Sleep Interruptions – Not so Trivial!

Many people talk to me about their difficulties sleeping, either difficulty falling asleep initially, or returning to sleep in the middle of the night, or in some cases waking up before they want to start the day.

One question that can be very helpful in this situation is “what woke you?” or “what prevented you from falling asleep?”  Surprisingly often, there is a clear environmental disturbance that is interrupting sleep.

Here are some of the external sleep interruptions I’ve heard of over the years:
– a snoring, or moving, bedpartner who may have a sleep disorder of their own
– bedpartner who gets into bed later, or who gets up earlier, thus waking up the person experiencing insomnia
– dog’s collar jingling
– cat asking for attention by scratching on the bedroom door
– outdoor lights that turn off and on with movement (hate those!)
– children in the bed, snuggled right up against the patient who then is uncomfortable
– an appliance or toy that beeps
– the cell phone, often a problem when it is used as an alarm clock
. . . and the list could easily go on.

When you are working to improve your sleep, you first want to eliminate as many of these interruptions as possible. I recently was working with a woman struggling to sleep well, waking 2-4 times each night. When asked “what wakes you in the night” she identified that sometimes her husband’s snoring woke her. We dialed down into that a little more, and she estimated that his loud snoring is responsible for half of her wakings, and realized looking back on it that when he’s away she does sleep better. Another person, a mother, said that she’s often squished between her children during sleep, and has no sleep problem if she has the bed to herself.

When you are working to improve your sleep, a helpful first step is to see if any external factor is interrupting or preventing you from sleep. Systematically resolve those interruptions, and then re-assess. You may find that those interruptions you were tolerating are not so trivial!

Start School Later goes to Washington DC

Over the last week the efforts for the national Start School Later initiative have been intense. This week, March 7th, this petition will be presented to Congress. You can see the press release copied below.

SUPPORT BY SIGNING PETITION NOW at http://signon.org/sign/promote-legislation-to.fb1?source=s.fb&r_by=1521139

400 more signatures are needed as of this moment. I support this initiative in part because many of my adult insomnia patients say that their sleep problems began as a teen, and I’d like to prevent that in the next generation. Thank you, Catherine

Grassroots Petition to Start School Later Goes to Washington for Sleep Week
FOR IMMEDIATE RELEASE
March 1, 2012

CONTACTS
Annapolis, MD- Terra Ziporyn Snider, Ph.D., StartSchoolLater1@gmail.com 410-975-9759
Seattle, WA- Catherine Darley, ND, drdarley@naturalsleepmedicine.net, 206-293-2899

Annapolis, MD. To honor National Sleep Awareness Week, a grassroots coalition of parents, teachers, and health professionals will begin delivering a petition advocating a minimum school start time of 8 a.m. to Congress and White House officials on Wednesday, March 7, 2012. The petition, garnering national attention, has signatures from all 50 states and Washington, DC and has fueled activity in local communities from Short Hills, NJ to Woodinville, WA.
“Most U.S. high schools today start in the 7 a.m. hour, a practice that began several decades ago primarily to save money on bus runs,” explains Terra Ziporyn Snider, Ph.D., a medical writer and the petition creator from Maryland who is also the mother of three. After more than a decade of work advocating for later start times in her local school system, Snider recounts, “Although evidence is crystal clear that starting later is best for health and learning, political obstacles and myths have made change virtually impossible in most districts.”
The petition effort has galvanized a national coalition of health professionals, sleep researchers, educators, parents, and other concerned citizens called Start School Later. The coalition has representation from 16 states and includes an advisory board comprised of notable sleep researchers, adolescent health care providers, and education leaders.
Voluminous research indicates that later school start time can lead to:
• Reduced sleep deprivation, depression, mood swings, and suicidal ideation
• Decreased stimulant abuse, weight gain, and diabetes risk
• Reduced early morning traffic accidents and drowsy driving by new teen drivers
• Improved safety by eliminating waiting or walking in dark, low visibility settings
• Reduced risky after-school behaviors in unsupervised adolescents
• Reduced truancy and absenteeism, and improve school performance
• Improved lifetime earnings potential, according to a recent study published by the Brookings Institute
Locally, in Washington state about 375people have signed this national petition.
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Signature totals and comments from Start School Later’s campaign: http://signon.org/sign/promote-legislation-to.fb1?source=s.fb&r_by=1521139

For more information on Start School Later: http://www.startschoollater.net/
Start School Later is a coalition of health professionals, sleep scientists, educators, parents, students, and other concerned citizens dedicated to increasing public awareness about the relationship between sleep and school hours and to ensuring school start times compatible with health, safety, education, and equity.

Sleep Health in ‘Whole Living’

Recently I spoke with journalists at ‘Whole Living’ along with other sleep specialists. It’s a great article, filled with information and skills that adults need to sleep well. Here’s a few highlights:
– Go to bed at your ideal bedtime
– Create a great place to sleep
– Avoid alcohol, the snooze button and oversleeping
– Learn to calm yourself back to sleep
More information on the many ways sleep impacts your health (think weight gain, heart disease, and wrinkles) can be found in the full article in the October issue. http://www.wholeliving.com/

Family Sleep Health

Last month we discussed infant sleep health, today I’d like to follow-up with discussion of family sleep health. Whenever I’m working with a family to help them improve their child’s sleep, I also think about the parents sleep too. So many parents come in saying they get hours less sleep each night than they need, and they can’t think as well as they used to, or that they aren’t getting along like they used to. Here’s some more information.

Facts About Parents’ Sleep
Many adults in our culture don’t get adequate sleep. For parents, an additional sleep disturbing factor is the children who wake them up in the night or early morning. This sleep disturbance can have a broad impact on how parents function during the day, and even on how parents get along with each other.

In the 2004 Sleep in America poll it was found that among parents of children 10 years old and younger:
– 58% of parents think they need 8-9 hours of sleep each night
– But on average get 6.8 hours
– 62% said they are not getting enough sleep
– And 20% say daytime sleepiness interferes with their daily activities
– 5% of parents say their childs’ sleep causes marital stress

In mothers of infants and toddlers, after just 3 weeks of their child sleeping better, the mothers are less depressed, and able to think more clearly.

How to Get Healthy Sleep for the Whole Family
So if you find that someone in the family isn’t sleeping well, take the opportunity to create a healthy sleep plan for the whole family. Here are some questions you can think through for each parent. You may want to print this out and post it so everyone will know the plan and can be involved.

For each individual have a section with these answers:
1. Nightly sleep need:
2. Quiet (non-task) time will start at:
3. Lights out at:
4. Night waking responsibility:
5. Wake time:

Remember how not getting adequate sleep can affect physical and cognitive performance, and mood. When everyone is well rested you’ll be better able to enjoy your family!

Lessen the Effects of Shiftwork

About 20% of Americans do shiftwork, starting work either in the late afternoon or in the middle of the night.  Their health suffers, and their relationships can suffer too.  If you are on a shiftwork schedule, here are some strategies to manage the shiftwork lifestyle well.

– First, establish a wake / sleep schedule that you can maintain most days of the week.  Try to have some of your sleep hours the same, regardless of whether it is a work day or day off.

– Shiftworkers typically get less sleep than those who work during the day.  Adjust your schedule to allow enough sleep time, close to 8 hours each night is probably needed.

– To help you sleep those hours, make your bedroom ideal for sleeping.  It needs to be cool, dark, relatively quiet, no pets, and no lit clocks.  If you are trying to sleep during the day this can take more effort, but it will be worth it.  Get blackout shades, or use an eyecover.  Keep a fan running softly or earplugs to keep it quiet.  Train your pets that you are not available during your sleep time.  Set the alarm to wake you up, and then ignore the time, allowing yourself to be ‘off duty.’

In our 24 hour society people will need to work at all hours.  With a thoughtful strategy working shifts can be easier.

At The Institute of Naturopathic Sleep Medicine, Dr. Darley provides care for people of all ages who have sleep problems. More at http://www.naturalsleepmedicine.net/

Shiftwork and Your Health

High numbers of people in America do shiftwork – 20% of those who are employed. One definition of shiftwork is starting work after 6pm, and before 6am. “Swing shift” which often starts around 3-4pm is also included in some definitions of shiftwork. Whichever definition you use, it is clear that the health of people who do shiftwork suffers.

Shiftworkers experience symptoms such as stomach upset, moodiness, high blood pressure and elevated stress hormones. In the long term these employees also have higher rates of breast and colon cancer in women, and prostate cancer in men.   These problems are thought to be due to the fact that shiftworkers are awake and engaged during a time that our body clock and circadian rhythm are programmed to be asleep.

Although these symptoms and conditions are concerning, it’s clear that some industries must work around the clock. Especially industries such as public safety, healthcare, and transportation. Fortunately there are ways in which the negative effects of shiftwork can be minimized. Check back on Friday for info on how to lessen these effects.

At The Institute of Naturopathic Sleep Medicine, Dr. Darley provides care for people of all ages who have sleep problems. More at http://www.naturalsleepmedicine.net/

Are Naps Healthy?

I get this question all the time from patients who ask “what about naps?” Let me give you a little information about naps and night time sleep. Another day we’ll look at the effect of naps on alertness and performance.

There are several things to know before deciding to take a nap or not. First of all, from the time we wake until the time we go to bed our sleep drive increases. This sleep drive helps us fall asleep easily. When a nap is taken, it decreases our sleep drive back to zero, and there is less time than normal until bedtime, so at bedtime our sleep drive is less than normal. This can result in difficulty falling asleep, or in a short sleep duration.

The second thing to understand is the sleep cycle. There are four stages of sleep – REM, and NonREM stages 1, 2, and 3. Stage 3 is considered “deep” sleep, and is the most difficult to wake up from. We cycle through all these stages every 90-120 minutes. So a short nap of 30 minutes, or a longer nap of an hour and a half is best. This helps avoid waking out of stage 3 sleep and feeling groggy.

So overall, if you are going to take a nap, take it earlier in the day so that your sleep drive has time to build up again before bedtime and help you fall asleep easily. Also time your nap for less than 30, or more than 90 minutes so that you can wake feeling alert, not groggy.

The Healing Power of Nature

Over the last several months we’ve talked a lot about sleep medicine.  This month I’d like to share with you some interesting information about the healing power of nature.  The Healing Power of Nature is one of the principles of naturopathic medicine, which sets it apart from other medical philosophies.  As the year comes to a close, you may be thinking about how you want 2010 to be different.  Using this information will get the new year off to a great start.

Medical research has shown many ways that being in a natural environment with views of trees, birds, and plants of all kinds improves health as opposed to being in a ‘built’ environment.  ‘Built environment’ means the man-made cars, concrete, high-rises and pollution most of us are surrounded by in our urban neighborhoods.  Here’s a sample of the research findings:

–         Hospital patients recover more quickly, require fewer painkillers, and have fewer post-op complications when they have a view of trees and animals out their window.

–         Office workers report less job stress, fewer illnesses and overall higher job satisfaction when they have a view of nature outside their desk.

–         When roads are surrounded by a greenbelt drivers’ blood pressure and heart rate decrease, as does their sympathetic (fight or flight) nervous system.

–         When urban people go into a natural setting for a few days (like on a camping trip) their concentration and problem-solving improve while mental fatigue decreases.

In our modern lifestyle we spend less time outdoors than people did historically.  Recently the book Last Child in the Woods brought attention to this disconnection from nature that children experience.  In my practice many sleep patients report problems with stress and anxiety.  One of my recommendations is to cultivate a habit of being outside regularly, as lower stress, lower sympathetic nervous charge, and greater feelings of pleasure will improve sleep.

Sleep Habits for Immune Health

There are many ways that healthy sleep supports a healthy immune system. And remember, our immune system is constantly working to rid our bodies of foreign bacteria and abnormal cells. These abnormal cells can become cancerous, so it is important that our immune system weeds them out. To strengthen your immune system:
1. Be sure to get adequate rest most nights.
2. Sleep in accordance with the natural light-dark cycle. When the light bulb was invented and became widely available it significantly changed our way of life. Occasionally think to yourself “Would I be up right now if there was no electricity and light?” This question can help you stay in sync with natural light-dark cycles.
3. The techniques and skills we’ve discussed in this blog will help a cancer patient sleep better. Those include making the bedroom a good sleep environment, keeping a regular schedule, etc. (Past issues of the more comprehensive e-newsletters can be found on the website at http://naturalsleepmedicine.net/news_letters_page.html).

Why Naturopathic Medicine? Part 1 of 3

What is Naturopathic Medicine?

Naturopathic Medicine is a unique philosophy of medicine which is based on the healing power of nature. Naturopathic Medicine has it’s roots in the traditional medicine practiced in Europe hundreds of years ago. It is philosophically distinct from the allopathic medicine practiced by MDs in this country.

The Principles of Naturopathic Medicine are:
Vix Medicatrix Naturae – The Healing Power of Nature.
Nature acts powerfully through healing mechanisms in the body to maintain and restore health. The naturopathic physician works to restore and support these inherent systems.
Primum Non Nocere – First Do No Harm.
The naturopathic physician seeks to provide the most effective health care with the least risk to the client.
Tolle Causum – Find Cause.
The naturopathic physician shall strive to identify and remove the causes of illness, rather than merely eliminate or suppress symptoms.
Docere – Doctor as Teacher.
The naturopathic physician educates the client, inspires rational hope, and encourages self-responsibility for health.
Treat the Whole Person –
Health or disease comes from a complex interaction of physical, emotional, dietary, genetic, environmental, lifestyle or other factors. The naturopathic physician treats the whole person, taking these factors into account.
Wellness –
Wellness is a state of being healthy, characterized by positive emotion, thought and action. Wellness is inherent in everyone. The naturopathic physician shall seek to restore, maintain, and optimize wellness.
Preventive Medicine –
The naturopathic physician promotes health through the prevention of disease for the individual, each community, and the world.
In working with sleep patients, these Principles are so important that they are posted in the waiting room, and guide my work each day.