It is a frustratingly common scenario: You fall asleep easily at bedtime but are wide awake at 2 or 3 in the morning. Only after a half-hour or more of staring at the ceiling can you finally fall back to sleep. This middle-of-the-night insomnia happens to everyone every once in awhile. It is an appropriate, normal response to stress, doctors say.
But for a significant number of people it can become a chronic disorder. In fact, this type of insomnia is the most common, more so than having trouble falling asleep at bedtime.
About 30 percent of American adults have symptoms of some sort of insomnia each year, according to scientific studies. Chronic insomnia is generally defined as having difficulty sleeping at least three times a week for three months or more.
Chronic problems falling asleep at bedtime are often associated with stress and anxiety, says Michael Perlis, director of the Behavioral Sleep Medicine Program at the Perelman School of Medicine at the University of Pennsylvania. Waking up too early is often linked to depression. Either type of insomnia can be caused by a circadian rhythm disorder, where there is a mismatch between one’s biological clock and normal sleep times.
Middle-of-the-night awakenings can be caused by medical conditions like sleep apnea, chronic pain or gastroesophageal reflux disease (GERD). Older adults are more likely to wake up overnight. Hot flashes from menopause and some prostate conditions that cause frequent urination can drive people out of bed.
The best thing to do to prevent an occasional bout of middle-of-the-night insomnia from turning into a chronic problem seems simple: “Nothing,” says Dr. Perlis. “Don’t sleep in. Don’t nap. Don’t go to bed early the next day and everything will turn out fine.”
It may seem counterintuitive, but early research from the University of Pennsylvania's School of Medicine suggests that the best response to a few nights of insomnia is to do nothing — not even nap.
Most people experience insomnia at some point in their lives. Although it's part of human evolution — think back to when we had to flee dangerous predators in the middle of the night — it can still feel frustrating and exhausting.
"Chronic insomnia, when it is untreated, is not only ruinous to the quality of one's life and impacts one's relationships, but it has been clearly shown to be a risk factor for the development of a variety of medical and psychiatric disorders," said Dr. Michael Perlis, who's heading the research on insomnia at Penn.
And the worst thing one can do is try to regain control by attempting to compensate for sleep loss, he said.
"The very best thing that you can do is absolutely nothing — you don't sleep in the following morning no matter how tired you are, you don't nap, and you don't go to bed early," he said.
Perlis' research team has provided the early data that could ultimately confirm that theory, based on findings from sleep diaries kept by 1,000 people.
The hypothesis stemmed from a well-trusted theory suggested by sleep researcher Arthur Spielman in the 1980s. Spielman believed that trying to nap, sleep in or go to bed early would just make insomnia worse.
Perlis said his research has begun to show that the 50 percent of those who try to make up for lost sleep after a few white nights are more likely to develop full-blown, chronic insomnia. Those who don't, he said, usually go back to getting good sleep.
The research will continue into the next two years.
Natalie Nevares spent three years in a stupor, sleeping just eight hours a week. Try as she might, the 45-year-old, who lives in Brooklyn, couldn’t fall or stay asleep. “You feel like you’re losing your mind,” she tells The Post.
For Kim Cattrall, who opened up about her long-running battle with chronic insomnia in an interview in early June, the sleep disorder was a “tsunami.” In 2015, Cattrall’s insomnia was so crippling that she dropped out of the musical she was starring in at the time, angering fans.
“It was a gorilla sitting on my chest,” Cattrall, 59, told Britain’s RadioTimes. “I didn’t understand the debilitating consequence of having no sleep.”
It’s a feeling to which the roughly 50 million to 70 million Americans suffering from chronic insomnia can relate. Despite the prevalence of the condition, characterized by trouble falling asleep, staying asleep and feeling rested, effective treatment is still elusive and can even be downright dangerous — from Ambien-induced sleep-eating sessions to car crashes caused by groggy, drugged-up drivers.
And while newer, safer medications show short-term promise, a long-term, drug-free treatment called cognitive behavioral therapy for insomnia, or CBT-I, is getting a seal of approval from the medical community.
The same treatment Cattrall credits with finally providing some relief, CBT-I typically runs between six and eight sessions over the course of four or five months, during which a sleep therapist will help identify behavior that prevents falling and staying asleep and work to change it.
“Medications are a Band-Aid, whereas CBT-I tries to teach people what sleep really is, [and] what are the things that prevent us from sleeping,” Dr. Jeremy Weingarten, director of the Centre for Sleep Disorders at New York Methodist Hospital, tells The Post. It’s then on the patient to carry out the changes CBT-I suggests, which can include creating a technology-free resting space and getting out of bed after 20 minutes if you’ve yet to enter dreamland.
Although CBT-I has been a treatment for the past two decades, recent research is revealing just how effective it really is, and it’s finally gaining street cred with docs. A 2015 report in Annals of Internal Medicine found that CBT-I is an effective treatment for insomnia, improving sleep time, onset and efficiency with no adverse outcomes, while a University of Pennsylvania study published last week shows that getting out of bed when insomnia hits, as CBT-I suggests, can help sufferers get better shut-eye.
And in May, the American College of Physicians announced that CBT-I should be the initial treatment for insomnia before prescribing pills or trying over-the-counter sleep aids. “Many [doctors] believe that [CBT-I is] the only treatment that should be offered, but it’s very effort-dependent on the patient,” Weingarten says.
It’s also dependent on the practitioner. Regular CBT — practiced by a therapist to treat mental illness — may alleviate some of the stressors, but for a cure, it’s worth seeking out a sleep therapist trained in CBT-I. (Many are covered by insurance and listed in a database at SleepFoundation.org.)
For others, getting to the root of the problem may take a different path. That was the case for Nevares, who now works to help sleep-train new families through her Manhattan-based business, Mommywise, by implementing changes similar to those promoted in CBT-I.
“I kept thinking, ‘If I could only get a good night’s sleep, I would feel better,’” she says, but at one point, “I was in the bathroom thinking, ‘My kids would be better off without me.’” It wasn’t until she visited a psychiatrist that she realized she had major depression. Just days after taking her first antidepressant, she was sleeping through the night.
Now she devotes her time to helping others beat insomnia. “[Sleep deprivation] is a torture method used around the world,” she says. “I know what that feels like, and it’s my mission to help parents diagnose and beat it.”
Tricks for hitting the hay
CBT-I is tailored to each patient, but the treatment promotes certain techniques that any insomniac can try.
• Ditch caffeine later in the day (4 p.m. is a good cutoff time), eating two hours before bed and drinking alcohol in excess. They can all keep your body from falling asleep, even if you’re mentally exhausted.
• Keep clocks out of view to nix the stress that comes when sleep doesn’t. Modal TriggerPhoto: Shutterstock
• Set a bedtime and wake-up time, and stick to them, even on weekends. Sleeping in on days off may feel good in the moment, but it can mess with your internal clock.
• Invest in blackout shades, better air conditioning and a sound machine — keeping your bedroom dark, cool (around 65 degrees) and free from street noise will help your brain tune out.
• Stop trying so hard. Just lying in bed, even if you’re not sleeping, will help you let go of stress.
Doctor Robert Daniel always leaves space in his carry-on bag for a little extra.
The founder of the Sandton Eye Clinic, an ophthalmologist with training in human physiology and neuroscience, never boards a flight without his invention, SleepSpec.
He has them littered around his house and never checks into a hotel without a pair.
Daniel cites research pointing to the dangers of light - in particular artificial light and more specifically blue light - for his obsession with the device, a pair of amber-lensed glasses which harness the body's melatonin-producing process to encourage sleepiness.
The glasses should be worn two hours before going to sleep.
They eliminate the spectrum of blue light responsible for suppressing production of melatonin, the hormone of sleep.
At night the brain produces melatonin needed to prepare the body for sleep. When the sun rises, light - in particular blue light - increases, stopping the production of melatonin, causing the body to wake up.
''But today artificial light from lamps and electronic devices means that the brain struggles to distinguish the change from day to night, melatonin production is suppressed and so our bodies are unable to move effectively into sleep mode," Daniel says.
The same thing happens when we traverse time zones. The sleep-wake pattern is upset, as are the rhythms for eating and working. Until these factors are able to respond properly to the new environment we get jet lag.
''We all know the relaxed feeling we get having sundowners watching the sun set," says Daniel, explaining the effect of the longer-wavelength red light with lower energy. Blue light has a short wavelength and produces more energy, which keeps us alert.
Melatonin depletion can lead to serious health issues.
''Even if you're getting the required eight hours of sleep a night, your brain could not be producing enough melatonin," says Daniel. ''Your brain starts producing it only two hours after lights and screens are turned off and the hormone is needed to rid the brain of toxic waste products. People who lack melatonin are at extreme risk of dementia."
Daniels says that sleeping pills slow the brain's function and it s ability to neutralise toxins.
Three of South Africa's Super rugby teams have started using SleepSpec when they travel.
The Lions, the first team to travel to Japan this year, used SleepSpec during their travels. Dr Rob Collin, team physician, says there was a marked improvement in their recovery time on their arrival in Japan compared with previous trips to Australia and New Zealand and a decreased reliance on sleeping pills.
'The mood in the team was great," says Collins. ''And energy levels were good almost immediately."
SleepSpec can be used daily by anyone with sleep difficulties, says Daniel. Other than wearing his orange glasses, what is the doctor's best advice? ''Guard sleep jealously."
Jerusalem, Jun 19 (PTI) Procrastinators, beware! People who tend to put things off may be at a higher risk of having insomnia, a new study has warned.
Researchers studied 598 people and found that procrastinators also had more problems sleeping than those who did not put things off.
"At bedtime, people who procrastinate are ruminating about the things they need to do and have not done, and that makes it difficult to go to sleep," said Ilana S Hairston from Academic College of Tel Aviv in Israel.
This is the first study that shows a relationship between insomnia and procrastination, said Hairston.
The participants completed online questionnaires that studied their tendencies to procrastinate, and also their sleep problems and emotional states, 'Live Science' reported.
The questionnaires also examined whether the people were morning or evening types, meaning whether they tended to go to bed early and get up early, or go to bed late and get up late.
The study showed that morning people had lower levels of procrastination and fewer sleep problems, compared with the evening people.
Among evening types, those who had higher levels of procrastination also had more sleep problems, researchers said.
Sleep problems may be an important and overlooked outcome of procrastination, they said.
WE'VE all had those mornings where we groan at the alarm clock and might be tempted to push the snooze button to give us just a few minutes longer in bed.
A poor night's sleep can leave us feeling irritable, sluggish and struggling to concentrate. It's common to have the odd day like this, especially in the summer where we might need a little time to adjust to the brighter mornings. However, if you feel like this regularly, you might be suffering from insomnia.
Insomnia is the difficulty getting to sleep, or staying asleep long enough to feel refreshed the next morning. This can include waking up several times throughout the night or early in the morning and being unable to go back to sleep, and feeling exhausted when getting up.
It's a common problem and affects roughly one in every three people in the UK. Occasional episodes of insomnia can come and go without causing any serious problems, but for some people it can last for months, or even years at a time.
Getting a good night's sleep and regular rest is much more important than many of us realise.
In order to function, we need a healthy and well-balanced diet, regular exercise and rest.
When we sleep, we're allowing our bodies to recover from the previous day. Poor sleep on a regular basis not only puts you at a greater risk of developing a serious medical condition such as obesity, heart disease and diabetes, but it actually shortens your life expectancy.
If you think you might have insomnia, there are a few things you can do to tackle it and get a good night's sleep.
Routine: set regular times for going to bed and waking up.
No screens: give your eyes a rest and don't watch TV, use your mobile phone or tablet an hour before bed. The lights and programmes stimulate your eyes and brain.
Diet: Avoid caffeine, nicotine, alcohol and heavy meals a few hours before bed. All these things will keep your brain, digestive system and muscles working overtime.
Diary: If worrying is keeping you awake, try keeping a notepad and pen by your bed. Writing down your worries or to-do lists can actually clear your mind before you sleep.
Environment: Use thick or 'blackout' curtains/blinds, an eye mask and earplugs to prevent you from being woken by light and/or noise.
There are some mobile phone apps designed to help with sleep problems. Your local pharmacist may be able to provide some over-the-counter medication. If it remains a problem after a month or so, make an appointment to see your GP.
They will look into your medical history and review any medication you're taking which might be leading to insomnia. There may be some underlying issues such as anxiety which may be preventing you from sleeping.
More information on insomnia at www.nhs.uk/conditions/insomnia http://www.burtonmail.co.uk/top-tips-to-get-a-good-night-s-sleep-from-swadlincote-gp/story-29414132-detail/story.html
There’s nothing like a good night’s rest to get you off to a fresh start on a new day. But for many people, especially those in middle age and older, that sweet sleep is an elusive dream.
Jann Jones, 62, of Glenburn remembers clearly the last solid night of sleep she got.
“It was in 1986,” she said. “I was visiting a friend’s mother in New York, and I slept right through the night.” Jones, a registered nurse, said people who suffer from insomnia hold on to the memory of a sound sleep.
“Because they’re so unusual, we remember them for a long time,” she said.
Insomnia — defined as a persistent inability to fall asleep, stay asleep or both — can strike at any age, including, rarely, in early childhood. But the likelihood of insomnia increases with age, in association with changes in health status and activity levels, as well as the influence of medications, emotional stress and the normal processes of advancing age.
Jones’ thinks her insomnia took root during a time of acute anxiety, long ago, over the well-being of her aging parents, who lived across the country.
“Finally, I told myself I could lie here and worry all I want and it wouldn’t change anything,” she said. “Eventually I was able to just shut the door on that anxiety.” Her mind has quieted on that issue, but her sleep habits have never returned to normal.
“You learn to live with it,” she said. “But those of us on the quest [for a cure] leave no stone unturned.”
While individuals differ, most adults need at least seven hours of sleep every 24 hours to be at our healthiest and most alert. Missing a night’s sleep once in a while or even a few weeks of choppy sleep because of real-life stress or anxiety is unlikely to cause serious problems, according to Dr. Ganesha Santhyadka, a board-certified sleep medicine specialist at St. Joseph Healthcare in Bangor.
“Situational insomnia can result from the loss of a loved one, the loss of a job, worries about children, parents or finances,” Santhyadka said. “That’s actually normal. But if it lasts for more than a couple of months, we label it chronic insomnia.” And that’s another story.
Chronic insomnia, especially in older individuals, can lead to debilitating fatigue; a dangerous decrease in cognitive functions, such as judgment, memory and problem-solving; and an increased risk of heart disease, diabetes, depression and other illnesses.
Prime suspect: Sleep apnea
When older adult patients with chronic insomnia consult him for help in re-establishing healthy sleep patterns, Santhyadka said, he first rules out medical causes. Chief among these is obstructive sleep apnea. In sleep apnea, often characterized by loud snoring interrupted by episodes of not breathing at all, muscles at the back of the throat relax to the point that the airway is completely blocked. Breathing may stop 30 or 40 times an hour or more for several seconds or even minutes at a time. Decreasing blood-oxygen levels jolt the brain back to activity to open the airway and resume breathing — and snoring.
Sleep is broken many times a night by these repeated apneic episodes, preventing the deep, restful slumber needed to refresh the body and brain. While bed partners and other members of the household may be kept awake by the snoring, the person with sleep apnea is most often unaware of the disruptions. The biggest tip-off is typically chronic fatigue and waking up exhausted every morning. Sleep apnea becomes more likely as we age, especially — but not exclusively — among individuals who are overweight or obese. It is also associated with underlying health conditions such as congestive heart failure and the use of alcohol and certain pain medications.
Diagnosing sleep apnea is best done through a monitored overnight sleep study performed in a clinical setting. A positive diagnosis likely will result in the patient being outfitted with an all-night sleeping mask that delivers continuous positive air pressure, or CPAP. The masks range in size from bulky “Darth Vader” models that completely cover the nose and mouth to less cumbersome ones that seal neatly around each nostril. An air hose provides pressurized room air from a quiet tableside compressor.
Gerald “Corky” Potter of Orono reported one recent evening to the St. Joseph Healthcare Center for Sleep Medicine in Bangor. Generally active and fit, the 71-year old sea kayak guide and business consultant suffered some recent health problems and hasn’t bounced back.
“I’ve always been a physical person, a worker,” he said, waiting for the sleep technician to wire him up for the study. “But recently, I’ve just been really fatigued and low energy.”
While he wasn’t looking forward to the possibility of having to use a CPAP machine, Potter acknowledged the quality of his sleep has been poor lately, impacting his mood and his ability to work, garden and enjoy outdoor activities.
In Bucksport, 73-year-old Jack Corrigan started using a CPAP about two years ago. He was reluctant at first to strap the big mask on, even though his wife had been using one for a couple of months to good effect.
“It’s just not normal to sleep with something like that on your face,” he said. But he went with it, and after just a few nights he noticed that a longstanding pain in his legs was gone. “I had been cutting off the flow of oxygen to my legs at night,” he said.
Now, he said, he feels better rested in the mornings and more alert and energetic during the day. “I don’t feel like I’m pushing a rope uphill any more,” he said. “I’m committed to it now. I think everyone should be tested for sleep apnea.”
Other causes and treatments
While sleep apnea is one common, age-related cause of chronic insomnia, there are many others. Untreated depression, anxiety and pain; gastric reflux; frequent nighttime trips to the bathroom; and many medications are all culprits.
Santhyadka said it’s important to address these issues. Light therapy, cognitive behavioral therapy and careful medication management can help. Pharmaceutical sleeping aids, including over-the-counter and prescription drugs, come with so many side effects and negative interactions with other drugs that they should be used only occasionally, he said. The hormone melatonin offers an alternative that is relatively free of side effects, he added.
But, he said, there are some basic “best practices” that can help almost anyone sleep more soundly, starting tonight.
First, make sure you’re getting enough exercise during the day. “A tired body needs sleep,” Santhyadka said. But don’t exercise vigorously late in the day, because that will excite your brain. Mornings are a better time.
Don’t drink stimulating caffeinated beverages — coffee, tea, soda or “energy drinks” — after noon. Chocolate, especially dark chocolate, also contains caffeine. Some people are so sensitive to caffeine they can’t tolerate it at all. Smoking, in addition to all its negative health impacts, also has a stimulant effect.
Enjoy your main meal at noon and a light supper in the early evening; this will help empty your stomach and reduce acid reflux and general discomfort at bedtime. Avoid any foods that cause you gastric distress. This list typically includes spicy-hot foods, garlic and onions, fatty foods and acidic foods. Eating salty snacks in the evening will keep you thirsty and uncomfortable.
Don’t drink water or other fluids after 6:30 or 7 p.m. This will help limit nighttime trips to the bathroom. Especially steer clear of alcohol in the evening. It may make you sleepy, but it very often causes you to wake up in the middle of the night and not get back to sleep.
Stop watching television, texting or using your computer at least an hour before bedtime. Studies show the light from these devices, as well as the mental stimulation of engaging with them, may contribute to sleeplessness.
Establish a soothing bedtime routine to signal your brain it’s time for sleep. This could include a warm shower, some gentle yoga and meditation, 10 minutes of relaxing reading and a quiet bit of music. Keep your bedroom cool, uncluttered and dark, with no television or pets.
If you wake in the night and are unable to get back to sleep after 20 minutes or so, don’t lie there fretting. Get up, go to another room and read, meditate or listen to soothing music until you feel sleepy enough to try again.
These practices take time and patience to establish, Santhyadka said, but often pay off in long-term improvement in the quality and quantity of sleep, without the disturbing side effects of medications.
“There are three essentials in life: water, food and sleep,” he said. “Sleep really is an essential thing.”
People who procrastinate may be more likely to have insomnia, according to a new study.
In the study of nearly 600 people, researchers found that those who tended to put things off also had more trouble sleeping, compared with people who did not tend to procrastinate.
Although it isn't clear how the link may work, the researchers said that it seemed to be explained by people worrying about things that they wanted to get done before going to bed, the researchers said. At bedtime, "people who procrastinate are ruminating about the things they need to do and haven't done," and that makes it difficult to go to sleep, said study author Ilana S. Hairston, a sleep researcher at Academic College of Tel Aviv in Israel.
This is the first study that shows a relationship between insomnia and procrastination, Hairston said. In the study, 598 people completed online questionnaires that examined their tendencies to procrastinate, along with their sleep problems and emotional states. The questionnaires also assessed whether the people were morning or evening types, meaning whether they tended to go to bed early and get up early, or go to bed late and get up late. The researchers found that the morning people reported lower levels of procrastination and fewer sleep problems, compared with the evening people. And among evening types, those who reported higher levels of procrastination also had more sleep problems, the researchers found. The new results show that sleep problems may be an important and overlooked outcome of procrastination, the researchers said in their study, which will be published in the October issue of the journal Personality and Individual Differences. The finding that evening people tend to procrastinate more than morning people is consistent with previous research, the researchers said. But the new results also add to previous studies on the relationship between people's sleep preferences and their personalities.
For example, research has shown that morning people tend to be more conscientious, emotionally stable and socially desirable, whereas evening people tend to be more neurotic and more likely to seek novelty, the researchers said.
Research has also shown that evening people are more likely to have problems with self-control, which may lead to difficulties with planning that can underlie procrastination, the researchers said. Moreover, evening people may naturally start completing certain tasks later in the day, and then feel bad about this delay, which may lead them to postpone even further before completing the tasks.
The new study shows an association but does not prove that procrastination causes insomnia, the researchers said. It is still possible that another factor, such as perfectionism, may underlie the relationship between the two traits, the authors said. Moreover, procrastination could be the result of insomnia hindering a person's functioning, the researchers said.
More research is needed to examine the relationship between sleep problems and procrastination, the researchers said.
A new research suggests restricting the amount of time spent in bed can help those who have issues falling asleep. The American College of Physicians (ACP) says that between 70 and 80 percent of people can cure their sleeping issues by simply spending less time in bed. When a person chooses to stay awake instead of laying in bed attempting to fall asleep is a tactic used in cognitive behavior therapy (CBT), and the ACP says this should be used as the first treatment for chronic insomnia. Dr. Michael Perlis, the director of the University of Pennsylvania Behavioral Sleep Medicine Program has also studied the effects of CBT on insomnia, and says of insomnia, "[It's] likely a natural part of the human condition. If you think about the fight flight response, as a trigger for sleeplessness, this makes sense. That is, it shouldn't matter that it's 3 a.m. and you've been awake for the last 22 hours, if you're being threatened and you believe there is a threat to your quality of life of existence, it's not a good time to sleep."
If you've ever suffered from insomnia, tossing and turning in a bid to get to sleep, a new study might shed some light on why it seems impossible – even though you went to bed early.
In a bid to understand why some insomnia sufferers seem to return to a normal sleeping pattern without too much trouble, while others become more and more sleep-deprived as night after night passes, scientists from the University of Pennsylvania's Perelman School of Medicine analysed the sleeping habits of more than 500 people who had kept sleep journals for more than six months.
They noticed that the time spent in bed by the 394 participants deemed "good sleepers" didn't vary over those six months, while 36 members of that cohort spent less time in bed after developing short-term insomnia.
But it was the 31 participants who developed chronic insomnia who spent the most time in bed in a bid to get some shut-eye, and the research team have speculated that it may be one of the worst things those suffering from insomnia can do for their recovery.
"Electing to stay awake (rather than staying in bed trying to sleep) is not only a productive strategy for an individual with acute insomnia, but is also one that is formally deployed as part of cognitive behavioural therapy for chronic insomnia," lead author Michael Perlis said in a media release.
"[People with insomnia] go to bed early, get out of bed late, and they nap," he added.
"While this seems a reasonable thing to do, and may well be in the short term, the problem in the longer term is it creates a mismatch between the individual's current sleep ability and their current sleep opportunity; this fuels insomnia."
You should always consult your GP for strategies for coping with insomnia, but there are some small changes you can make in the meantime: try to maintain a regular sleeping schedule (getting up and going to bed at the same time each day), keep computers and smartphones out of the bedroom, and ensure you're sleeping in a cool, dark, quiet environment.
The research will be presented at this week's meeting of the American Academy of Sleep Medicine.
Lack of sleep can greatly increase your risk of a heart attack. Shocked? You shouldn’t be, as lack of sleep has been linked to a number of serious health problems. To fully understand this connection, let’s examine sleep and heart disease, along with ways to boost our health and reduce the risk. The World Health Organization (WHO) is warning that the lack of sleep is increasing the risk of heart disease. The WHO compares it to being as harmful as smoking and even prolonged sitting.
In the latest study, 657 men from Russia were observed closely to monitor their quality of sleep and their risk of heart disease. Over the course of 14 years, cases of heart attack and stroke were recorded from the participants.
The researchers uncovered that those men who reported incidences of sleep disorder had an increased risk of a heart attack – up to 2.6 times higher than those who had no sleeping problems.
Additionally, the risk of stroke increased fourfold in comparison to men without a sleep disorder.
Because heart disease, in particular, is one of the leading causes of death around the world, these findings are quite useful. Understanding the sleep and heart disease connection can then help us find means to improve heart health and reduce our risk of developing heart disease. Therefore, the take-home message here is, heart health starts with a solid good night’s rest.
Importance of sleep for good heart health
As previously mentioned, sleep is important for overall good health. A survey conducted between 1999 and 2004 revealed that 40 million Americans suffer from a variety of sleep disorders and most of them go undiagnosed. As you can see, sleeplessness is a large problem that needs to be addressed. Before we reveal effective means of improving your sleep, let’s further explore how lack of sleep affects our health.
Below are some of the most prominent examples of what the lack of sleep can do to your health.
Impaired brain activity, decreased brain clarity, memory fog
Moodiness
Depleted energy
Depression
Weakened immune system
Increased risk of accidents
Weight gain
Elevated blood pressure
Increased risk of diabetes
Hallucinations
Increased risk of angina and arrhythmias
Increased risk of fluid in the lungs, which can lead to heart failure
As you can see, lack of sleep affects all major functions within the body, so improving the quality of sleep is vital for your overall wellbeing.
Tips to improve sleep for good heart health
With this study in mind, it’s important that we try getting the most and best kind of sleep possible.
Many factors may contribute to your lack of sleep, which can hurt your heart health, so pinpointing the underlying cause is the first step. Do you have a particular medical issue? Are you stressed? Are you on medications that may keep you awake at night? These are important questions to ask yourself when trying to improve your sleep. Some fundamental recommendations for sleeping well involve reducing one’s stress levels, eating well (junk food can promote insomnia), staying physically active, and avoiding caffeine and other stimulants, of course. These tips can work to immediately improve your sleep.
If you avoid caffeine, exercise frequently, enjoy a healthy diet, and still can’t get to sleep, it may be time to speak with your doctor. They will be able to detect if you have an underlying condition that is preventing you from sleeping.
For example, some conditions like arthritis, an overactive bladder, and joint pain are all factors that could be keeping you awake. Furthermore, if you’re currently on certain medications, like steroids or hypertension medications, these, too, can prevent you from sleeping.
Even depression or other mental health disorders can prevent you from sleeping. Seeking out help for these conditions is important not only to treat the mental illness, but to achieve better sleep as well.
One thing to keep in mind when improving sleep is avoiding sleeping aids as much as possible. Not only do they cause side effects, like constipation, headache, and drowsiness, but they can have even more severe side effects like drug dependency, they can interact with medications you are currently on, and they can be toxic to your liver. With this in mind, it’s then important to try natural solutions for improving sleep.
Heart disease is preventable, and a good first step is to improve your sleep quality. With natural tips for sleeping better and other lifestyle factors – like eating well, exercising, and not smoking – you can successfully reduce your risk of heart disease.
Insomnia is a frustrating condition with a multi-million dollar industry attached – and there’s no guaranteed cure.
Adding to the pills, herbs and mental exercises is a new technique from Dr Andrew Weil, a scientist from Harvard University who claims getting a good night’s sleep is all about breathing.
Dr Weil’s technique is called the ‘4-7-8 Breathing Exercise’, and it’s quick, requires no equipment and costs nothing.
Better still, Dr Weil claims the technique can also be used to help with bouts of anxiety, food cravings and generally upsetting situations.
A sleep specialist tells The New Daily similar breathing techniques were often used in treating insomniacs, but users should not feel they need to stick to the designated seconds.
How to do it
The technique involves inhaling through your nose for a count of four, holding that breath for a count of seven, then exhaling slowly through your mouth for a count of eight.
“Try and keep your tongue touching the roof of your mouth while performing the technique,” Dr Weiss says in an instructional video.
When you blow out at the end, you should make a “whooshing sound”, blowing forcefully so that your lips flare out.
He advises repeating for no more than four breath cycles in your first month, before moving up to a maximum of eight cycles.
Apparently holding your breath is the most important step, as that’s when oxygen floods your lungs and bloodstream, giving a natural feeling of calm.
‘Go at your own pace’
Delwyn Bartlett, a sleep researcher and clinician at Woolcock Institute of Medical Research, tells The New Daily she often uses similar breathing techniques on patients having trouble sleeping.
“Any breathing techniques are useful because they help people calm down, but it all depends on the person’s lung capacity,” Ms Bartlett says.
“If someone doesn’t have the capacity to breathe out for eight seconds they may become even more anxious and rigid, and that won’t help them sleep.”
Ms Bartlett suggests her patients try deep breathing at their own pace, without the pressure of adhering to a specific number of seconds.
“Do whatever’s comfortable for you.”
Ms Bartlett emphasises that it isn’t normally one technique that answers the prayers of insomniacs, but a combination of different ones.
Other uses
On his website, Dr Weil explains the 4-7-8 technique can be used as more than just an insomnia cure.
“Use it whenever anything upsetting happens – before you react,” he writes.
It appears the technique can be used to assist you in just about any situation that requires calming the mind and body – even dealing with food cravings.
“Use it whenever you are aware of internal tension.”
Dr Weil also claims the technique works for mild to moderate cases of anxiety, helping you to focus on breath rather than a stressful situation at hand.
I don’t know if it’s just a writer thing, but I get spells of insomnia all of the time. I will be laying in bed, fully aware that I NEED to get to sleep so that I can function the next day, but I just can’t. I am usually fairly tired, too, but my mind just can’t shut down. I once heard that if you want to imagine what the mind of a creative individual looks like, think of a web browser with thousands of tabs open all the time. I can’t help but laugh, because it’s completely true! My mind has a hard time turning off, which makes bed time almost impossible.
I’m not the kind of person who would take prescription pills. Not knocking those who do, because we all have issues that could be helped with them, but it’s just not my style. My anxiety is already through the roof, and I know I would be imagining every side effect possible from the drugs. I would much rather use something natural to help with my problems, and luckily there are tons of things you can do to try and promote better sleep patterns that are natural.
Therapy
If your sleep problems are getting bad enough that they are interfering with your job and day-to-day life, it’s probably time to see someone about it. Your best bet is to see a therapist, who can help get to the root of your sleep issues. They can help give you ideas to fall asleep easier, and even stay asleep. You should first see someone who focuses on natural remedies, rather than medication. I always like to try every possible alternative before I resort to meds. Your therapist may ask you to keep a sleep journal, so that they can better understand what issues you are having before recommending a solution (or two). Meditation
One of the main reasons people suffer from insomnia is because their minds cannot slow down. When you go to bed with a lot on your mind, you are going to end up laying their thinking about everything before you can fall asleep. The best solution for this is to “wind down” before bed and clear your mind. Meditating is a way to be mindful and aware of all of the thoughts running through your mind. Most people who practice mindful meditation find that they are more at peace and calm after. If you allow your mind to drift during meditation, you are going to feel more relaxed later, and you may be able to finally get some sleep in that night. Studies have shown that mindful meditation led by a certified instructor improves insomnia, depression, and fatigue better than prescription medication.
BedTime Cocktails
If you have tried these suggestions, and still are having a hard time catching some shut-eye, there are some natural “cocktails” you can whip up before bed that may help. Almost everyone has heard of sleepy-time tea, a tea drink that contains ingredients like chamomile that help you fall asleep naturally. There are many more drinks you can take before bed that can help you just as much as sleepytime tea can. Hot milk is very well known for helping you fall asleep because of the tryptophan that is in the milk helps you produce sleep-aiding hormones. Some homemade drinks like turmeric golden milk can help you fall asleep by mixing coconut milk, turmeric, honey and cinnamon. Not only does it help you fall asleep, but it can also help certain illnesses like the common cold. Win-win situation there! If you like to enjoy an adult beverage before bed from time to time, many people swear by mixing hot water, whiskey, and honey for a fool-proof sleep aid.
If none of these work, don’t be ashamed to visit the doctor for a prescription. I like to try out every other option first, but sometimes there is nothing that will work for a person. Using medicine to fall asleep when needed is better than going about your life seriously sleep deprived. It can even be dangerous to try and function normally when you haven’t gotten a good night’s sleep in too long. There’s no denying that there are many ways you can try to get sleep in a natural, healthy way, however. It is also never a “one size fits all” sort of thing, what works for someone else may not work for you, so don’t be discouraged if you can’t find the answer right away. Just keep trying, and you will get it all figured out one day.
The reality is that most people have transient periods of sleeplessness. But persistent sleep disorders are a plague for those who have them. Think about common reasons why people say they can’t sleep:
Travel
Different sleeping locations (hotels, etc.)
Stress
Medications
Do any of these ring true for you? If so, you’re in an overwhelming majority.
Notice how I separated ‘travel’ from the sleeping conditions that are incurred during travel. This is because there are two separate operating factors here: One is the stress that accompanies the act of traveling itself, and the other is the change in sleeping environment. We become well-calibrated to expect certain pre-sleep rituals at home (perhaps brushing teeth, reading books, etc.), and a change in the order or format of these rituals can spell the end for deep sleep. Part of the reason is because of certain cells in the brain devoted to location (the place and grid cells): When we are in a different location, the way we know this (besides that the wallpaper and hanging art may be strange and distasteful) is because there are activations of different arrangements of these pyramidal place cells.
One set of activity lets your brain know that it’s ‘at home in the living room,’ another neuronal firing pattern in this region lets it know that it’s ‘in aisle five of the local grocery store.’
The effect that novel places have on our sleep is well-known and is referred to as the ‘First night effect.’ Current research and brain imaging has indicated that sleeping in new locations keeps the left hemisphere of the brain active, scanning for threats. Sounds picked up by the right ear (more direct pathways to the left hemisphere of the brain) seem to induce wakefulness more effectively in new environments.
Where this gets even more interesting is thinking about the survival benefit of why these phenomena exist. Certainly, sleeping lightly and being roused by small noises or other environmental changes was likely responsible for the preservation of many of our ancestors: Those who slept too soundly may not have been able to defend against or evade emergent environmental stressors. Many animals rest one brain hemisphere at a time, with the other hemisphere passively patrolling for danger.
Back to the travel example as a common source of insomnia: We optimize our behavior when under stress, and so getting stressed allows us to perform slightly better during travel. This is the modern-era equivalent of fight-or-flight: the preparation for battle is the metaphor for our approach to getting on public transportation, airlines, etc. However, too much stress can make people less effective at battle (travel), and so hence the 268,000,000 Google hits I was just rewarded with by typing in ‘travel stress.’
When we travel, we’re on high alert, which activates our sympathetic nervous system and causes us to be more vigilant. This directly leads to reduced sleep duration and/or lower quality of sleep.
Also, there are several medications which can cause or contribute to insomnia, either by directly interfering with neurochemicals involved in sleeping, or by affecting (nor)epinephrine levels, blood pressure, heart rate, etc. For these situations, there are effective pharmaceutical treatments, however some can have very long half-lives and remain in physiologically-relevant levels in the blood stream well into the next day, leading to grogginess.
The other causes and contributors of insomnia are in a certain way more difficult to identify than those on the list above, because they are part of genetics and brain structure. They are innate, and therefore difficult to separate out as a background variable. I’ve written previously about genes associated with sleep, most notably ‘Chrono.’ The genetic predisposition toward insomnia is a hypothesis still in its early stages of research, though several influential genes have been identified.
Depression is also often ironically associated with insomnia. The relationship between mental status and sleep is one in which the direction of causality has not been unequivocally determined: Often those with clinical depression have a difficult time sleeping properly; but it could also be that an underlying sleep disorder is contributory to the presence of the depression.
Another factor which appears to be associated with insomnia is the presence—or lack thereof—of white matter in the brain. Specifically, researchers observed less white matter in the right hemisphere in people who had reported suffering from insomnia. Interestingly, lower levels of white matter tend to be found as a causative mechanism in certain strokes and dementia. Problems or deficits in white matter lead to poorer information transfer across different brain regions. Limitations
The newest research focusing on white matter in the brain used a novel technique called diffusion-weighted magnetic resonance imaging, which is able to detect small variations in diffusion of water molecules within tissues of the body. Though fundamentally, there is not enough empirical data as to what a diffusion MR image should look like for nominal white matter levels, so determining certain features and considering them aberrant is a bit of a stretch. Also, the finding regarding white matter content in the brain is associative in nature, meaning that less white matter structure was associated with—but not necessarily causal in—the respondents’ insomnia. The sample size was also very small: 23 people, and a control group (regular sleep patterns) of 30 people. Additionally, the 23 people who reported insomnia were self-reporters, meaning that there were no comparative objective measures of sleep comparing the quality, type, or duration of sleep within and between the two groups.
Sleep clinics have had good success improving sleep outcomes in those suffering with sleep disorders. As we learn more about the mechanisms and physiological architecture involved in sleep, future treatments will be targeted to deal with specific types and aspects of insomnia, making the therapy more effective. Until then, the most effective practices to optimize sleep remain:
No consumption of caffeine, nicotine, or alcohol before bed (which can all interrupt sleep phases in different ways).
Establishing and maintaining a nighttime ritual, which prepares the body for sleep expectancy.
Limiting blue-spectrum lights (as found in smartphone and computer screens), which can be done by limiting viewing, using certain apps (which limit the flux of light in the blue end of the spectrum), or using blue light-blocking glasses.
And limiting stress, especially ruminative thoughts, prior to sleeping.
For those of you who have tried these palliative methods and still haven’t found substantive relief, the new recommendation for first-line treatment of chronic insomnia is to seek out cognitive behavioral therapy (CBT), which teaches more positive psychological approaches to sleep hygiene and beliefs about insomnia.
“By engaging patients to be active participants in their sleep health, CBT-I therapists teach cognitive and behavioral skills that resolve or attenuate chronic insomnia in 70% to 80% of treated persons, often without supplemental medication.” – Roger G. Kathol, MD, from the University of Minnesota in Minneapolis, and J. Todd Arnedt, PhD, from the University of Michigan Medical School in Ann Arbor.
Kathol and Arnedt also note that psychological alternatives to pharmacologic therapy for insomnia will accomplish better and safer patient outcomes. Ensuring receipt of proper care is a patient’s right, and some health practitioners don’t consider insomnia to be a health problem – but it is. Sleep is an important part of good health, and the important takeaway is that it can be properly managed.
Doha: Fasting in the month of Ramadan can have many advantages for some individuals living with various psychological disorders such as mild degrees of depression, anxiety and insomnia.
According to Dr. Suhaila Ghuloum, Senior Consultant Psychiatrist at Hamad Medical Corporation (HMC), fasting, and the spiritual and social practices that accompany it, can help some individuals cope with certain stresses in daily life. Six percent of the world’s population suffer from depression or about 350 million people of all ages, according to World Health Organisation.
Research studies revealed that fasting can help promote self-restraint and also supports anger management in individuals who may be more inclined towards being easily angered.
Fasting and associated acts of worship, such as Taraweeh (the evening prayer usually performed in a congregation with other worshipers) during the holy month of Ramadan helps to promote communication and social interaction among people. ‘Qiyam Al Layl’ (the special late evening voluntary prayers) in Ramadan can also contribute to peace of mind and thereby curb frustrations associated with the burdens and pressures of life. There are studies showing that in addition to the established physical health benefits of fasting, there are also benefits on mental health. Fasting increases the release of some endorphins, these are the body’s naturally released ‘happiness’ hormones, the deficiency of which is linked with depression and anxiety disorders. Patients with mild to moderate degrees of depression participating in such activities tend to get removed out of their secluded lifestyle and think more positively of themselves and others around them.
During the first few days of fasting, the body starts to release these ‘feel good’ hormones. As a result, individuals may find that their ‘mood’ improves. Sleep is known to improve in quality during fasting, though cultural practices of staying up late may partially interfere with that.
According to Dr. Ghuloum, international research has revealed that fasting had a great positive impact on individuals undergoing therapeutic treatment for addiction and substance abuse, as this act of worship promotes positive behavioural change in these individuals. In fact, there has been some research suggesting that spiritual practices result in structural changes to the brain in areas associated with depression, thereby offering a protective element.
One of the most common complaints of my sleep patients, especially those with insomnia, is hyperarousal. You've heard the complaint, "I just can't get my mind to turn off when I'm trying to go to sleep." What has always thought to be a nocturnal sleep disorder may be something quite different than expected: research now suggests that these patients may have a 24-hour arousal disorder.
As providers, we struggle with how best to treat our insomnia patients. We want them to have good sleep, but we are sometimes reluctant to prescribe medication as many patients end up with a lifelong dependence on sleep aids. Approximately 55% of insomnia patients prescribed sleep aids will be taking them at a 6-month follow-up visit. Cognitive behavioral therapy and sleep hygiene can be helpful, but patients are reluctant to rely on these completely when they are lying in bed staring at the ceiling.
This study noted – as I have over the years in my own practice – that patients with lower Epworth Sleepiness Scale (ESS) scores tended to have the worst difficulties with insomnia. Patients with ESS scores of less than 6 tended to be more prevalent users of prescription sleep aids compared to the patients with ESS scores greater than 11, which is consistent with excessive daytime sleepiness. This suggests that hyperarousal, which consists of anxiety and elevated alertness, is a reliable determinant of those who will chronically use prescription sleep aids. In this study, alertness was significantly associated with both baseline and chronic prescription sleep aid use. In fact, hyperarousal was associated with a 33% increase in the odds of prescription sleep aid use.
This new hypothesis suggests that insomnia with elevated alertness is a phenotype that is significantly associated with prescription sleep aid (PSA) use. In short order, all that these patients want is the ability to sleep, and sleep aids are often beneficial to them. Anxiety was significantly associated with PSA; interestingly, depression was not related to the likelihood of PSA use. For years, we have blamed insomnia on depression, so this study should give us pause about how we are treating insomnia patients. Hopefully, more research will give us the answers to this troubling condition that affects so many patients.
Do any of these ring true for you? If so, you’re in an overwhelming majority.