sleep drbobOne of the most vexing aspects of our busy lives is our inability to get a good night’s sleep. It amazes me that many patients live on Ambien or Lunesta as sleep aids. Some people are into the hard stuff like benzodiazepines (Valium) and even opiates to sleep. Many of these people do not have pain, they have insomnia for a Variety of reasons, but some have actual illnesses like fibromyalgia, rheumatoid arthritis or bad degenerative arthritis that causes pain. Most of these patients have nothing but anxiety, family issues, worries about their children, their love life, their parents and so on. We are a tension-bent society and now more than ever it is reflected in our inability to sleep.

Greater than one-half of Americans have a sleep disorder of some kind. Some 50-70 million people have chronic sleep disorders. This is reflected in daytime sleepiness, parasomnias (the technical word for sleep walking), and circadian rhythm disorders (people who work the night shift, airline pilots and flight attendants, etc). All of this is recently in the news: train engineers falling asleep and killing people, car accidents in the wee hours of the morning wherein people unknowingly drive on the wrong side of the road, or people who sleep walk into traffic or out the window.

Before I go into the ways in which to get a good night’s sleep and things to avoid, I am going to say a word about sleep testing and something called obstructive sleep apnea or OSA as it is commonly called. It means you stop breathing when you sleep, which wakes you up. You might not even be aware of your light sleep or your constant sleep interruptions. It’s very common in middle age (24% of men and 9% of women), those who are overweight, people who snore, people who take sedatives to sleep, those with obstructed noses, people with under active thyroids, and those who stop breathing when they lay down (are supine). If you suspect you have it, get tested in a sleep center and do it soon. It is now required for pilots, train engineers, and others who do vital things that affect all of us. OSA worsens diabetes, causes irregular heartbeats, makes you eat more, and makes you sleep at every chance you get. You might even lose your job over it if you cause an accident or nod off at vital meetings during work. There are many ways to control sleep apnea, machines called CPAP or continuous positive pressure breathing and even minor surgical procedures. Those who use the machines cannot sleep without them. It’s also an incentive to lose weight, because that belly you live with can be the main reason you don’t sleep.

If you don’t have OSA and simply cannot sleep, here are some tips. Avoid napping after 3pm, don’t go to sleep too early, and don’t drink coffee or have caffeine after lunch (that includes diet sodas). About 2-3 hours before bedtime, don’t eat heavily, don’t smoke or drink alcohol, and avoid vigorous exercise (don’t jog at 11PM), and whatever you do— avoid taking vitamins or stimulants before bed. While you are trying to go to sleep, avoid complex problems, don’t go over life’s issues and do not review the day’s events. Get an on-line course in meditation and do that before you even lie down. The reason people read books before they sleep is to take one’s mind off of the heavy stuff, so you can just roll over and phase out of the day’s activities. Meditation is the easiest and most relaxing way to go to sleep, because it requires some easy self discipline and it works.

I hope that I have not caused you to nod off while reading my little essay, but if I have—keep it handy before bed.