Category Archives: Insomnia

9 Signs You’re Not Getting High-Quality Sleep

Between work, family and play, it can be difficult to get a good night’s sleep.     While it’s easy to tell you’re tired after a night of tossing and turning, there are a few more subtle signs that indicate you’re not getting the beauty rest you need and deserve.

If you find that many or all of the following signs are true for you, consider taking steps to improve the quality of your sleep:

1. You can’t stop hitting the snooze alarm.

Hitting the snooze alarm often is usually a sign that you either haven’t had sufficient sleep or that the quality of your sleep is poor.

2. You sleep late on weekends.

If you find that you’re constantly sleeping later on weekends, this may be due to the sleep debt you built up during the week.

Unfortunately, this catch-up sleep can’t make up for your lack of sleep. Even worse, it may throw your circadian clock off, making it more difficult to fall asleep on Sunday night.

3. You’re irritable and moody.

It’s unfortunate that so many of us fail to realize how insufficient sleep affects our moods. Sleep is very important in our processing of emotions.

4. You get frequent coughs and colds.

Many studies have demonstrated the importance of sleep in relation to our immune system. In fact, in my book I examine sleep and its relationship to the immune system.

5. You can’t shed those pounds.

Insufficient sleep is a major cause of obesity. When the body does not get enough sleep, it tends to overproduce an appetite-stimulating hormone called ghrelin, and underproduce an appetite-suppressing hormone called leptin.

6. You’re unable to focus and remember.

Sleep is a necessity if you want to be able to concentrate, problem solve, and remember things. During sleep, toxins that build up in the brain throughout the day called beta amyloid are cleared at a rate 10 times greater than during wakefulness. Also during sleep, information is uploaded and consolidated into our long-term memories. That is the reason that most people perform better on testing after a good night’s sleep.

7. Your blood sugar is creeping up.

Inadequate sleep is a cause of insulin resistance. In fact, many people labeled prediabetic will return to normal if they start to get seven to nine hours of sleep.

8. Your blood pressure starts to increase.

Sleep is very important to cardiovascular health. Actually, our blood pressure is usually 15 points lower when we are asleep; this is called “nocturnal dipping.” If you are consistently getting less than seven hours of sleep a night you may end up paying the price in the form of high blood pressure.

9. You consume caffeine all day.

There are many of us who consume coffee or caffeinated soft drinks from morning until night. In many instances, we have become so dependent on it to stay awake that we no longer realize why we are doing it. I have found in my sleep practice that this is frequently a sign of not enough or poor quality sleep.

The bottom line is that we need to appreciate how important sleep is to our physical and mental well-being. Too many of us fight sleep, not wanting to miss anything. Unfortunately, like most things in life, there are consequences when we do things in excess.

It’s very important to have an adult ritual before bedtime. This should consist of relaxing activities such as reading, listening to music, prayer or meditation. Above all avoid computers, televisions, iPads and cellphones at least one hour before bedtime. Eliminate all sources of caffeine, including dark chocolate, at least six hours before bedtime. Finally, exercise regularly!

Interrupted Sleep? No Wonder You’re Moody

Those of us in sleep medicine are very familiar with the effects of sleep deprivation. Many studies have shown us the problems associated with insufficient sleep. However, what happens to those of us whose sleep is disrupted for five or ten minutes at a time several times a night? This has never been studied despite the fact that it is a common occurrence in our day-to-day lives. The classic example being the parent who needs to tend to a child during the night. In fact, in a recent survey, 20% of parents of newborn to three-year-olds reported an average of three or more awakenings per night.

In a study published this month in the journal Sleep Medicine, researchers set out to find just what consequences this might have on mood and vigilance. Vigilance is defined as the ability to maintain attention and alertness over prolonged periods.

A group of students with no prior sleep problems was recruited. They were tested as to mood and vigilance one hour after awakening. These tests were performed under three different conditions. First, they were tested after eight hours of uninterrupted sleep. Then after their sleep had been restricted to four hours, and finally after a night in which they were awakened for a period of 10 minutes every 90 minutes. During this 10-minute period, they were assigned a task on a computer and then allowed to return to sleep.

As expected, when sleep was restricted to four hours, vigilance decreased. Moodiness, as indicated by depression, fatigue, and reduced vigor, increased significantly. However, what was most interesting was that their scores were just as bad after a night of brief awakenings. In other words, brief interruptions of sleep had the same negative impact on mood and vigilance as did a night of severe sleep restriction.

I think this is a very important study. So many of us, such as parents, shift workers, and physicians, have our sleep interrupted for short periods throughout the night. This study demonstrates the adverse effects of just one night. Imagine what the cumulative results on a parent of an infant or young child or a physician on call might be? I think it is obvious that it has to negatively affect their ability to function at the highest level.

What is the take home message? I think we need to have a greater appreciation for the adverse influence on function of interrupted sleep. In the case of parents, I think this study makes a great example for shared parental responsibility. Looking back to when I was a physician on call, it was common to get several requests a night requiring my full attention. I can remember that after such a night I was more irritable and not at my best the next day. Based upon this study, maybe a day off after such a night might have been in everyone’s best interest.

Could You Be Hypnotized into Better Sleep?

The place of hypnosis in sleep medicine has been a subject of debate for many years. A few studies have shown its usefulness in conditions such as nightmares, sleep terrors, bedwetting, sleepwalking, and insomnia. However, few if any of these studies have been based upon anything other than the individual’s subjective reports.

An objective demonstration of the positive effects of hypnosis on sleep, especially deep sleep, appears in this month’s journal Sleep. The researchers enlisted 70 healthy Swiss women aged 18 to 35 and divided them, by testing, into those who were “highly suggestible” to hypnosis and those who were categorized as “low suggestible” patients.

The women were exposed to 13-minute tapes, one of which was conducive to sleep and which particularly emphasized metaphors for deep sleep while the other tapes did not. They were allowed to fall asleep while listening to the tape or just after for a period of 90 minutes. Then they were awakened. During this time, brain wave activity was monitored using an electroencephalogram.

The findings were remarkable. Hypnosis had no effect on those women categorized as “low suggestible.” However, in those women who had been deemed as “highly suggestible,” hypnosis increased deep sleep on average by 80% and time spent awake was reduced by 67%. In addition, when those women who were “highly suggestible” were exposed to the other tapes, in particular one that was done in the same hypnotic cadence but contained no suggestion of deep sleep, there was no improvement in either their duration or depth of sleep.

We know that deep sleep, also referred to as slow wave sleep, decreases greatly with age. It is also diminished by many of the commonly prescribed sleep medications such as the benzodiazepines,–diazepam (Valium), and temazepam (Restoril), and the non-benzodiazepines such as zolpidem (Ambien). In fact, this loss of deep sleep has been correlated with a decrease in cognitive function, deterioration in the immune system, impaired tissue repair, as well as age-related brain atrophy.

What are we to make of this? It would appear that in those susceptible to hypnotic therapy, hypnosis might have a place in treating sleep disorders such as insomnia. In this very well done study, it did increase deep sleep and thus would appear to have a place in the non-pharmacological treatment of sleep disturbances. It may also prove to be of great benefit in our elderly population by preventing the usual deterioration of deep sleep seen with aging. I can tell you that I personally found this study to be eye opening. It is the first really well done study that demonstrates to me that hypnosis may have a very useful role in sleep medicine. I intend to be much more open to those hypnotic sleep applications on smart phones and hypnotherapy in general.