Sleep Archive

Doctors-in-training should be encouraged to do some on-the-job napping, according to the organization that sets the standards for residency programs around the country. The Accreditation Council for Graduate Medical Education (ACGME) issued new standards yesterday that came out in favor of a well-timed snooze. The guidelines, which are scheduled to go into effect next year, say this: Programs must encourage residents to use alertness […]

Q. I take ibuprofen p.m. on occasion — maybe once a month or so — to help me get to sleep. It seems to work. Is that okay?

A. Ibuprofen p.m. is a combination medication that contains ibuprofen and diphenhydramine, which is the active ingredient in Benadryl, an antihistamine taken for allergies.

Sleep-maintenance insomnia common complaint among women at midlife

You wake up and look at the clock: it's 3 a.m. You tell yourself you've got to get back to sleep, but thoughts about yesterday's troubles, the coming day's challenges, and all those "must-do's" race through your mind. You toss and turn and worry about not getting enough sleep. Maybe you doze off for an hour or so, but when the alarm clock gets you up for the day, you're far from rested.

Insomnia — inability to get the sleep you need to wake up refreshed — is the most common sleep complaint in the United States. It often takes the form of sleep-maintenance insomnia — that is, difficulty staying asleep, and in particular, waking too early and struggling to get back to sleep. Like difficulty falling asleep at the beginning of the night, called sleep-onset insomnia, sleep-maintenance insomnia is more common in women than in men.

Nearly everyone has spent at least one night lying in bed wishing for sleep. But for many men, it's a nightly struggle. A lucky few get relief from counting sheep, watching late-night movies, or sipping warm milk (or something stronger) — but most people with insomnia need more assistance. Fortunately, lifestyle changes and behavioral treatment can help many sufferers, and medication is available for those who need it.

Normal sleep

Sleep is essential for health, providing rest and restoration for mind and body. But although it's restful, sleep is actually quite complex and busy in its own right.

The snorts, whistles, gasps, and groans you make while sleeping may do more than rob you and your bed partner of a good night's sleep. They may steal years of your life, too. That's the message from two large studies that looked at the influence of sleep apnea, a special cause of snoring, on life span.

What is sleep apnea?

When you breathe, air usually flows soundlessly through the nasal passages and the pharynx (the back of the throat), and then on into the lungs. During sleep, the small muscles that hold open the pharynx relax, allowing the tissue to flop into the airway. Air rushing through this loose tissue can make it vibrate. We hear the vibrations as snoring.

Hot flashes aren't anybody's friend, but they may be getting an unfair rap for disrupting women's sleep at midlife. Studies have often reported that sleep problems increase during the menopausal transition, reinforcing the idea that hot flashes (also called vasomotor symptoms) are to blame. But even under controlled conditions in sleep laboratories, the connection between hot flashes and sleep disruption remains unclear. Moreover, in certain circumstances, vasomotor symptoms may be the result — not the cause — of nighttime awakenings. Now, a study concludes that some of the sleep problems that women typically attribute to hot flashes may instead be caused by primary sleep disorders such as apnea. The findings suggest that women may not be receiving appropriate treatment for their sleep difficulties.

To determine the cause of poor sleep in peri- and postmenopausal women, researchers at Wayne State University School of Medicine in Detroit assessed the sleep of 102 women, ages 44 to 56, who reported having trouble sleeping. The researchers found that 31 women had periodic limb movements (PLM), 23 had sleep apnea, and six had both. In other words, 53% had a primary sleep disorder. Among the entire group, 56% had measurable hot flashes. A separate analysis of the data showed that while apnea, PLM, and brief awakenings were the best predictors of poor sleep in the laboratory, on the questionnaires completed beforehand, poor sleep was more likely to be associated with anxiety and hot flashes during the first half of the night.

Why sleep is important to your health and how to repair sleep deprivation effects.

If sleep were a credit card company, many of us would be in deep trouble.

Medical evidence suggests that for optimum health and function, the average adult should get seven to nine hours of sleep daily. But more than 60% of women regularly fall short of that goal. Although each hour of lost slumber goes into the health debit column, we don't get any monthly reminders that we've fallen in arrears.

Disturbed sleep can trouble the heart and a troubled heart can disturb sleep

Sleep seems to be such a serene way to replenish energy and restore the mind. For your heart, blood vessels, and immune system, though, it's anything but peaceful. There are periods of calm, to be sure, but they are rudely interrupted by abrupt spikes in blood pressure and heart rate. Blood flow through the heart and brain varies widely during sleep, as do electrical activity in the heart, the elasticity of blood vessels, and the tendency of blood to clot. And all of this activity is just part of a normal night's sleep.

Researchers are just beginning to reveal the two-way street between sleep and heart disease: Poor sleep can interfere with the heart, and heart disease can disturb sleep.