Tuesday, September 9, 2008

Call it Sleepless


Rachel Dorfman can’t sleep. It’s time to nurse 6-week-old Brady again. Samantha, 2, will be up soon wanting to play. How will she keep up with her lively daughter, Rachel wonders. How will she soon return to work?

A relatable dilemma: Fussy babies, hungry babies, curious toddlers and beyond; once you’re a mother there’s no looking back. Weekends are barely discernable from week days. Going out bar hopping on a random night, one that starts at 10, is something (you must remind yourself) you actually used to do. If only you knew then what you know now, you could have hibernated, storing sleep in reserve. You’re in a different stage of life, and, to quote a sleazy mattress rep I once knew “Sleep is the new sex.”

According to the National Center of Sleep Disorders Research, sleep disorders add an estimated $15.9 billion to the annual national health care bill.

Vincent Giampapa, MD says benefits of adequate sleep should not be underestimated; it is one of the most important components of healthy aging. He writes in The Gene Makeover: The 21st Century Anti-Aging Breakthrough:

“It is during sleep that our body repairs most of the cell damage. It is also during sleep that key hormones are released that repair damage to DNA.”

Giampapa discusses the importance of core nutrients during this time of stress, through diet and supplementation, to help fight off bacteria, viruses, pollution, toxins and environmental stressors.

According to Joshua Rotenberg, MD, a San Antonio neurologist specializing in sleep disorders, "curing sleep disorders will have the greatest effect of any public-health measure in terms of adding productive years to life."

Rotenberg spent ten years in the Air Force studying the impact of sleep deficit on military personnel. “Sleep loss is detrimental to health and brain function,” he says. “Acute sleep loss can cause slow reaction speed, memory problems and “microsleeps” (“nodding off” quickly, often without even realizing it), which can lead to dangerous consequences when driving. Chronic sleep loss has been also linked to psychiatric symptoms, higher levels of stress, anxiety and depression, risk-taking behavior and impaired moral reasoning.”

Diabetes, cardiovascular disease and depression are among the long-term outcomes linked to chronic sleep restriction.

It’s widely known that obesity has been linked to sleep deprivation, but did you know that one study linked lack of sleep to retaining weight post-partum?[1]

This might explain the difficulty for some to shed pregnancy pounds, but Andrea Reed, a first-time mom at 36, had the opposite experience.

“I was overweight before pregnancy,” she says, “I lost all of that plus the pregnancy weight now that I’m a sleep deprived, working mom.” Reed explains that exhaustion makes her incredibly shaky, nauseous and unable to eat. “The one thing I have to be thankful for is the weight loss…oh, and another; Christian Dior concealer to hide the eggplants under my eyes.”

The author of Snooze…or Lose! Ten ‘No-War’ Ways to Improve Your Teen’s Sleep Habits, Helene Emsellem, MD, recommends 7-9 hours of sleep for adults. With many a new mom averaging 5 hours per night, it’s no wonder we’re feeling irritable, cranky and picking ridiculous spats with our spouses.

Dr. Rotenberg suggests napping during the day and if you don’t have the luxury of a long siesta, a catnap should suffice. He refers to a study of NASA scientists that showed the positive effects of a short nap on alertness and response time in pilots.[2]

Renee Fellows, 39, started her marketing business seven years ago after the birth of her second son.

“Sleep? Who sleeps?” she asks. “I burn the candle at all ends and occasionally find four or five hours a night.”

Fellows recuperates by making up for lost sleep over the weekends. It’s not just managing kids and early carpooling that cause her to skimp on slumber. She’s addicted to technology for work, emailing and typing up computerized reports at night.

Dr. Jacob Teitelbaum, MD, author of From Fatigued to Fantastic! confirms that there is merit to “catching up” on sleep over the weekend.

He recommends a number of quick energy boosters that people can do to feel better when tired, including going outside for a walk (exercise with sunshine can boost energy) and making sure one stays adequately hydrated.

He also gives the following acupressure tip: “rub your ears between your thumb and first finger for 10 to 15 seconds. This stimulates all of your acupuncture meridians and will actually give you an energy burst for a while.”

Both Teitelbaum and Giampapa advocate for a cup of green tea over coffee, saying that the former gives an energy boost minus anxiety. Green tea also contains theanine, which will give you a calm sensation while caffeine in the tea leaves you feeling energized. Green tea’s powerful antioxidants help fight free-radicals that cause our cells to weaken and age. The less sleep, the more stress and the more damage to our cells and increased chance of illness.

Additionally, Rotenberg explains that because some individuals are slow metabolizers of caffeine, the short term fix from strong coffee can worsen the following night. Other side effects of caffeine excess include anxiety, irritability, tremulousness, and insomnia. Caffeine also crosses into breast milk, and nursing babies whose mothers consume 600 mg or more a day (an 8 oz. cup of coffee has 80 to 150 mg) may be irritable and have trouble sleeping.

As for staring at a computer screen like Fellows, here’s a quick fact: We sleep on average 90 minutes less than we did before the invention of the light bulb!
A survey by the National Sleep Foundation shows people are spending an average of 4.5 hours each week working from home, on top of a 9.5 hour average work day. While 28 percent of people questioned in the survey said daytime sleepiness interferes with their daily activities, 63 percent said they are likely to accept their tiredness and keep going.
Renee Fellows says she falls into this category, but Giampapa recommends “breaking from the Blackberry” by making the conscious effort to end one’s day at a certain time. Focusing too heavily on work can elevate stress which could lead to excess levels of cortisol, the stress hormone and the prescription for premature aging.
Here are more tips from the experts on setting the stage for better sleep:
- Keep to a regular sleep schedule, says Scott Hall, MD, Diplomat of the American Board of Sleep Medicine. “Do not vary your wake up time too much day to day. This can cause trouble with your circadian rhythm when you need to get to sleep at a certain time the next night.”
Exercise helps sleep as long as it is not done within 4 hours of bedtime, he adds.
- Say no to Coffee, Alcohol and Cigarettes: Hall advises his patients to avoid caffeinated products after noon, and to avoid alcohol right before bedtime. “Alcohol can have the effect of helping people go to sleep, but it can cause rebound insomnia after a couple of hours of sleep.”
- Avoid nicotine, adds Elizabeth Lombardo, Ph.D., a psychologist specializing in sleep disorders. Nicotine is a stimulant that’s just as disruptive to sleep as coffee or alcohol, not to mention the other known health hazards.
- Create a “Sleep Friendly” Bedroom:
Invest in high quality sheets, says Candita Clayton, professional organizer and author of Clean Your Home Healthy: Green Cleaning Made Easy. “Nothing is more restful than a little luxury. Considering you spend a third of your life in bed, it's worth it.”

Lose the clutter, she adds, explaining that when surrounded by too many things, her clients feel compelled to do something else (like clean!) when they should be sleeping.

She also recommends using a plant as a natural air freshener and to enhance the bedroom décor.

- Follow a wind-down routine to help you relax before bedtime, says Lombardo. “Take a warm shower, listen to relaxing music with the lights dimmed, read…Relaxing the mind before getting into bed can help decrease stressful thoughts.”

Giampapa recommends meditating before bed: A study he conducted at the Monroe Institute in Faber, Virginia, showed that meditation increases key hormones like DHEA and melatonin, a key ingredient for proper sleep.

- Your Mattress Matters: “Constant tossing and turning is one of the leading inhibitors of a sound sleep, and often stems from the uncomfortable pressure points created by a mattress,” says Dr. Vaughn McCall, board certified in Sleep Medicine, a Fellow of the American Academy of Sleep Medicine and member of the Sealy Orthopedic Advisory Board. “Many manufacturers are designing mattresses with technology to alleviate pressure points, like Sealy’s new Posturepedic Innerspring line. Additionally, eliminating sound and light, removing pets from the bed and optimizing the bedroom temperature are necessary first steps to getting a better night’s sleep.’”


- Good Sleep Health from the Inside Out: Giampapa says that part of the approach to good sleep is getting in proper nutrients while awake. Aside from healthy eating, he recommends separate nutritional supplements for day and night. He formulated the Suracell line of am and pm core supplements, customized to the individual’s genetic health for better aging – and part of aging well? Sleeping better!

The reason for different combinations in the A.M. and P.M., he explains, is to regulate the autonomic nervous system responsible for our biological clock. This way, we’re alert during the day and calm for sleep at night.

And finally, if you’ve taken the above measures, but like Dorfman, you’re still tossing and turning, Lombardo suggests adopting Dale Carnegie’s strategy:

“If you can't sleep, then get up and do something instead of lying there worrying,” he said. “It's the worry that gets you, not the lack of sleep.”









[1] Gunderson EP, Rifas-Shiman SL, Oken E, Rich-Edwards JW, Kleinman KP, Taveras EM, Gillman MW. Association of fewer hours of sleep at 6 months postpartum with substantial weight retention at 1 year postpartum. Am J Epidemiol . 2008 Jan 15;167(2):178-87. Epub 2007 Oct 29
[2] Rosekind, M.R., Graeber, R.C., Dinges, D.F., Connell, L.J., Rountree, M.S., Spinweber, C.L., & Gillen, K.A. Crew Factors in Flight Operations IX: Effects of Planned Cockpit Rest on Crew Performance and Alertness in Long-Haul Operations. NASA Technical Memorandum 108839. Moffett Field, CA: NASA Ames Research Center. 1994.

0 comments: