suggests an international study released this week.

Sleep experts in the UAE estimate that 20-30 per cent of the working population in the country complains of poor sleep quality.

The consequences of sleep deprivation are manifold.

Medical opinion states sleep deprivation could lead to impaired cognitive function, irritability, decreased libido, poor judgement, weight gain, fatigue, high blood pressure (hypertension), weakened immune system, and general low quality of life.

The international study on the “Effects of Recovery Sleep After One Workweek of Mild Sleep Restriction…” is published by American Physiological Society.

The study posits that recouping lost sleep of the work-week or “recovery sleep” does little to help the damage already caused by a sleep-restricted working days.

The US-based researchers led by Alexandros N. Vgontzas studied 30 volunteers on a 13-day schedule whose performance on the attention test didn’t improve after recovery sleep. Further their ability to pay attention deteriorated significantly after sleep restriction and did not improve after recovery.

Norma Cairns, Counselling Psychologist at the American Centre for Psychiatry and Neurology in Dubai told Gulf News, “Sleeping is a restorative process. It is recommended that we get seven to eight hours sleep per night in order to function well. Skipping out on a few hours each night during the work-week in the hope that it can be ‘made up for’ by sleeping longer at the weekend can be unhealthy in the longer term.”

She explained that the term “functioning well” means a person has good concentration, feels alert, enthusiastic, balanced and focused. She said balanced life style is a significant key to psychological well-being. A balanced life can be achieved by having a healthy routine in terms of sleep, nutrition and exercise alongside work.

She warned against oversleeping during the weekend as it can leave a person feeling more tired.

Speaking to Gulf News, Dr Emmad Kowatli, an American-board certified specialist in pulmonary medicine and sleep disorders, and director of the Sleep Centre at the American Hospital, Dubai said, “poor sleep is linked to medical conditions like hypertension (high blood pressure), stroke, sexual dysfunction, and heart failure and heart disease.”

“It is also associated with certain cancers, diabetes and high cholesterol. Any sleep disorder negatively impacts natural sleep cycle, affecting daily functioning. Activities like driving and overall performance is affected. Sleep deprivation causes drowsiness that can slow reaction time and is linked to motor vehicle crashes,” Dr Kowatli added.

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What may be keeping you up at night?

This article discusses the common issues that keep people from getting a good night's sleep, such as insomnia, sleep apnea, narcolepsy, restless leg syndrome, and periodic limb disorder.

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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