At our MSG meeting 9/18 several women mentioned that they were unable to get to the 9/11  Neurology Institute sponsored lecture on sleep given by Dr. Kathy Yaremchyuk, chair of the Department of Otalaryngology-Head and Neck Surgery, Sleep Medicine.  I was able to attend and since there is much interest in this subject, I will share my notes with you.  My comments in italics.

• During sleep we cycle back and forth between light sleep and deep sleep.   It is unknown how important each type of sleep is. Normally, as we age the time we spend in light sleep increases and deep sleep decreases.  Arousals and awakenings increase.
• Desire to sleep is driven by a natural circadian rhythm influenced by light exposure, exercise, timing of meals and medications.
• Desire to sleep is also driven by “homeostatic pressure”.  The longer you stay up the more sleep debt you accumulate and the more pressure there is to go to sleep. ( I call this fatigue)
• Most  people need about 8 hours of sleep per night.  Greater than 8 or less than 6 is assoiciated with increased illnesses.  Older people need less sleep.  Men have more sleep disruption than women as they age. (surprising, but maybe we just complain more!)
• Sleep deprivation is associated  with lower pain tolerance, reduced glucose tolerance, increased accidents, decreased ability to learn or remember new information.  Nearly every body system is affected by sleep loss.
• Causes of sleep deprivation include over-stimuation from television, stress, shift work, lifestyles, some illnesses, some medications, body aches and pains (hot flashes?), poor sleep hygiene. (I love the concept of sleep hygiene, it sounds so clean)
• Sleeping pills are a temporary solution to insomnia.  Cognitive or Stimulus Control Therapy has been shown in studies to be as effective as sleeping pills but has the advantage of showing long term results. (HFHS offers Cognitive Therapy sessions. 313-916-4417 for more information)  Tai Chi exercise has also been shown to have long term benefit.
• The goal of therapy is to teach coping skills (and encourage good sleep hygiene) to prevent or minimize recurrance of sleep disturbances.

SLEEP HYGIENE HABITS

• Do not go to bed until you are drowsy.
• Maintain a consistent wake time, including weekends.
• Do not take naps
• Get regular exposure to outdoor or bright lights, especially in late afternoon.
• Keep bedroom quiet, dark and comfortable temperature (cooler is better, if you ask me. Also I suspect a good mattress and pillow are important.)
• Eliminate TV, radio, computer, books or other stimulus (like pets, kids, snoring men?)  
• Remove or turn your bedroom clock around.
• Use your bed only for sleep and sex. (ok, so he can stay )
• Exercise regularly but avoid 4 hours prior to bedtime.
• Avoid excessive fluids or large meals at least 2 hours prior to bedtime.
• Do not snack if you wake up at night.
• Avoid bright lights in the evening and before bedtime.
• Eliminate caffeine at least 6 hours before bedtime
• Stop drinking alcohol and smoking completely or avoid at least 4 hours prior to bedtime,
• Take medications as directed. Never take borrowed prescription medications. 
•  Avoid over-the-counter sleep aids.
• Never command yourself to go to sleep.  Identify sources of stress that affect sleep and address it.

Sweet dreams.

written by Deborah McBain, CNM MSN