Insomnia, Snoring, Sleep Apnea

The world and life of a sleep tech

Posts Tagged ‘insomnia’

Insomnia in our Children; Setting Limits Helps

Posted by amykr on June 2, 2009

sleeping mother and child2With the beginning of summer here and the end of the school year the need to consider our children’s habits while they are at home. Many children are home alone or home with older siblings and are limited in their activities. This can lead to issues that will increase health problems.

The sleeping pattern for a child is very important. During sleep they not only rest; they heal from injuries, grow and their minds process much of the information it accumulates during the day. The amount a child or teen needs is higher then an adult yet we treat our children as if they have the same needs as adults. Limit setting is sometimes difficult but is as necessary during the summer as the school year.

Here are a few tips for encouraging sleep in children:
• Set a strict bedtime for most days but allow for special occasions. This will keep them on a schedule and will reduce the need to adjust their schedule when school starts.
• Allow them to sleep in on the weekend. If your child has some sleep debt, a need the body has for extra sleep, it can help to be allowed to sleep in on certain days.
• Make sure that there room is dark and quiet. It is hard to go to sleep with excess light and noise. This does not allow the brain to settle down.
• Remove all electronics from the room. There are two problems with electronics such as game systems, television and computers, they are tempting to go back to when the patents leave, and using them right before they go to sleep will not allow the brain to prepare itself for sleep.
• Create a routine to help them unwind. If a child does the same routine every night they are set up for sleep success. A great routine would start with sitting quietly about 30 minutes before bed and read or be read to, then go brush their teeth, change into sleep clothes, get a glass of water for the bedside table ( will eliminate the “I’m thirsty” call), turn off the lights and get into bed.

Parents want what is best for their children. It is essential that we work with them to succeed in all areas of their life. Helping them to get enough sleep will help them to learn better, be healthier and be happier.

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Insomnia and Fibromyalgia; Combination Therapy Helps

Posted by amykr on May 27, 2009

Fibromyalgia patients have to learn to deal with chronic pain. The problem is that pain and insomnia cause a vicious cycle of increased pain and decreased sleep. Insomnia has been shown in many studies to decrease a patient’s pain threshold.

Treating insomnia can be quite difficult. Medications are usually the first line of treatment. They work well in the beginning but patients build up a tolerance over a period of time. This is particularly true of Fibromyalgia patients because it must overcome the pain the patient feels. When you mix the short term effects of medication such as Ambien or Lunesta with cognitive behavioral therapy, also known as CBT, patients have much more success.

Cognitive behavioral therapy is a psychological treatment where a therapist helps a person changes their thinking about an issue so they can change the behavior. This therapy has shown a 30%-40% success rate in the treatment of insomnia. When it is combines with short term sleep medications the efficacy increases to 65%-70%.

Many patients may be reluctant to go this route because doctors in the past may have told them their Fibromyalgia was in their head. The medical profession has changed their understanding of this condition and is looking to alternative therapies to help to deal with this condition. Cognitive behavioral therapy is one tool to not only help with insomnia but to help with the chronic pain as well.

As with any therapy you should always discuss your options with your doctor because he/she knows your full case history. For those who are looking for the best way to handle the sleepless nights these therapies are a great new option.

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Why is He Here?

Posted by amykr on May 6, 2009

I love my patients, but I have to admit there are some patients that make this job more challenging. They are not the patients with severe apnea or the patients who do not believe they have apnea; They are the patients who do not have anything.

You know the ones I am referring to: you put them to bed, you read their questionnaire, and you expect to see an AHI of at least 15 events per hour. Then it is 1 a.m. and you hear nothing. Not a snore, not a gasp, nothing. You look at the study and they have had plenty of stage 3 and REM already. You look to see if maybe they had not done any sleeping on their back. Nope, they have been asleep on their back the whole time.

When you talk to them the next morning you get one of two responses. My favorite is “This is the best night sleep I have had in years.” The other type of patient is convinced he did not sleep.

We had the former patient in our lab last week. He teaches college. He scores papers on his laptop in his bed until 1 in the morning, most nights. His wife complains that he snores but he says she snores as well. The best part was when I handed him the sleep hygiene tips sheet. He said I left one item off the sheet. He informed me that he slept with his two children in bed with him. Now I was standing there trying to figure out how he did not tell his doc this before the doc sent him to the sleep lab.

I do not know about you, but if I stayed up until 1 a.m. every morning, had two squirming children in bed with me every night, and taught college all day, I would be exhausted.

So what do we learn from this patient? That every once in a while it is nice to have an easy patient.

Oh yeah, and if he even remotely looks young enough to have kids, ask if they have their own room.
Reprinted for http://www.advanceforsleep.com

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Staring at the ceiling

Posted by amykr on January 27, 2009

You have been lying there counting the little holes in your ceiling tiles for days or should I say nights now.  Your tired, irritable and just wish you could sleep.  Insomnia is one of the biggest issues people seek help for.  This is especially true of women.  But few bring this issue to their physician because they do not want medications or they are taking over the counter medications.    

 

I think that its time we looked at all the choices you have when dealing with insomnia.  I like many of you are a fellow sufferer.  I have spent many a night completing a novel or watching that really bad movie at 1am.

 

So I thought it might help to discuss options to help deal with the issue.     Of course I am not a physician and my first recommendation is to go visit your primary care to discuss the problem.

 

The first thing I always try is to look at my sleep hygiene.  Do I have a calm relaxing sleep environment? Is the room dark, the television off, all the pet off the bed and is the room organized?  All these make for a relaxing place to sleep.

 

Next I look at my sleep routine.  Do I go to bed at the same time? Do I have a specific routine that tells my body its time to get ready to sleep?  This is important as the brain needs these cues to get ready for sleep. 

 

So you have done all these things and you are still having problem sleeping what choices do you have?  Over the counter medications contain antihistamines that have the side effect of causing sleepiness.  These are good for an occasional problem. 

 

 The natural products vary greatly.  There is some very interesting research going on with Melatonin as a sleep aide.  It is a hormone your body produces that helps you to sleep.  There is also research going on with Valerian Root but it has not been as successful.  The problem with natural remedies is that they are not regulated and they can interact poorly with other medications you are taking.  You also need to let your doctor know you are taking them before a medical procedure as they can have an effect on your blood and its ability to clot. 

 

Finally there are prescription medications.  I will save that for another blog.

 

If you have any questions please do not hesitate to write me. 

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What our eyes tell us

Posted by amykr on January 10, 2009

As we get older we notice many changes to our bodies. The need for reading glasses being one of them. The other one being that we just do not sleep as well as we used to. Well these two issues may very well be connected. In a study done at University of Kansas by Dr. Patricia Turner M. D., “as the eye ages the pupil gets small and the lens absorbs more light. These two issues work together to decrease circadian photoreception” A fancy way of saying the eye is not as able to absorb different spectrums of light then it used to be. So the part of the eye that helps regulate our bodies just does not work as well.

This inability to judge absorb adequate light can lead to problems such as insomnia depression, or other issues.

So would I bring up this problem if I did not have an answer for you to help you. It appears according to this article that indoor lighting might be a contributor to the problem because it is not as bright and it is heavier on the blue spectrum of light. One thing that might help if you are having issues of insomnia or depression is to go outside. The light outside is brighter it has all the light spectrum so it will allow you to absorb more of the light you need. A second thing you can do is make sure your eyes are as healthy as can be. Go see an optometrist once a year. Lastly if your vision is poor and you seem to be having issues you might want to talk to your doctor about Melatonin supplements.

It is always interesting how research seems to prove the ideas our mothers used to tell us. Like go outside and play, you will feel better and sleep better.

Turner, P, Mainster, M. Circadian Photoreception: Ageing and the Eye’s Important Role in Systemic Health. British Journal of Ophthalmology. Posted on Medscape 12/26/2008. http://www.medscape.com/viewarticle/582906_print

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Extra Side Effect of One New Years Resolution

Posted by amykr on January 2, 2009

Many people suffer from insomnia. We work hard, relax little and suffer from input overload. As woman we also suffer from hormonal changes that can increase insomnia. What can you do about this if we do not wish to take medications?

One New Years resolutions that might be able to help is exercising. There are some rules thought. It works best in the morning according to Dr. Youngstedt’s research at University of California at San Diego. He found that it can help regulate the body’s internal clock also know as circadian rhythm based on when you do your exercise. That outdoor exercise has the added effect of light exposure which helps to regulate this rhythm as well. He also recommends that people with insomnia try exercising different times of the day as some people it does help to exercise in the evening.

Since many of us commit to exercise as part of the New Year it might help to try exercising in outdoor light, do small intervals throughout the day or to experiment with the time you exercise as a way for you to improve you sleep.

I hope you are having a great and productive New Year.

http://www.acsm.org/Content/ContentFolders/NewsReleases/2003/TROUBLE_SLEEPING__A_LITTLE_EXERCISE_MIGHT_HELP.htm

http://www.physsportsmed.com/issues/1997/10oct/young.htm

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