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Newsfeed display by CaRP "To sleep--perchance to dream," wrote Shakespeare in his masterpiece play, Hamlet. It's a nice concept. However for many men, women and children, the elusive road to slumberland is anything but a dream.

Sleep is a natural part of everybody's life, but many people know very little about how important it is, and some even try to get by with little sleep. Sleep is something our bodies need to do; it is not an option. Even though the exact reasons for sleep remain a mystery, we do know that during sleep many of the body's major organ and regulatory systems continue to work actively. Some parts of the brain actually increase their activity dramatically, and the body produces more of certain hormones.

Sleep, like diet and exercise, is important for our minds and bodies to function normally. In fact, sleep appears to be required for survival. Rats deprived of sleep die within two to three weeks, a time frame similar to death due to starvation.

An internal biological clock regulates the timing for sleep. It programs each person to feel sleepy during the nighttime hours and to be active during the daylight hours. Light is the cue that synchronizes the biological clock to the 24-hour cycle of day and night.

Sleepiness due to chronic lack of adequate sleep is a big problem in the United States and affects many children as well as adults. Children and even adolescents need at least 9 hours of sleep each night to do their best. Most adults need approximately 8 hours of sleep each night.

When we get less sleep (even one hour less) than we need each night, we develop a "sleep debt." If the sleep debt becomes too great, it can lead to problem sleepiness – sleepiness that occurs when you should be awake and alert, that interferes with daily routine and activities, and reduces your ability to function. Even if you do not feel sleepy, the sleep debt can have a powerful negative effect on your daytime performance, thinking, and mood, and cause you to fall asleep at inappropriate and even dangerous times.

Problem sleepiness has serious consequences – it puts adolescents and adults at risk for drowsy driving or workplace accidents. In children, it increases the risk of accidents and injuries. In addition, lack of sleep can have a negative effect on children's performance in school, on the playground, in extracurricular activities, and in social relationships.

For many, the road is paved with obstacles--often a sleep disorder, ranging from insomnia to restless legs syndrome (RLS) to sleep apnea--where individuals usually snore, experience fitful sleep, and may stop breathing for short periods, in some instances hundreds of times a night. The consequences of sleep deprivation, specifically the "problem sleepiness" during the day that normally follows, can have extremely serious, even life-threatening consequences.
Considering we spend nearly one-third of our lives tucked under the sheets, you would think we would know how to get a good night's rest. Not so for many. If you have sleep difficulties, you're not yawning alone--chances are some of your family members, coworkers, and neighbors also have a "sleep debt," the cumulative effect of not getting the quantity or quality of sleep that one needs. As many as forty million Americans are afflicted with more than 70 different types of sleep-related problems.

While some sleep disturbances may be linked to biological changes associated with aging or certain physical diseases, especially those that cause pain, others may be associated with a mental health disorder such as depression or anxiety. Poor sleep may also stem from "bad" habits such as napping too long or too late in the day, or doing shift work, which applies to nearly one quarter of the population, according to the National Center on Sleep Disorders Research. The Center is part of the National Heart, Lung, and Blood Institute, a unit of the National Institutes of Health (NIH). On the other hand, you may simply not be giving yourself the opportunity to acquire ample shuteye.

What we can say with certainty is that there is a pervasive nature of sleep deprivation out there--no question about it. It's part of how our society functions.

Why isn't America getting a better night's rest? "It's a two-part problem," the NIH scientist explained. "First, we have a society that's on a 24-hour cycle--with multiple jobs in many cases and multiple responsibilities both at work and home. When you're pushed for time, as many people are, the first thing that usually goes is sleep." However, when you sacrifice hours this way, you frequently end up paying for it in terms of decreased productivity and an increased risk for errors in judgment and accidents.
Further he said that the second part of the problem relates to actual sleep disorders.

Insomnia--the inability to fall asleep and remain there--affects many millions of people. "For sleep apnea, easily another 10 to 15 million. Narcolepsy, falling asleep uncontrollably during the day, perhaps 250,000. We don't even know how many people have restless legs syndrome (RLS). In general, society is not well rested, and looking at these numbers and their causes, you begin to see why," he explained.

While people of any age may be affected, there seems to be a large prevalence of sleep disturbances among elderly men and women. Sleep studies reveal that they get less REM deep - sleep over time. With aging, sleep becomes more fragile, that is, it doesn't take much disturbance to awaken the individual. Women may first notice this during menopause.

Lack of sleep and its link to accidents--automobile and on-the-job--now appears to be a problem of far greater magnitude than previously believed. Fatigue leads to diminish mental alertness and concentration. Accordingly it's the resultant "near miss" such as in a motor vehicle or otherwise, that sometimes makes people recognize they have a problem and need to seek professional help. There could be as many as 1,500 fatalities and one hundred thousand sleep-related automobile accidents annually in the United States. Shift workers are especially prone to this problem. "Their biological clock is ticking at the wrong time, and they typically drive home after work when they're extremely tired. Young males under 25 also have a disproportionate number of auto accidents related to sleepiness. We want to target them through education; in fact, we're currently working on a program with the U.S. Department of Transportation that we hope will be very effective in this area," a NIH scientist said.

What about napping? In some countries, a siesta or short daytime rest is a respected, time-honored daily ritual. It may have an important role. "With older people in particular, napping is a good practice. Because their sleep is fragmented and they get less of it at night, they typically make up for it with naps during the day. Napping works, it definitely has a role," he explained, adding that it can increase productivity and help restore your ability to think.

What about waking up too early, like before the birds' first chirp? While such "early morning awakenings" may be a sign of depression or other treatable emotional disorder, the passage of time may be the culprit. "As you age, your biological clock ticks at a slightly different rate. Because of this, you run into people with an advanced sleep syndrome--they go to bed early and then wake up too early," he further explained. "Again, sleep is very fragile with age and we really don't know why." In some cases, going to bed a bit later may help reset your biological clock and allow you to sleep later.

How many hours per night should you sleep? NIH sleep experts believe you should be obtaining somewhere in the range of 7 to 8 hours of sleep a night. This figure varies considerably across the age span and from person to person. Still, if you're getting less than 6 hours of sleep per night regularly, chances are you're building up your "sleep debt," and may be compromising your health and welfare, sleep authorities contend.

If you're having chronic sleep difficulties, should you merely lie there and take it? No. However, if you've done all you can and still aren't getting good, quality sleep, talk with your family doctor. If you need additional help, ask for a referral to a sleep specialist. This may be needed, in particular, for more complex conditions such as narcolepsy. While this disease is not curable, it is treatable, though the regimen with carefully prescribed medications is complicated, and best handled by a sleep specialist.

The Greek philosopher Sophocles once remarked that "sleep is the only medicine that gives ease." As researchers seek to unravel the remaining mysteries surrounding sleep, many more men, women, and children should soon find a night in the bed a more pleasant pill to take--rest assured.

These substances disturb a variety of bodily processes. They impair a person’s ability to get a good night’s sleep. For example, alcohol may help a person fall asleep, but it interferes with one’s ability to stay asleep. If you are dependent on drugs or alcohol, let your doctor know, and seek assistance for this problem.

A child who has not obtained adequate nighttime sleep is at high risk for symptoms of physical and/or mental impairment. The child may fall asleep in school; have difficulty concentrating in school and other activities, and/or exhibit behavioral problems. Some children who are sleepy become agitated rather than lethargic and may be misdiagnosed as hyperactive. Not getting enough sleep is one cause of problem sleepiness.

Undiagnosed/untreated sleep disorders can also cause problem sleepiness. Children as well as adults can suffer from sleep disorders. Parents should talk to their pediatrician about a possible sleep disorder if their child has any of the following:
1. Snoring.
2. Breathing Pauses During Sleep.
3. Problems with Sleeping at Night.
4. Difficulty Staying Awake During the Day.
5. Unexplained Decrease in Daytime Performance.

Problem sleepiness has serious consequences – it puts adolescents and adults at risk for drowsy driving or workplace accidents. In children, it increases the risk of accidents and injuries. In addition, lack of sleep can have a negative effect on children's performance in school, on the playground, in extracurricular activities, and in social relationships.

Inadequate sleep can cause decreases in:
1. Performance
2. Concentration
3. Reaction Times
4. Consolidation of Information Learning

Inadequate sleep can cause increases in:
1. Memory Lapses
2. Accidents and Injuries
3. Behavior Problems
4. Mood Problems

Other Strategies:
a. Limit substances that contain caffeine, e.g., soda, coffee, and some over-the-counter medicines.

b. Try to set a regular sleep/wake schedule:
1. A consistent sleep schedule helps to regulate and set the body’s "internal clock," which tells us when we are tired and when it is time to sleep, among other things.
2. Make your sleeping area as free from distractions as possible:
3. Aim for quiet surroundings; keep the room darkened; keep the television out of the bedroom.
c. Consider a light nighttime snack:
1. A light snack after dinner may prevent hunger from waking you up in the middle of the night.
d. Avoid over-arousal for at least 2-3 hours prior to going to sleep:
1. Try not to get your body and mind in "arousal mode." Things that may tend to do this are: heavy meals, strenuous exercise, heated arguments, paying bills, and action-packed movies.
e. Don’t worry that you can’t sleep:
1. Remember, there may be a number of reasons for your sleep problems. The first step is to talk to your doctor.

Talk to your doctor.

Let your doctor know that you have trouble sleeping. Tell your doctor exactly what the problems are; he or she can help you best if you share this information about yourself.

Let your doctor know about any physical problems that you think are contributing to your sleep problems. For example, chronic pain associated with traumatic injuries can make it difficult to sleep.

Let your doctor know about any other emotional problems you have–these may also be contributing to your sleep problems. For example, depression or panic attacks can make it hard to fall asleep or to stay asleep.

Depending on your sleep symptoms and other factors, your doctor may prescribe some medication for you.

Your doctor may recommend that you work with a therapist skilled in dealing with emotional and behavioral problems. Psychologists, social workers, and psychiatrists fall into this category. They can help you take a closer look at, and possibly change, the variety of factors that may be preventing you from sleeping well.


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Submitted: 08/01/06

Description: "To sleep--perchance to dream," wrote Shakespeare in his masterpiece play, Hamlet. It's a nice concept. However for many men, women and children, the elusive road to slumberland is anything but a dream.

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