<![CDATA[Sleep - Health.com]]>

<![CDATA[Sleep - Health.com]]> en daily 1 Subscribe with My Yahoo!Subscribe with NewsGatorSubscribe with My AOLSubscribe with BloglinesSubscribe with NetvibesSubscribe with GoogleSubscribe with PageflakesSubscribe with PlusmoSubscribe with The Free DictionarySubscribe with Bitty BrowserSubscribe with Live.comSubscribe with Excite MIXSubscribe with WebwagSubscribe with Podcast ReadySubscribe with WikioSubscribe with Daily Rotationf you have difficulty falling or staying asleep, it can affect all aspects of daily life. Here's what everyone looking for some quality shut-eye needs to know. <![CDATA[Sleep-Deprived Americans Can't Get Any Shut-Eye]]> http://feeds.health.com/~r/health/sleep-disorders/~3/qGJ40mGbacQ/0,,20316621,00.html

And people in the eastern United States—particularly West Virginians—have it the worst, according to the first survey to take a state-by-state look at people’s perceptions of sleep—or lack of. (People in California and North Dakota seem to get the best rest.) The Centers for Disease Control and Prevention (CDC) survey found that overall, more than 1 in 10 people, or 11.1%, did not get enough sleep or rest on any night in the past 30 days. A lucky 30.7% said they got enough rest or sleep every night for the past month.

The rest fell somewhere in the middle, according to the 2008 survey of 403,981 adults.

As people got older, they tended to report better sleep. Hispanics slept better than whites or blacks, while men slept better than women. A whopping 25.8% of people who were unable to work said they had not gotten a single night’s good rest in the previous month, while 13.9% of unemployed people fell into this category, compared to 9.9% of people with jobs and 11.1% of students and homemakers.

There were big differences among states, with 19.3% of West Virginians reporting no nights of adequate rest for the past 30 days, compared to 7.4% of North Dakotans and 8% of Californians. Other bad-sleep states included Tennessee, with 14.8% having been sleep deprived for the past month; Kentucky, with 14.4%; and Oklahoma, with 14.3%.

The study suggests that people out West really may be more relaxed than Easterners: in fact, 12 of the 14 best-sleeping states were west of the Mississippi.

The authors of the CDC report suggest that the higher prevalence of obesity, hypertension, and other chronic disease in the southeastern U.S. could be a factor in why people there aren’t getting a good night’s rest.

Next Page: Aim for 7 to 9 hours a night

But this report didn’t look at the reasons behind people’s lack of sleep, or ask them how many hours of sleep they actually got. While the National Sleep Foundation recommends that people aim for seven to nine hours a night, many seem to be falling short.

For Elizabeth Gordon, six hours of sleep a night is pretty darn good. She’s had trouble sleeping on and off since second grade, and now with a 1-year-old and a 3-year-old, those quiet hours after the kids go to bed are a good time to get things done.

“I’ll be exhausted at 9 and then I get a second wind and I’m up to like 1 or 2,” says the Maplewood, N.J., mom.

Rich St. Germain, 40, a self-employed business appraiser in New Castle, N.H., doesn’t have little kids—but that doesn’t mean he rests easy. “I personally go through bouts of insomnia when I’m stressed out. My head hits the pillow and my mind starts racing…it is awful. Exercise seems to help, but stress can still get the better of me.”

Experts agree that exercising during the day—if it’s not too close to bedtime—is a great way to improve your chances of getting a good night’s rest. Other common-sense advice: Stay away from caffeine in the afternoon and evening, and make your bedroom a TV- and Internet-free zone.

If these strategies don’t work, get some professional help, sooner rather than later, says Lisa Shives, MD, the medical director of North Shore Sleep Medicine, a sleep center in Evanston, Ill.

Many patients who complain about insomnia to their primary care doctor might immediately be prescribed a pill. However, sleep medications are no long-term solution, Dr. Shives says. “They don’t work great; they don’t work forever,” she explains. “What we really try to do is teach people coping strategies, teach them relaxation techniques, and teach them really good habits.”

Some really bad habits? Late-night TV-watching and Internet surfing, she says. “You don’t want anything late at night that gets a lot of light into your eyes because it signals to your brain center that it’s time to get up and feed the chickens,” Dr. Shives says. Tossing and turning in bed while worrying about not sleeping is another bad idea. “Lying there trying to sleep is going to frustrate you, give you anxiety, and totally perpetuate the anxiety you’re developing around your sleep,” she explains.

Dr. Shives recommends going through the American Academy of Sleep Medicine to find an accredited sleep center.

]]> Getty Images http://www.health.com/health/condition-article/0,,20316621,00.html <![CDATA[How to Survive Jet Lag: Advice on Medication and Sleep-Friendly Habits]]> http://feeds.health.com/~r/health/sleep-disorders/~3/lDVILinPj0s/0,,20315009,00.html

A jaunt to London, Milan, or Paris just won’t feel like a vacation if you can’t shake off the time-zone shake-up. That’s why Health magazine asked Minnesota Regional Sleep Disorders Center expert Carlos Schenck, MD, author of Sleep: The Mysteries, The Problems, and The Solutions (Penguin/Avery Press, 2007), to share his tricks for combating jet lag. For more than two months a year, Dr. Schenck treks across the country and overseas, speaking at sleep powwows. And he swears he’s never fallen asleep in the middle of a meeting.

Q: Everyone hates jet lag. Why does it happen?
A: There is a master clock in your brain that programs your body to wake up, have breakfast, lunch, and dinner, and go to sleep in concert with the daily sun cycle where you live. The more time zones you cross, the greater the mismatch in sleep-wake rhythm between your home time zone and your “adopted” one—and the greater the feeling of inappropriate sleepiness or wakefulness.

Q: Any ways to prevent it?
A: It depends on where you’re going. Sleeping as much as possible on an overnight flight to Europe (west-east travel) helps you stay awake the next day. Two drinks might help you sleep, but also drink plenty of water. After you arrive in the morning or early afternoon, two cups of coffee may help you stay up. Get bright light early in the day to keep awake by turning on a bright lamp or taking a walk in the sunshine. Unless you can take a nap at home without it affecting your sleep at night, avoid naps; they can increase the tendency to stay up too late, and then you’ll wake up too late the next day.

If you’re going in the opposite direction (east-west travel to, say, Hawaii), arriving typically in the afternoon, take a nap on the plane or upon arrival to help you to stay awake longer and soak up a bit of late-afternoon sun. If you fall asleep too soon, then you’ll wake up too early the next morning.

Q: You didn’t mention sleeping pills. Are those a good idea?
A: A very short-acting pill like Sonata or Ambien may help on the way to Europe, but don’t take it while drinking unless it’s about two hours after having wine with dinner. For east-to-west travel, take a long-lasting pill, like Lunesta or Ambien CR. But never take any sleeping pill for the first time on a plane; get used to it at home first.

Q: Some people swear by the supplement melatonin. Can that help?
A: The levels of the hormone melatonin rise as our brains register darkness and prepare for sleep, regulating our sleep-wake cycles. After arriving in Europe, if you want, take 3 milligrams of melatonin two to four hours before bed to help you feel sleepy.

Q: Is it crazy to shift to the new time before you travel?
A: No, not crazy, but you have to be quite motivated. Do this in steps over a period of days. Otherwise, sleep could become a problem even before the trip.

Q: So you really never have jet lag away from home? That seems hard to believe.
A: It’s true. Going to Europe, I try to take the latest flight in the evening. My favorite time: a 9 p.m. flight. After dinner and wine, it’s easy for me to sleep a good four to five hours.

This article was first published in Health magazine, July 2007.

]]> http://www.health.com/health/condition-article/0,,20315009,00.html <![CDATA[5 Ways to Fall Asleep Faster]]> http://feeds.health.com/~r/health/sleep-disorders/~3/lfe0SmPjHRQ/0,,20283287,00.html

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Are economic worries keeping you awake? How do you cope?

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"Charlotte has been really hit recently; Wachovia [is] based here, and so our phones have just been ringing off the hook the past few weeks with people complaining about sleeplessness and insomnia," she says, referring to the ailing bank that is close to being swallowed up by Wells Fargo. "The economy means our jobs, and that’s always much more threatening than other problems that can seem easier to intellectualize and think through, especially when we’re lying awake and things seem hopeless. It’s our bread and butter, our source of pride, and that hits home a lot faster than other crises."

Next Page: Stress takes a physical toll

 The progressive decline of the economy has been taking a physical and emotional toll on people across the country, according to a 2008 Stress in America survey released in October by the American Psychological Association. About half of the people polled said they are increasingly stressed about their ability to provide for their family’s basic needs, and 80% say the economy is a significant source of stress (up from 66% in April). Women especially reported worries about money, job stability, housing costs, and health problems affecting their families.

Compared with 2007, more respondents also said they are fatigued, irritable or angry, and lying awake at night as a result of stress. Almost one-fifth of Americans reported drinking alcohol to manage their stress, and 16% reported smoking—two factors that can affect your ability to get quality sleep. (Gauge your personal stress level here.)

Another recent survey by BettyConfidential.com found that women are concerned about issues like "affording groceries and other staples like gas," "losing what took so long to acquire," and "things getting worse in the country and it affecting me." One respondent wrote, "I don’t sleep more than four hours a night. I get headaches. I worry that my kids can’t go to college and my doctor now has me on antianxiety meds. (Thankfully, they are cheap!)" It’s not just U.S. citizens who are affected by the global crisis, either: British website NetDoctor.co.uk found that one-fifth of U.K. residents surveyed are regularly getting fewer than five hours of sleep a night, and one-fourth wake up more than three times a night. Two-thirds of those reporting insomnia cited money and work as sources of their sleep troubles.

Next Page: Is it possible to chill out?

Some people may be able to break this cycle by taking a step back: "Turn off the news and turn off your computer a couple of hours before bed," advises Dr. Esther. "We now have access to news 24 hours a day and we are certainly taking advantage of it. And this is a particularly difficult time because it’s been such a roller-coaster ride and everyone is just waiting, checking back constantly to see what will happen. It reminds me of what people went through right after 9/11, this sense of unknown anxiety."

A break from all that intensity may be just what you need. Read a fashion magazine or a funny book—something to make you laugh and get your mind off money and the news. Try getting your news updates in the morning, when you have a fresh start.

Basic sleep hygiene rules are still important: Be sure you’re getting enough downtime before bed, even if it means putting away your checkbook and bills after dinner or promising yourself you’ll leave work at a decent hour. Pay attention to how you handle stress too: If you’re turning to alcohol or cigarettes more than usual, alter your habits—try exercising or taking a walk instead.

Get help if you need it
If these tactics don’t help after a few weeks of sleeplessness, see a doctor. "If patients come to me and say that they just can’t get their mind off these problems, then it’s a perfectly appropriate time to use a sleep aid," Dr. Esther says. She doesn’t often recommend over-the-counter medications (most include antihistamines and can leave people feeling drowsy or hungover the next day); instead, she might prescribe a few weeks' worth of prescription hypnotic medication to break a cycle of sleeplessness.

You and your doctor should decide how—and how often—you’ll take this medication. Some patients benefit from a pill every night, while others may take pills only as needed, such as two or three times a week.

"Often Sunday nights are particularly difficult, because you’ve been up all weekend and you’re worried about work the next day," says Dr. Esther. "It always depends on the patient." Newer prescription sleep medications, called nonbenzodiazepines, have been shown to cause less rebound insomnia—so you can stop taking them as soon as your sleep problems are under control, provided you continue to practice good sleep habits.

It’s also important to talk to your doctor to see if you may be at increased risk for depression—especially if your sleeplessness lasts for more than a few weeks or leads you to spend your daylight hours sitting at home dozing in and out. In such cases, an antidepressant may work better than a normal sleeping pill.

Whether you’re out of work or overworked, a few things remain constant. Establishing a regular routine—including waking up at the same time, exercising, and getting out in the sunshine during the day—and working step-by-step toward goals can help keep you focused and upbeat. And putting your sleep needs first—whether that means closing your laptop, devoting eight hours to bed, or talking to your doctor about short-term solutions—will leave you better able to overcome the challenges ahead.

]]> Don't overdose on stressful financial news, especially right before bed. (FOTOLIA) http://www.health.com/health/condition-article/0,,20235290,00.html <![CDATA[Tired of Ambien? Meet the Sleep Medications of the Near Future]]> http://feeds.health.com/~r/health/sleep-disorders/~3/chXQKQX1ZPE/0,,20245385,00.html

insomnia to restless legs syndrome, they haven't stopped the pharmaceutical industry from searching for newer, more effective, and more profitable medications.

No new prescription sleep drugs hit the market in 2008, but research in several fields is under way. "I'm excited about a lot of these new drugs," says Lisa Shives, MD, president and medical director of Northshore Sleep Medicine in Evanston, Ill., and spokesperson for the American Academy of Sleep Medicine. "The brain is a complicated setup with approximately 17 different neurotransmitters involved in the sleep-wake cycle and, as soon as we fully understand all of them, drugs will present better solutions for sleep disorders."

Here, some potential treatments that could soon help you rest easier—and suggestions for what to do in the meantime.

For jet lag or shift work
In the pipeline: Two clinical trials have found that a new medication called tasimelteon helped subjects whose sleep pattern had been shifted forward by five hours fall asleep faster and sleep for longer. The drug, called a melatonin analogue, works by targeting melatonin receptors in the brain. Melatonin is the naturally occurring hormone that helps regulate the body's sleep-wake patterns. Unlike existing benzodiazepine-hypnotic sleep medications, melatonin analogues have shown no tendency toward addiction or dependence. The manufacturer of tasimelteon hopes the product will be available to patients within the next few years.

For now: While there's no drug specifically approved for helping jet lag sufferers sleep, Dr. Shives explains that taking over-the-counter melatonin "one or two hours before your new adjusted bedtime" for two to four days before an east-bound flight can help your body transition. (East-bound flights are typically tougher on sleep schedules than west-bound flights.) Upon arrival at your destination, you would take melatonin at your desired bedtime, and then upon your return home, you'd take it again at your regular bedtime to help readjust. Read more about melatonin.

For age-related sleep issues
In the pipeline: Circadin, a new drug developed in Israel, may help people 55 and older get much-needed sleep, as melatonin levels in their brains decrease as a consequence of aging. By slowly releasing small amounts of melatonin over time—rather than one immediate dose, as is typically the case with over-the-counter melatonin—the drug has been shown to help people sleep thorough the night without sacrificing next-day alertness. Already available in several European countries, Circadin is expected to be offered stateside sometime in 2009.

For now: The first thing Dr. Shives recommends is a thorough examination to determine the cause of the sleeplessness, whether it's insomnia or an underlying problem like sleep apnea. For insomnia, she recommends patients try cognitive behavioral therapy along with low doses of prescription nonbenzodiazepines, such as Ambien, Lunesta, or Sonata, which have been shown to cause relatively low incidences of grogginess and next-day alertness problems. Although she does not recommend it, she notes that it was common in the past for people to take over-the-counter antihistamines for their sedating properties. "If an antihistamine doesn't say it's non-drowsy, it will make you drowsy," she explains. "But we should always be careful when using antihistamines because they may have the opposite affect and make older patients feel wide awake." Read more about sleep and aging.

Next Page: For those who can't sleep through the night

For those who can't sleep through the night
In the pipeline: U.S. Food and Drug Administration approval is pending for Intermezzo, a new medication to help insomnia sufferers fall back to sleep when they wake up in the middle of the night. The lozenge, which dissolves on the tongue in about two minutes, contains 28% of the active ingredient zolpidem, which is found in Ambien and its generic version. This lower dosage allows Intermezzo's effect to wear off in three or four hours, making waking up in the morning easier.

Why not just take half of a stronger pill? "The doses come in 1.75 and 3.5 milligrams, so it's not quite the same as cutting a [5- or 10-milligram] Ambien in half," explains Dr. Shives.

For now: If you're taking these medications as directed and still wake up in the middle of the night, talk to your doctor about altering your plan. You might consider changing medications, raising your dosage, adding a shorter acting drug to your regimen, or taking half of a pill when you wake up. (Some medications, though, such as Ambien CR and other time-release formulas, will not work properly when cut in half.) Read more on prescription sleep aids.

For restless legs syndrome
In the pipeline: Calming jittery legs may one day be as easy as slapping on a Band-Aid. The medicated skin patch Neupro, which is approved in Europe for the treatment of Parkinson's disease, was shown to help relieve RLS symptoms in a July 2008 study. Neupro contains the dopamine agonist rotigotine and is designed to be applied once a day to offer 24-hour support for moderate to extreme suffers. Although the rotigotine patch was previously available in the United States for the treatment of early-stage Parkinson's disease symptoms, it was pulled off the market in April 2008, due to problems with its delivery system. The manufacturer plans to initiate proceedings with the FDA in 2009 to bring the patch back to the U.S. market.

Another new drug, called Solzira, has also shown promise in the treatment of RLS. Unlike previous dopamine agonist RLS medications, Solzira's active ingredient is gabapentin—an anticonvulsant drug currently approved to treat epilepsy and also commonly prescribed off-label to relieve hot flashes. (It's also commonly used to treat migraines and chronic pain.) Clinical trials have shown safety and effectiveness in easing RLS symptoms in the course of 12 weeks, and the FDA recently asked Solzira's manufacturer to reorganize and resubmit its application for drug approval consideration.

For now: The prescription dopamine-agonist Requip became available as the generic ropinirole in May 2008, giving RLS sufferers a less expensive treatment option. The other leading drug approved for restless legs syndrome, Mirapex, is still available as a brand name only. Read about drug-free treatment options.

Next Page: For insomnia

For insomnia
In the pipeline: In higher doses, the drug doxepin is used to treat depression and anxiety—but at doses as small as 3 to 6 milligrams, it has been shown to help insomniacs too. The drug's sedative abilities improved the total sleep time of those involved in a clinical trial. Silenor, the proposed trademark name, is expected to receive FDA review by February 28, 2009.

For now: "There have been lots of clinical studies showing that cognitive behavioral therapy does better in the long run for people with chronic insomnia," Dr. Shives says. "But it can be hard to find CBT physicians, they're not always covered by insurance, and it takes at least four to eight sessions before it begins to work. For those patients are willing to try CBT, sometimes they need short-term medication as well." Watch how medications and behavioral changes can work together to help you sleep.

For sleep apnea
In the (not-too-near) pipeline: The severity of sleep apnea might be related to levels of omega-3 fatty acids in the body, researchers from the University of Missouri in Kansas City reported in a 2008 study. Of the 350 test subjects, those with lower body levels of docosahexaenoic acid (DHA), a type of omega-3 fatty acid, had more severe cases of apnea. It's not clear yet whether severe apnea lowers DHA levels, or whether less DHA leads to worsening apnea. More studies are certainly required, but if this link is established, a DHA-derived drug treatment is a possibility.

Dr. Shives is hopeful that drug therapies that target the brain's neurotransmitters may hold promise for patients with sleep apnea. "If you asked me a couple of years ago if we'd ever have another treatment besides the CPAP machine, I'd have said no," says Dr. Shives, referring to the continuous positive airway pressure device. "But it all goes back to the neurotransmitters." The same chemicals that control the sleep-wake cycle may also control the tone and stiffening of the muscles in your throat that keep the airway open, she explains. If researchers can develop a pill to activate those neurotransmitters to keep throat muscles toned, in theory, airway tissues wouldn't collapse and sleep apnea could be lessened or even avoided.

For now: Though it's too early to draw any specific guidelines from the University of Missouri research, you can increase your omega-3 intake by adding fish and nuts to your diet. And though sometimes uncomfortable, the CPAP machine has proven results. Read more about sleep apnea treatments.

It's estimated that it takes an average of 12 years and nearly $500 million to get a new drug from the lab to pharmacies—and even once a drug is approved, post-marketing studies are often just beginning. The fact that these medications have shown promising results is encouraging, but there's no guarantee that they'll solve your specific sleep problems or even make it to the market. Until you can try them for yourselves, talk to your doctor about healthy habits, relaxation techniques, and current treatment options that can help you get your z's.

]]> New sleep medications could reach pharmacy shelves in 2009. (ISTOCKPHOTO) http://www.health.com/health/condition-article/0,,20245385,00.html <![CDATA[Quick Facts About Insomnia: What You Need to Know Now]]> http://feeds.health.com/~r/health/sleep-disorders/~3/d71WC-Pi8jY/0,,20188381,00.html

]]> http://www.health.com/health/condition-article/0,,20188381,00.html <![CDATA[Provigil and Nuvigil: Medication Options for Sleep Apnea and Daytime Sleepiness]]> http://feeds.health.com/~r/health/sleep-disorders/~3/pzCSDu0rBEI/0,,20189595,00.html

Obstructive sleep apnea is not generally treated with medication; in fact, sleeping pills and other sedatives can worsen the condition. But if a patient suffers from excessive daytime sleepiness even while using a continuous positive airway pressure (CPAP) machine at night, there are medication options that can promote wakefulness.

These drugs are available by prescription only, are not meant to be a substitute for other sleep apnea treatments, and should only be taken in addition to nightly CPAP therapy.

The following is from our A-Z Health Library:

]]> http://www.health.com/health/condition-article/0,,20189595,00.html <![CDATA[Cancer, Chemotherapy, and Insomnia: 15 Home Treatment Tips to Help You Sleep]]> http://feeds.health.com/~r/health/sleep-disorders/~3/zdAdwnxY8WI/0,,20188521,00.html

]]> http://www.health.com/health/condition-article/0,,20188521,00.html <![CDATA[Prescription Sleep Drugs: What You Need to Know Now]]> http://feeds.health.com/~r/health/sleep-disorders/~3/X5jboaO0QPo/0,,20188971,00.html

But not all prescription options have been shown to be effective for long-term treatment of insomnia. And many of these medicines can cause side effects such as low blood pressure, anxiety, and nausea. Evidence suggests that these medicines also may become less effective when your body gets used to them.

Not all prescription sleep medicines are the same. Here are a few options you may discuss with your doctor.

Hypnotic medications, such as benzodiazepines and nonbenzodiazepines, help you fall asleep or stay asleep.
Antidepressants that have a calming or sedative effect are sometimes prescribed to aid sleep.
Rozerem is a different type of sleep medicine that helps regulate your body's internal clock. Rozerem has few side effects and appears to be non-habit-forming.

When taking prescription sleep medications, it’s best to take them only as directed by your doctor, for a short period of time at the lowest-effective dose. It’s important to stop taking them as soon as you can; older adults especially can become dependent on sleep enhancers. Also, be sure to talk to your doctor about other drugs or supplements you might take along with your sleep medication, to protect against dangerous interactions or unnecessary side effects.

For long-term treatment, behavioral therapy has proved to be more successful than medication. Behavior modification can both improve sleep quality and teach you how to fall asleep, without side effects.

]]> http://www.health.com/health/condition-article/0,,20188971,00.html <![CDATA[Sleep Studies: What You Need to Know Before You Go]]> http://feeds.health.com/~r/health/sleep-disorders/~3/ri3RTnfR5Rg/0,,20188242,00.html

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