You still lose if you don't snooze
Experts discuss what's keeping you awake and how to get a good night's sleep
By Joan Tupponce CONTRIBUTING WRITER

Insufficient sleep syndrome is the most common sleep disorder in the United States. Most experts recommend getting around eight hours of sleep each night, but studies show many people fall far short of that. File photo

It may not be tonight or tomorrow night, but it's a good bet that one night you will find yourself tossing and turning, unable to go to sleep.

The National Sleep Foundation's 2007 Sleep in America survey revealed more than half of American women - 60 percent - report they only get a good night's sleep a few nights per week or less. Sixty-seven percent said they frequently experience a sleep problem, and 43 percent noted that daytime sleepiness interferes with their daily activities.

These findings don't surprise Dr. Douglas W. Puryear of The Sleep Disorders Center of Pulmonary Associates. According to Puryear, the most common sleep disorder in the United States is insufficient sleep syndrome.

"People aren't allowing enough time to sleep each night," he explained. "Insufficient sleep is the most common cause of drowsiness."

Doctors agree that the average person needs around seven-and-a-half to eight hours of sleep a night.

"Some people require less, some more. A lot of people sleep five or six hours a night," observed Puryear. "If you are sleeping less than the normal and are tired, you need to spend more time in bed."

Insufficient sleep syndrome is just one of several sleep disorders that can interfere with your rest. Another common disorder that affects millions is sleep apnea. There are two types of sleep apnea - obstructive and central.

"Obstructive sleep apnea is the more common of the two," said Scott Clary, director of respiratory care services and the Sleep Disorder Center at CJW Medical Center. "Something is obstructing the airway and causing them to stop breathing during sleep. In central sleep apnea, the brain doesn't send appropriate signals to tell you to breath."

Signs of the disorder include difficulty staying awake, being drowsy during the day, feeling tired all the time, and waking up and not feeling rested.

Clary works with many patients who have the disorder.

"It's caused by some kind of soft tissue in the back of the throat or mouth that relaxes when you sleep, causing an obstruction of the airway," he explained. "It's fairly prevalent. About 12 million Americans have obstructive sleep apnea. Out of that number about 80 percent have not been diagnosed."

Even more alarming, he adds, is that one to three percent of American children have obstructed sleep apnea.

"That's something people are just becoming aware of," he said. "People don't think about that in younger children."

Clary believes that the rising obesity rate in children could be one factor.

"We're also seeing more children snoring, about seven to nine percent of children snore," Clary said. "That is an indication of potential sleep apnea."

The most prevalent treatment for the disorder is CPAP (Continuous Positive Airway Pressure), an airflow generator with a mask that fits over the nose. Airflow blows into the back of the throat and keeps the airway open.

"It's a portable device," Clary said, "about the size of a loaf of bread."

Other sleep disorders include narcolepsy, a genetic disorder that causes excessive sleepiness; restless legs syndrome, a neurological movement disorder; and periodic limb movement disorder, involuntary leg twitching or leg movements.

Contrary to what many people believe, insomnia is a symptom, not a disorder.

"People who have pure insomnia have trouble going to sleep," Puryear explained. "They are usually wired in a way that their bodies get tired at night but don't want to shut down."

There are two types of insomnia - sleep onset where you can't fall asleep in 20 to 30 minutes and acute or chronic insomnia where you fall asleep but wake up in a few hours and can't go back to sleep.

"It usually happens every night," Puryear said. "People dread to go to bed."

When you are sleep deprived - less than four hours of sleep a night for a few nights - you don't function as well as normal. You may have problems with balance and coordination. Irritability is also a byproduct.

"People have trouble doing skills such as driving or complex motor skills," Puryear said. "It's equivalent to driving while you are intoxicated. It's dangerous."

Sleep has many benefits, including rejuvenating the body and the mind. According to the National Sleep Foundation, it helps with muscle repair, memory consolidation and release of hormones that regulate growth and appetite.

"Lack of sleep can lead to physical problems, decreased immune function, and it can affect your metabolism. You tend to gain weight," said Dr. Richard Parisi, medical director of the Sleep Disorders Center of Virginia. "You'll be less productive at work, have more diffi- culty concentrating and remembering things. There's also a greater chance of depression and anxiety."

If you feel tired during the day, you may benefit from a 20-minute nap around midday.

"That will refresh you," said Dr. Rakesh Sood, professor of psychiatry at the VCU Medical Center and director of the VCU Sleep Disorder Center. "But don't take the nap late at night."

Sleep is an issue of quality and quantity. If you get enough sleep but it's not quality sleep, you may have an underlying disorder.

"The good news about sleep disorders is that we have very effective treatments for almost all of these problems," said Parisi. "Most people who have persistent sleep problems, especially excessive sleepiness, would benefit from a sleep study so they can find out what it is that is disturbing their sleep and decide how best to treat it."

Sleep tight

Tips for getting a good night's rest from the National Sleep Foundation:

+ Establish a regular bedtime routine and a regular sleep-wake schedule.
+ Don't spend too much time in bed.
+ Don't eat or drink too much before bedtime.
+ Create a sleep-promoting environment that is quiet, dark, cool and comfortable.
+ Consume less or no caffeine, particularly late in the day.
+ Avoid alcohol and nicotine, especially close to bedtime
+ Exercise regularly but not within three hours of bedtime.
+ Don't nap after 3 p.m.
+ Do something relaxing before bedtime.