Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: TUESDAY, March 17, 1992 TAG: 9203170188
SECTION: EXTRA PAGE: EXTRA 6 EDITION: METRO
SOURCE: GARRET CONDON THE HARTFORD COURANT
DATELINE: LENGTH: Long
Newsweek magazine reported last year that more than 7 million Americans take Halcion and that U.S. pharmacists fill about a half-million Halcion prescriptions a month.
Despite the convenience of pill-induced shut-eye, sleep specialists say drugs such as Halcion should be used only as short-term solutions to sleep problems.
"I think there has been a history of more people using sleeping medication than have needed to," says Dr. Bruce Rothschild, a psychiatrist and associate director of residency at the Institute of Living in Hartford, Conn. He says many now using hypnotics to sleep could benefit from drugless alternatives offered by physicians and psychologists, especially at sleep disorder centers. Therapies include sleep restriction, relaxation methods and techniques for making the bed and bedroom more conducive to sleep.
If you can't get to sleep at night, you are not alone. The National Institutes of Health - and many national surveys - report that insomnia affects about a third of American adults, and half of these consider the problem serious. The Los Angeles-based National Sleep Foundation says that nearly everyone has at least one bout of insomnia in his or her life. And the problem occurs more frequently among the elderly.
Insomnia is having regular trouble getting to sleep or staying asleep, or both. Sometimes, says Arthur Spielman, a psychology professor and director of the Sleep Disorders Center at the City University of New York, there is a concurrent emotional or psychological problem. Also, certain physiological conditions, such as a breathing disorder or involuntary muscle movement, can cause insomnia. Other times personal stress may trigger insomnia that continues after the cause has vanished.
"The thing that initially causes the sleep disorder is not always the thing maintaining the sleep disorder," says psychologist Susan Rubman, director of the Sleep Disorders Clinic at Mount Sinai Hospital in Hartford. A mother who gets up nightly with a newborn child, for instance, may find when the child begins to sleep through the night that she cannot.
The sleep hygiene advice that follows is meant for those suffering temporary insomnia - a few nights of poor sleep.
Sleep professionals contacted for this story think these steps may help. However, individuals who have regular trouble getting sufficient or restorative sleep should talk to their physicians or consult with one of the several sleep disorder clinics in the area.
(A 1991 Gallup Poll disclosed that only 5 percent of those with insomnia had discussed their problem with their doctor.)
You need to discover the cause of the disturbance, says Dr. Quentin Regestein, director of the sleep clinic at Brigham and Women's Hospital in Boston.
Here are some tips for getting a whole night's sleep, holistically:
Get up at the same time every day, even on weekends. It is the best way to correctly set your body's sleep-waking clock.
Spielman suggests that those having trouble getting to sleep try going to bed an hour later than usual for a week or two - getting up at the usual time. "It can consolidate sleep, make it more robust and more reliable," he says.
Regestein points out that regular, vigorous exercise gives you a higher metabolic rate, and those with higher metabolic rates tend to be better sleepers. (Children, who have twice the metabolic rate of adults, rarely have sleep problems.)
Rubman and others also suggest that exercising in the late afternoon or early evening (but not too close to bedtime) promotes better sleep.
Some people are extremely sensitive to caffeine. Most sleep pros recommend that troubled sleepers limit caffeine use to the morning.
Remember that besides coffee, tea and colas, many non-cola soft drinks, chocolate foods and over-the-counter pain relievers contain caffeine. Check the label.
Also, check with your doctor or pharmacist about possible side effects of any prescription and non-prescription drugs you may be taking. These may be interfering with your sleep.
Alcohol can also create problems. "It's the world's oldest sleeping pill, but, I'm sorry, it makes for sleepless nights," Regestein says.
Booze starts as a sedative, he says, but hours later its presence in the body creates a flood of adrenalinelike substances that wake us up or disturb our sleep.
Rubman says no alcohol is best but that drinks should be consumed no later than 2 to 4 hours before bedtime.
Most of those who work with the sleep-deprived encourage them to get out of bed if they are not sleeping. "If you can't get to sleep by a certain time, you have to get up and go into another room," says psychologist Robert Watson of the New Haven Sleep Disorders Center.
He adds, however, that if you are comfortably dozing, stay in bed. When you start getting frustrated about not being able to sleep, that's the moment to get out of bed and do something that's not too stimulating: Watching TV or reading are good choices. Then, when you feel sleepy, hop back into bed.
Use your bed for sleeping and having sex. Period. Do not watch TV in bed, eat in bed or read in bed.
by CNB