Can't sleep? This may be why

Too much food, drink, and stimulation keep 70 million Americans from getting good rest.

Posted: March 20, 2012

Why are 70 million Americans having trouble getting a good night's sleep? Let us count the ways:

We are over-caffeinated (coffee, soft drinks, energy drinks, snacks) and over-medicated (prescription and over-the-counter drugs, including alcohol), wreaking havoc with slumber patterns.

We are over-wired (video games, Web browsing, social media, texting) and overstressed (money, work, relationships, overloaded schedules), making us too restless to doze off when we should.

We are overworked (longer hours, night shifts incompatible with our biological clocks) and overweight.

And then there's societal pressure, which sleep expert Mark Mahowald calls "the pervasive, erroneous attitude that sleep is not a biological imperative, that it is negotiable. We have raised sleep deprivation to a badge of honor."

The effects are hardly as benign as many of us might think. "Any degree of sleep deprivation will impair performance behind the wheel, in the classroom, or workplace," Mahowald said.

He said the Bhopal, Challenger, Exxon Valdez, and Three Mile Island disasters "all are officially attributed to problems from sleep deprivation. But the biggest risk of sleep deprivation is car crashes, period."

No wonder the number of accredited sleep centers has risen nationwide by 630 percent in 15 years. Experts such as physicians Mahowald and Michael Schmitz know a lot more than researchers did even a decade ago.

Most adults need seven to nine hours of sleep a night. The amount one needs is genetically determined, Mahowald said. "Some people might need four hours on the short end, up to 10 on the high end. We have absolutely no control over this."

Anyone who uses an alarm clock "is by definition sleep-deprived," Mahowald said, "because if the brain had received the amount of sleep it wanted, you would have woken up before the alarm went off."

"Some people are early to bed, early to rise; others late to bed, late to rise. We have very little control over that," Mahowald said. "So you see a lot of problems when an owl marries a lark and each one thinks the other is being stubborn."

With sleep deprivation, consequences could be diabetes, heart disease, and stroke.

With insomnia, there is no evidence of long-term physical problems. But insomnia can lead to depression.

There is some evidence that severe sleep apnea can lead to hypertension, heart problems, and a higher risk of strokes.

To help with transient or acute insomnia, avoid late eating and drinking, keep the bedroom cool and dark, and wind down before bedtime.

For chronic insomnia, cognitive behavioral therapy is equally as or more effective than medication. Medication often is useful for acute insomnia.

See your doctor if you have had difficulty falling and staying asleep for more than a week or if you snore, awake frequently, and feel sleepy during the day. Anyone with apnea symptoms should seek treatment.

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