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among Americans, 15 percent of whom saythey suffer from chronic insomnia, which maydrag on for weeks, months or even years.

“We need sleep to rejuvenate ourselves atnight,” says Nader, sitting in one of the sleepstudies rooms of her Menlo Park clinic, wherea queen-size bed complete with a teddy bear ispart of the furnishings.

“Try not sleeping for a whole night and youare a zombie. More car accidents are caused bysleep deprivation than by alcohol intoxica-tion,’’ she says. “The more sleepy you are, themore dangerous you are. Not to mention thehealth risks of not getting enough sleep.”

“People don’t realize how serious it is tohave sleep problems,” continues Nader, whoseclinics in Menlo Park, Los Gatos and SanFrancisco diagnose and treat a wide variety ofrelated disorders. “Heart disease, high bloodpressure, sexual dysfunction, stroke, poormental health, obesity — all of them can berelated to poor sleep.”

By Melinda Sacks

Your husband’s head has barely hit the pil-low and already he’s snoring away. Meanwhile,you lie next to him with eyes wide open, worry-ing about the kids, work, bills — and how youwill get up in the morning if you can’t get anysleep tonight.

Or, it’s 3 a.m. and the glow from the alarmclock seems to be getting brighter by theminute. The harder you try to doze off, themore awake you feel. The odds of your beingalert for that 8 a.m. meeting are not lookinggood.

Sound familiar? According to the NationalSleep Foundation, nearly 40 percent of adultssay they have some symptoms of insomniawithin a given year. Lack of sleep, says TaraNader, managing director of Bay Sleep Clinic,has reached epidemic proportions in the UnitedStates. And the results of poor sleep are farmore significant than most people realize.

Insomnia, Latin for “no sleep,” is defined bythe non-profit National Sleep Foundation(NSF) as the inability to fall asleep or remainasleep. It is the most common sleep complaint See SHUT-EYE, page 12

Having troublecatching your Z’s?Take steps to get

a good night’s rest.

The no shut-eye bluescoverstory

Photos by Norma Lopez Molina

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Most people who suffer from insom-nia find the problem plagues them for afew nights and then goes away for awhile. Half of all those who experienceit report that it is related to stress andworry, according to a 2004 nationalsleep survey conducted by NSF.

When it comes to shut-eye, howev-er, the number of hours logged isn’t thesole answer.

“An individual’s sleep requirementdepends on sleep quantity as well assleep quality and timing,” says Dr.Shanon Takaoka, a pulmonary/criticalcare physician and post-doctoral fellowat the Stanford Sleep Disorders Center.“Although existing data suggest thateight to nine hours of sleep is optimal for

many people,” she says, “there is con-siderable variability in sleep length.”

To figure out a person’s require-ments, Takaoka says it is important toknow how long he or she would sleep ifleft to awaken on his/her own. It is alsocritical to notice how fatigued someonefeels after different amounts of sleep.The goal is to obtain enough sleep towake refreshed and be able to remainalert without effort through the day.

Good sleep hygieneTo become a healthy sleeper, it’s use-

ful to think about sleep as part of over-all personal hygiene. Just as we brushour teeth and try to eat a healthy diet,developing and maintaining goodsleep habits will lead to better health,according to Takaoka.

For most people, following somesimple steps can pave the way to a bet-ter night’s repose:

Before bed:• Avoid alcohol. Even though it may

help you fall asleep, it will wake youup in a couple of hours.

• Don’t eat or drink a large amountwithin four hours of bedtime.

• Eliminate or reduce caffeine inyour diet, especially during the last six

hours of the day.• Get some exercise daily, but not

within three or four hours of bedtime.Yoga, meditation and other forms ofrelaxation can also be very helpful.

• Take a warm shower to raise yourbody temperature. As your tempera-ture falls after the shower it will helpyou become sleepy.

• Keep naps to no longer than onehour.

• If you wake up and can’t fall backto sleep within 15 minutes, leave thebed and try reading or drinking a glassof warm milk until you are sleepy again.

• When you wake up in the morning,look at light. It will help you awaken.

In the bedroom:• Use the bed and bedroom for sleep

and sex only. If you want to read orwatch TV, do it in another room.

• Establish a regular bedtime rou-tine and a regular wake-up scheduleand stick to them even on weekends(within an hour or two at most).

• Keep the temperature down in thebedroom.

• Block out light and sound. Try aneye pillow or earplugs.

•Consider using a fan or white noisemachine or play very soft, calming music.

One of the most important things youcan do before going to bed is to “retireyour day,” as Nader puts it. “Write downeverything you have to do and everythingthat is weighing on your mind before yougo to bed,” she suggests. “Then leave ituntil morning. There is nothing you candoabout it while you are in bed.”

When to turn to the prosIn reality, everyone needs slightly

more than eight hours of sleep to main-tain optimal levels of performance,says Dr. Alejandro D. Chediak, presi-dent-elect of the American Academy ofSleep Medicine. Chediak runs a sleepdisorders program at Mt. Sinai Med-ical Center in Miami Beach, Fla.“Humans have a great capacity tocompensate for sleep loss using behav-iors such as increased consumption ofalertness-promoting substances likecaffeine, increased carbohydrateintake and other similar measures,” hesays. But these coping strategies don’tmean someone is getting enough rest.

Women are slightly more likely toexperience sleep disturbances thanmen, largely due to hormonal fluctua-tions, say experts. Aging can also con-tribute to difficulty sleeping.

SHUT-EYEFrom page 11

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If getting enough rest is provingevasive even after trying the measuressuggested here, it is probably time fora professional evaluation, says Stan-ford’s Takaoka.

Other signs that a consultation maybe helpful include heavy snoring, dailyfatigue, teeth grinding or severely rest-less legs that interfere with falling asleep.

At places like Bay Sleep Clinic andthe Stanford Sleep Disorders Center,individuals may wind up having theirslumber monitored all night.

Treating the problemMany of those who suffer from sig-

nificant sleep problems have sleepapnea, say the experts. Four out of100 males over 40 are reported to bevictims of the disorder, which is oftensignaled by snoring.

Obstructive Sleep Apnea is a condi-tion in which a person repeatedly stops

breathing for short periods during thesleep cycle because of a collapse of aportion of the breathing airway. Theresult is that air does not reach thelungs, sleep patterns are disrupted andfatigue and chronic sleepiness result.

Sleep apnea can be caused byanatomical obstructions such asenlarged tonsils, by the natural agingprocess — which can cause a slacken-ing of airways or the muscles thathold them open — or by the tonguefalling back into the mouth.

One treatment for this disorder isthe CPAP, or Continuous PositiveAirway Pressure device. The mask-like CPAP, prescribed and fitted by aphysician, helps keep the airway openand is highly effective, but does notcure the problem. If the CPAP doesnot work, surgery is a last option.

Sleep medications, called hyp-notics, can be taken, but only whenthe cause of insomnia has been prop-

erly evaluated and sleep difficultiesare interfering with daily life. Whilehypnotics will help many, if taken forlong periods they can also causemorning sedation, memory prob-lems, headaches and addiction.

These solutions may seem drastic,but there is no getting around theimportance of sleep. After all, humansdevote one-third of their lives to it.Plus, sleep deprivation, warns Takao-ka, “can result in impairment of short-term memory and attention, moodchanges such as depression, anxiety orirritability, and diminished motor skillsand ability to process new information.Individuals who are excessively sleepyare at high risk for automobile acci-dents and work errors.”

Fortunately, “most sleep disordersare readily diagnosed and treated,”Takaoka says. Her bottom-line rec-ommendation: “Have a low thresh-old for seeking help.”

Sleep questionnaireIf you answer yes to two or more of the following questions,you should consider talking to a health professional aboutyour sleep, according to Bay Sleep Clinic:

Have you been told that you snore excessively, or that yourbreathing is interrupted while you sleep?

Do you feel sleepy or fatigued during the day?

Do you doze off while reading, watching TV or driving?

Do your legs jerk frequently or feel uncomfortable (restless)before or during sleep?

Do you have trouble falling asleep?

Do you awake with a headache?

Do you experience memory loss?

Do you awake gasping for air?

Do you find your heart beating irregularly at night?

Do you awake in the morning without feeling refreshed?

Do you ever experience sleep paralysis?

Do you have a weight problem?

Is your work or family life affected by sleep problems?

Do you feel that you get less sleep than you need at night?

Norma Lopez Molina

Resources Bay Sleep Clinic: www.baysleep.com

Stanford Sleep Disorders Center: http://www.stanfordhospital.com/clinics medServices/clinics/sleep/sleepDisorders

National Sleep Foundation: www.sleepfoundation.org

American Academy of Sleep Medicines: www.sleepeducation.com

The Promise of Sleep: A Pioneer in SleepMedicine Explores the Vital ConnectionBetween Health, Happiness and a GoodNight’s Sleep, by William C. Dement andChristopher Vaughn. Bantam Dell Pub Group.

No More Snoring, by Victor Hoffstein,M.D., Ph.D., head of the Respiratory andSleep Division at the Nose and SinusClinic at St. Michael's Hospital in Toronto.John Wiley & Sons Inc.

A Woman’s Guide to Sleep: GuaranteedSolutions for a Good Night’s Rest, by JoyceWalsleben and Rita Baron-Faust. RandomHouse Inc.

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