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In the Spotlight

February 25, 2000

Insomnia: Will Reading This Article Put You To Sleep?

By Michael Woo-Ming M.D., MPH
Personal MD.com
Medical Contributor

 
The Sleep Cycles
During sleep, you usually pass through five phases of sleep: stages 1, 2, 3, 4, and REM (rapid eye movement) sleep.

Stage 1 - Light Sleep. This is the time during which you can be easily awakened. During this stage, your eyes move very slowly and muscle activity slows.

Stage 2 - This is the time during which your eye movements stop and your brain waves (fluctuations of electrical activity that can be measured by electrodes) become slower, with occasional bursts of rapid waves.

Stages 3 and 4 - Deep Sleep. This is the time during which it becomes very difficult to awaken you. If you are awakened, you may feel groggy and disoriented for a few minutes. During these stages your brain waves become very slow. There is no eye movement or muscle activity.

REM Sleep - This is the time during which, if you were awakened, you could describe your dreams. During this stage, your eyes move rapidly in various directions, your breathing becomes rapid, irregular, and shallow; and your heart rate and blood pressure increases. For men, this is also the time when erections occur.

These stages progress in a cycle from Stage 1 to REM sleep (on average, this cycle takes about 90 to 110 minutes), then the cycle repeats.

You will spend about 50 percent of your total sleeping time in Stage 2, about 20 percent in REM sleep, and the remaining 30 percent in the other stages.

Can't fall asleep? Join the club. Approximately one in three Americans suffer from chronic insomnia, the inability to, or having trouble falling asleep. About 90 percent of us will suffer from some temporary insomnia now and then. Difficulty falling asleep often leads to prolonged daytime somnolence at work, which has resulted in millions of dollars of lost in today's workforce.

There are many causes for insomnia. Some common culprits include:

  • Stimulants: Caffeine in coffee and cola drinks
  • Medications including over-the-counter (OTC) and herbal supplements
  • Diseases such as sleep apnea and hypothyroidism
  • Psychological problems such as anxiety and depression
  • Smoking tobacco and drinking alcohol
  • Stress from work or family concerns
  • Change in daily routine such as travel (jet lag) or starting a new job
  • Exercising just before going to bed

What can you do?

If you have insomnia problems lasting more than a few days, see your family physician. He or she will ask questions about your sleep, exercise, and eating habits; what medications you take; and your usual sleeping rituals. It's important to remember that insomnia may be a symptom of another problem. It is not a disease in itself. Your physician may recommend starting a sleep diary, which can keep tract of your evening sleep patterns. Other tests may include checking your blood oxygen level for sleep apnea or a sleep study known as polysomonography.

How is insomnia treated?

Treatments of insomnia often recommended by physicians include relaxation therapy and medications. It is important to remember that medications are often a temporary solution, and often do not provide truly restful sleep. The elderly should also be wary in taking OTC sleeping pills, as they may cause dizziness or confusion, and never taking sleeping pills with alcohol or before driving.

Here are some ideas to lead to restful sleep:

  • Set a standard sleeping ritual. Wake-up and go to bed at regular times.
  • Bed should be used for sleep and intercourse. Don't watch television, eat, or read in bed.
  • Avoiding eating a large meal late at night.
  • Avoid drinking alcohol and smoking tobacco.
  • Learn relaxation or stress-reducing techniques before going to bed. Clear your mind of today's worries.
  • Avoid exercise just before going to bed. Ideally, you should be more active before dinner.
  • Drink a warm glass of milk before going to bed.
  • Avoid taking a nap, especially in the evening.
  • If you cannot sleep after twenty minutes, get up to another room and perform a light activity such as reading. Nothing is worse than lying in bed "clock watching".
  • Reduce loud noises using soft music or a "white noise" device.
  • Sleep in a darkened room or wear an eye mask.
  • Be sure you are sleeping on the right mattress for you, it can do wonders for a better sleep.
  • Make sure your room is at an ideal temperature, and well-ventilated.

It's important to know the amount of sleep varies with each person. Finding in yourself what may be causing your insomnia is the key to success.

Well, I hope this article puts you to sleep. No offense taken!

 

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