Do You Have Sleep Problems?

Did you know that there are 91 recognized sleep disorders? Your daytime tiredness and sleep disruption may be caused by many potential disorders, including those involving your brain, your airway, or your legs.

Everyone requires sleep, and nobody’s sleep is perfect every night. It also makes sense that many of us have health problems and medical disorders involving or during sleep, just as during wakefulness.

Millions of people in this country have sleep disorders. Many do not even know that they have them, perhaps because their symptoms are so longstanding or gradual in onset that they may not even discuss them with their families or doctors.

One of our goals at Comprehensive Sleep Medicine is to increase the public’s awareness of such problems. Many people hear that something can actually be done to help their sleep, oftentimes even without the use of medicines, in part because of increased media attention but also because more people recognize that the quality and quantity of your sleep can play a major role in your quality of life, health, productivity, and emotional state during the day.

The 3-Question Quiz For Sleep Apnea

You may have heard a lot lately about obstructive sleep apnea (OSA), a very common, under-recognized breathing problem in which the airway in your throat collapses during sleep. This disorder is associated with an increased risk for high blood pressure, heart disease, and early death. To find out if you or a loved one should be concerned about sleep apnea, take 5 seconds to take this 3-question quiz.

What Symptoms Do You Have?

There are many different reasons why a patient may wish to see us. Some specific symptoms are seen very commonly in our clinic. Here are some simple steps to recognize what might be happening and what you can do about your sleep problem.

Excessive sleepiness

1. Get proper amounts of sleep (most adults need 7.5 – 8.5 hours per night)
2. Get about the same amount of sleep every night, including weekends
3. Arrange your lifestyle to accommodate for proper amount of regular sleep
4. If you do awaken at night, ask yourself why; was there a symptom that caused you to awaken?
5. If you are sleepy during the day despite getting proper amounts of sleep at night, TELL YOUR DOCTOR

Snoring

1. Is your snoring loud enough to consistently awaken and/or bother your bed partner?
2. Is your snoring loud enough to be heard in other rooms of the house?
3. Do you ever awaken hearing a snort or feeling a gasp?
4. Has anyone ever told you that you sound like you’re snorting suddenly, choking, gasping, or stopping your breathing during sleep?
5. If the answer to these questions is YES, don’t ignore your bed partner about this. TELL YOUR DOCTOR

Insomnia: perceived difficulties falling or staying asleep

1. Regulate your sleep schedules
   1. Awaken at the same time every morning, preferably to an alarm, including days off and weekends
   2. Go to bed roughly the same time, but only when you’re drowsy
   3. If you are sleep-deprived to begin with, gradually add on small amounts of sleep per night, by 15-20 minutes per night, instead of going to bed much earlier than usual or sleeping in
2. Spend as little time awake in bed as possible
   1. Don’t go to bed until you are sleepy
   2. Avoid television, music, radio in bed
   3. Get out of bed and do a relaxing activity in another room if you are not sleepy after 20-30 minutes in bed, or if you are frustrated in bed
      1. Crochet, needlepoint
      2. A boring book or a magazine you’ve already looked through
      3. A jigsaw puzzle, crossword puzzle
      4. AVOID: action movies, homework, house chores, taxes, things that you HAVE to do anyway
3. Don’t do things that can make you awake
   1. Stop drinking caffeinated beverages at least 8 hours prior to bed
   2. Stop smoking well before bed
   3. Reduce the use of alcohol (which disrupts sleep 3-4 hours after ingestion)
   4. Avoid exercise shortly before bed
   5. Avoid bright light late at night
   6. Avoid exciting or stimulating activities before bed
   7. Turn the alarm clock away from you (“clock-watching” doesn’t make the time go any faster and just frustrates you more)
4. Do things that can promote drowsiness
   1. Try a hot bath 60-90 minutes before bed
   2. Start winding down mentally for a couple hours before bed
   3. If you think or worry a lot in bed, set aside 1/2 hour during the day to think and plan the things you usually dwell on at night
   4. Try exercise early in the morning
   5. Try bright light exposure, such as outdoors, early in the morning, even if it is cloudy outside
5. Insulate your bedroom from light, noise and heat
   1. Try black curtains over the windows if you sleep when it’s light outside
   2. Talk to your family and neighbors about their noise, if applicable
   3. Talk to your bed partner about his/her snoring, if applicable
   4. Don’t let pets sleep on your bed
6. If sleep disruption continues, TELL YOUR DOCTOR

Unusual movements or vocalizations during sleep

1. Ask your bed partner to describe what’s going on
2. Do you remember what happened?
3. Do you recall dream imagery just before you awaken with these movements?
4. Is this a new thing for you, or have you been making the movements since childhood?
5. Do the movements occur near the beginning of the night or near the end?
6. TELL YOUR DOCTOR about this

Leg discomfort

1. Do your legs feel uncomfortable, primarily or only at night?
2. Do you feel like you have to move or kick them?
3. If you move or kick them, do your legs feel better briefly?
4. Do you have iron deficiency?
5. If the answer to these questions is YES, TELL YOUR DOCTOR

Disclaimer: the educational and clinical content in this website should not be construed as actual medical care.

Myths

• Myth: All this sleep medicine stuff is a fad.
  • Reality: It may feel this way, because so many people talk about it these days; many of our new patients tell us that they have a family member, friend, or colleague that has undergone a sleep medicine evaluation. The fact is that sleep problems and sleep disorders have plagued people for generations, but only recently has there been an increased public awareness and physician awareness regarding these sleep disorders and their effects. Therefore you’re probably hearing about sleep disorders and their management more than you have previously.
• Myth: It’s normal to be tired during the day.
  • Reality: Many things can cause you to feel tired. One form of tiredness is sleepiness, the feeling that you have difficulties staying awake and alert. The most common cause of this feeling is just plain old insufficient amounts of sleep; the vast majority of adults require 7.5 – 8 hours of sleep per night, and if you don’t get this much sleep per night you should expect to feel sleepy from time to time. However, just because you have felt sleepy for a long time doesn’t make the symptom NORMAL. In addition, if you are feeling sleepy despite getting proper amounts of sleep at night, that situation is NOT NORMAL and you should consider speaking with your health care provider about that problem.
• Myth: Everybody snores. It’s OK.
  • Reality: If you snore loudly enough to bother others, or if the snoring can be heard in other rooms of the house, the snoring may suggest that you might have a breathing problem in your sleep, which is NOT OK. Obstructive sleep apnea is associated with an increased risk of developing heart disease and high blood pressure, and should be evaluated.
• Myth: I don’t believe I’m snoring, because I’ve never heard it.
  • Reality: Of course you’ve never heard it. You’re asleep. If your spouse is telling you that you’re snoring loudly, chances are that he/she is not lying to you. Please take your bed partners’ concerns seriously, especially if you’ve also been told that you sound like you’re gasping or stopping your breathing.
• Myth: All sleep centers do is slap CPAP on you.
  • Reality: It doesn’t have to be that way. Just as in all businesses, you can find a wide range of quality and care for the customer from sleep center to sleep center. As a patient, you should have a choice regarding who assists in your medical care. Look for a sleep physician that is willing and able to take care of all of your sleep issues, and importantly to follow through with your treatment and help manage your therapy long-term.
• Myth: Nobody can actually use that CPAP thing!
  • Reality: Many people do, and they often feel so much better during the day and at night IF they do. With proper support and guidance of your sleep doctor, your sleep center, and your CPAP provider service, almost all potential problems associated with CPAP use are FIXABLE. We can’t help you, however, if you don’t follow up with your sleep doctor or decide in your mind that CPAP is potentially tolerable.
• Myth: I can’t sleep without the television on.
  • Reality: Yes you can. The fact is that your body doesn't require the presence of a television to sleep. Many people simply are used to having the television on at night, and this becomes a habit. People being the creatures of habit that they are, such habits become difficult to break, and a change in routine can make one feel uncomfortable. Thus, not having the television on can then lead to the feeling of poorer sleep. People generally sleep best in a dark, quiet, cool environment, and the content of the television program, in addition to the light and noise from the TV, can in fact cause or worsen insomnia.
• Myth: I have to think about things at night when I’m in bed.
  • Reality: No you don’t. Many people can fall into the habit of doing so, however, because it’s a naturally convenient and comfortable place to think. Many of us are busy during the day, and don’t have as much time to reflect, organize, worry, or think about things, so sometimes this can occur at night when everybody’s leaving you alone. Problem is, those thoughts can be alerting emotions, which can cause a stimulatory effect, thus causing you to feel more awake.
• Myth: I should TRY hard to fall asleep.
  • Reality: How are you going to do that? You can’t simply will yourself to fall asleep; trying to do so often makes insomnia WORSE, because the unsuccessful attempts of trying so hard creates frustration and creates a feeling that you are physically unable to sleep. The key is to allow your body’s natural mechanisms to do the work of becoming drowsy for you. Remember: your body is designed for you to sleep. You REQUIRE sleep. Let it happen naturally. Your trying may well be working against you.
• Myth: I’ll never been able to sleep well again.
  • Reality: If you spent much of your life sleeping normally, it’s unlikely that your brain’s or body’s biology has changed to cause permanent difficulties sleeping. It can feel permanent, however, if you’ve had the problem for a long time. Remember: if you believe that you will not sleep well tonight, you probably won’t. It is better to assume that you will sleep well at night instead.