Desperately Seeking Shut-eye

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Once upon
a time, getting a good night’s sleep wasn’t an issue for
me. I went to bed when I was tired and woke up feeling refreshed.
No tossing and turning before I drifted off to dreamland –
no middle-of-the-night awakenings. Then I started having babies,
who roused me at all hours and made eight-a-night a thing of the
past. But even after they started sleeping soundly, I couldn’t
seem to slip back into my old, good-sleep patterns. Why?

“Many
factors go into whether or not we’re able to fall asleep and
stay asleep, such as stress, hormones, and what’s going on
in our lives at a given time,” says Jacob Teitelbaum, MD, medical
director of the Fibromyalgia and Fatigue Centers. “And since
all of these factors fluctuate as we go from one life stage to another,
we can expect our sleep patterns to change as well.”

The statistics
alone on Americans and insomnia could keep you up nights. As a nation,
we spend more than $3.5 billion on prescription sleep medications
each year, trying to bring relief to the 126 million of us (that’s
six out of 10 Americans) who experience symptoms of insomnia at
least a few nights a week. How does this inability to get a good
night’s rest affect us? Ninety-three percent of Americans believe
sleep loss can impair work performance, and 86 percent feel a lack
of sleep can lead to health problems.

So what’s
an insomniac to do? “Understanding why you might be experiencing
trouble sleeping can help you make changes that will lead to better
sleep,” says Teitelbaum. Here’s a guide to how your sleep
can change through the years – and what to do to give yourself
the best shot at a better night’s rest.

Teens and
early 20s

For a young
adult, the obvious sleep robbers – late nights, too much television
and computer time, poor diet, and school or new-job stress –
clearly play a role in sleep disorders, but teens and 20-somethings
also have a physiological reason for not sleeping well. Their circadian
rhythm – the natural body clock that signals when to go to
sleep and wake up – is in flux.

In young adults,
the body produces melatonin – a hormone created by the brain
to help induce sleep – at 9 p.m. or 10 p.m. (in adults that
happens earlier, around 7 p.m. or 8 p.m.). So a teen’s sleep
cycle gets pushed back, which explains why she might not feel sleepy
until around 11 p.m. or midnight. What’s more, everyone gets
a “dip” in their circadian rhythm twice a day; for adults
they typically come at 2 a.m. and 2 p.m., while adolescents hit
their low points around 7 a.m. and 4 p.m., which explains both their
torturous early-morning wake-up calls and late-afternoon naps.

Too much caffeine
can also affect sleep in this age group. From after-school lattes
to late-night energy drinks, a caffeine jolt lasts well beyond bedtime
– affecting a young adult’s ability to fall and stay asleep
and worse, setting the body clock back even further.

Sleep-Well
Tips

  • Stay warm.
    Take a hot bath or shower before getting into bed. Cold temperatures
    can delay the release of melatonin – the last thing a teen,
    whose melatonin release is already delayed, needs.
  • Steer clear
    of sleep-sabotaging caffeine in the afternoon and evening.
  • And parents,
    fill your kids in on another downside of smoking: Nicotine is
    a vasoconstrictor that affects circulation and prevents deep levels
    of sleep, which is when the body restores, heals, and regenerates.
  • Consider
    blue light therapy. Scientists at the Lighting Research Center
    at the Rensselaer Polytechnic Institute in Troy, New York, found
    that light travels to the back of the eye and reaches the master
    clock in the brain, which means exposure to light and dark stimuli
    help re-set the body’s clock to match the solar day. Teens’
    circadian rhythms are set to make them fall asleep late at night
    and thus wake up later in the morning. Keeping the lights dim
    when teens have to wake up for school or work – and then
    exposing them to blue light when they would’ve naturally
    awakened mid-morning – can reset their clocks enough so that
    they get sleepier earlier in the evenings. Why blue light? The
    researchers believe it’s tied to the thousands of years humans
    worked almost completely outdoors, making us blue sky-sensitive
    creatures.

20s, 30s,
and early 40s

Sleep research
shows that adults need seven to nine hours of shut-eye a night,
with a little more than eight ideal. At this time in our lives,
however, we’re often too busy creating careers and families
to find that much time for sleep. Our outward focus not only cuts
into that ideal snooze time, it also creates a lot of stress, says
Evangeline Lausier, MD, assistant clinical professor of medicine
at Duke Integrative Medicine in Durham, NC. “For so many, this
is a high-anxiety time of life, because it’s nearly impossible
to get as much solo time and relaxation as you need,” she says.
“So even little stressors, like getting stuck in traffic or
getting the kids ready for school, can cause a lot of anxiety.”

And while it
may seem obvious that anxiety will keep you tossing and turning
at night, research has shown that it actually produces a physiological
change in the brain that can make drifting off next to impossible.
Stress and anxiety trigger the release of cortisol, the fight-or-flight
hormone that prompts you to feel alert and awake. Cortisol levels
are typically high in the morning and low at night, but too much
stress-induced cortisol production during the day causes a decrease
in the evening production of serotonin – the hormone that helps
you wind down. “If the cortisol stays high at night, when it
should be low, then you get a double whammy of having too much cortisol
and not enough serotonin at bedtime,” says Teitelbaum. This
leaves you wide awake when you should be sleeping.

Sleep-Well
Tips

  • Take power
    naps. Rather than disrupt your sleep-wake cycle by going to bed
    earlier than usual one night and late again the next, sneak as
    little as 10 minutes of snooze time before dinner. Research shows
    this can improve cognitive abilities, without the post-nap grogginess.
  • Sleep with
    white noise. The steady hum of an air purifier or a fan will train
    your brain not to wake up to everything it hears.
  • Exercise
    (and that includes having sex!). The feel-good endorphins released
    by physical exertion play a big role in helping us fall asleep
    faster and stay asleep through the night, says Teitelbaum. And
    you don’t necessarily have to work out in the morning. Some
    studies show exercising a couple hours before bed promotes sleep.

From late
40s on

As women enter
their 40s and 50s, their menstrual cycle starts to change. During
this transition, hormones seemingly run amok, and since they help
control all bodily functions – including sleep – “the
change” can disrupt shut-eye. Around age 50, for example, fluctuating
hormones commonly cause hot flashes, which can wake a woman out
of deep sleep and make it difficult for her to fall back. Men experience
something similar, called andropause, which hits around this time.
Most often marked by testosterone deficiency, andropause can cause
depression, night sweats, and achiness – all of which can disrupt
sleep.

Alcohol can
also affect sleep. “So many of us think of alcohol as a sleep
aid, because it helps us drift off quickly,” says Ulysses Magalang,
MD, director of the sleep medicine program at Ohio State University
Medical Center. “But while it’s true that alcohol will
make you fall asleep faster, it actually causes a lot of brain arousal
once it’s metabolized – which usually happens during the
second half of the night.” The result? An inability to achieve
deep, slow-wave sleep, the restorative type of sleep that helps
us feel so well rested in the morning.

Read
the rest of the article

November
13, 2009

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