Chasing the dream

Most people will spend about one-third of their lives sleeping – that is if they are fortunate enough to be able to sleep. Each year 60-100 million of us wake each day but do not feel rested. A few years ago I became one of the countless victims to suffer from the oh-so-common disorder known as insomnia.

In response to this agonizing quest for somnolence, I, like so many others, began to search for the magic pharmaceutical that would restore balance to my wake/sleep cycle. It is likely that physicians will have no shortage of drug recommendations for us, as the market is flooded with various medications that claim to give us a good night’s sleep. Before electing to go that route, it is important that we understand some basics in an effort to end the torturous, long hours in bed trying to drift off to sleep.

 Insomnia, defined as difficulty getting to and/or maintaining sleep – or waking up too early thereby losing sleep (which then affects daytime function) – is the most common sleep disorder. Other conditions such as narcolepsy, sleep apnea and restless leg syndrome have a biological component and may require a different treatment approach.

If these conditions are suspected, you may want to consult with your physician or a sleep lab at one of the local hospitals, where they are equipped to perform overnight or day nap studies.

Short-term insomnia, as a result of mental or physical stress, will surely affect all of us at some point during our lifetime. This can last from several weeks up to a few months. When sleep issues drag on, however, occurring at least three times per week for three or more months, and they cannot be attributed to insufficient access to sleep or a poor sleep environment, the sleep problem is considered chronic.

“Sleep hygiene” as it has come to be known, or the ways in which we alter our lifestyle or behaviors to create an atmosphere conducive to sleep, is vital to obtain the sleep we need.

The following habits have been shown to improve sleep:

•             Avoid stimulants such as caffeine products and tobacco which can keep you up for eight or more hours after ingestion.

•             Avoid alcohol which interferes with normal sleep patterns.

•             Avoid heavy meals or vigorous exercise five to six hours before bedtime

•             Allow about one hour before sleep to wind down – keep your bedroom cool, dark and quiet and avoid watching TV or using the computer at bedtime.

 •            Establish a set time to turn in and get up in the morning.

Every effort should be made to eliminate any bad habits associated with poor sleep. Our bodies are naturally programmed to sleep seven to eight hours per day.

“Cheating” on the number of hours we sleep has consequences to our emotional, mental and physical health. Furthermore, “catching up” on sleep does not provide us with the same benefits as a normal night’s sleep. Repeated nights of poor sleep or no sleep will affect you the next day. You may be irritable, sluggish, impatient, forgetful and your job performance can suffer. You’ll be yearning to go home and what else … sleep!

That, however, is not the solution because a long afternoon nap will surely interfere with a good night’s sleep. Get the picture?

If your efforts fail to produce sleep, it may be time to consult your physician about a prescription. Selecting a medication will depend on the type of insomnia you are experiencing as well as your age and medical history.

In recent years we have seen an increase in the number of medications on the market to treat insomnia. Some medications are developed specifically for insomnia, whereas others are used for a primary purpose other than sleep (e.g., antidepressants, antipsychotics or antiseizure medications), but have the secondary effect of sedation.

I have often heard people express fear about using medications to sleep, thinking they will become addicted or not wake up from the induced sleep. Fortunately, many of the newer medications are shorter acting, safer and do not leave you with a “hangover” the next morning. It is wise, however, not to suddenly discontinue a medication that you’ve been taking for a long time. This abrupt cessation may cause you to experience withdrawal symptoms or even rebound insomnia.

All things considered, it is possible to find a safe, effective medication to produce sleep – the alternative of not sleeping can certainly cause you to experience even more disagreeable consequences. Herbal products are also available but, like any drug, may contain ingredients that interfere with other prescription medications. The FDA does not regulate herbal products, so limited data is available. Some of the more widely used herbal remedies include valerian, melatonin and chamomile. Again, before trying one of these products it’s a good idea to run it by your physician.

Following are two sleep labs in Rhode Island where you may schedule an evaluation:  Roger Williams Hospital (401-351-2747) and Kent County Hospital (401-737-7010). Check to see if your insurance company requires a referral.

Also, the National Sleep Foundation @ sleep.org may offer some valuable information. Pursuing a good night’s sleep is worth the effort; “when you have insomnia, you’re never really asleep, and you’re never really awake.” (from the movie “Fight Club”).

LINDA AMORE, RN is program manager of Home Care Solutions a program of Jewish Family Service.