Sleepless Nights

 Studies in the U.S. have shown that 30% of the population complain of sleep difficulties and half of these consider it a serious problem.  The study of sleep is relatively new.  Little research was done before the mid-1950’s.  In the 1960’s, sleep disorder centers were established to address problems related to ineffective sleep.  Presently, most major medical centers in the U.S., including Robert Wood Johnson University Hospital, have a sleep disorder center. 

 The results of chronic sleep deprivation are seen throughout our daily lives.  Aside from constant exhaustion, lack of effective sleep can cause reduced productivity in the workplace, less leisure activity and social interaction with others, and an increased susceptibility for accidents.  Health, mood, behavior, decision-making, and ability to deal with stress can all be impaired due to poor sleep. 

 For people who experience the most common complaints of insomnia, the following sleep hygiene tips can be useful: 

Limit alcohol consumption to within 2 to 3 hours of bedtime.  Alcohol does not promote sleep but instead interferes with deep sleep and dream activity. 

Restrict caffeine (in coffee, tea, cola) and nicotine use during the day.  Both are powerful stimulants and can reduce sleep. 
Add regular exercise to your daily routine, preferably in the late afternoon or early evening.  Exercise initially elevates core body temperature and then decreases it.  This decrease in core temperature facilitates sleep onset. 

Practice physical and mental relaxation techniques and, if needed, learn these skills from a professional. 

Pay attention to sleep environment.  A quiet, darkened room with a cool temperature aids sleep. 

A light carbohydrate snack can increase the level of seratonin, a brain neurotransmitter, which plays a role in effective sleep.  Alternatively, a heavy meal before bedtime can interfere with sleep and should be avoided.  Fluids should also be restricted a few hours before bedtime so trips to the bathroom will not interrupt sleep. 

There can be numerous medical and psychiatric reasons for ineffective sleep.  People with complaints of chronic insomnia, which do not respond to the simple techniques of sleep hygiene, should consult their primary care physician.  A referral to a sleep disorder center may be indicated.  ALS patients may have specific reasons for sleeplessness, such as inability to shift position, muscle cramps, and breathing difficulties.  These problems should be identified and treated by the physician managing the ALS. 

A recommended resource for people wishing to learn more about this subject is:  No More Sleepless Nights by Peter Hauri, Ph.D., Director of the Mayo Clinic Insomnia Program, and Shirley Linda, Ph.D.