To sleep: perchance to dream; ay, there’s the rub. —William Shakespeare’s Hamlet, Act III.
You and I spend approximately one-third of our lives asleep. Although at time we may appear to be sleepwalking through life, perhaps due to occasional bouts of restless sleep, few of us would like to experience daily problems with sleep loss. Not only do we become irritable and less productive with chronic sleep deprivation, but we may also develop serious and sometimes fatal health problems — hypertension, depression, cardiovascular disorders, immuno-suppressive disorders, and increased risks of automobile and occupational accidents. According to a sleep study, 27 percent of drivers reported having dozed off at least once in the last year. Sleep problems are estimated to cost about $50 billion per year in lost worker productivity and absenteeism, to say nothing of the difficulties caused at home by loved ones who are sleep-deprived zombies — they are there but not there. Sleep disorders affect our overall health functioning and quality of family life — they are no laughing matter.
Unfortunately and tragically, many sleep problems go undetected even though they often can be effectively managed and remedied. Less than half of us, especially children, get the recommended eight hours of sleep per night. Some teens sleep their way through classes after working late-night jobs after school. Too many of us who are juggling busy jobs with the frantic demands of family life are not even aware that we fail to get enough sleep. A client of mine, who is a successful single mother and college student asked, “Sleep? What’s that? Besides, who’s got time for it?!” Despite the glowing promises of greater convenience from technology, most of us driven souls have even less time than ever and we regard sleep as a luxury. Far too many of us rely heavily on our daily coffee fixes, herbal remedies, and frantic lifestyles to mask the fact that we are simply not fully present in our lives. When we face and remedy our sleep problems, we wake up and our whole lives change.
Types of sleep disorders
Insomnia is the most common sleep problem. Almost all of us have nights where we cannot fall asleep, have restless repose, or wake up too early. Some of us may be under a great deal of external stress and excitement or else we may be unconsciously troubled by emotional problems that surface during our bedtimes. Persistent insomnia may start interfering with our lives as our sleep deprivation accumulates. Many physical symptoms—lack of concentration and memory, lethargy and apathy, and persistent illnesses—are the result of unrecognized chronic insomnia.
Other common sleep difficulties include snoring and sleep apnea. When breathing during sleep gets obstructed, we have frequent awakenings and we’re robbed of deep sleep. Apnea has biological origins, is common in two percent of women and four percent of men, and often goes undetected because awakenings are not remembered. Unfortunately, when we persistently fail to get enough sleep and oxygen, our entire cardiovascular system is stressed throughout the daytime. People with untreated apnea have serious risk of strokes and heart attacks.
Other sleep disorders include narcolepsy (falling asleep too easily no matter how much sleep you get), restless leg syndrome (inadvertant kicking or jerking of the legs during sleep), and nocturnal seizure disorders and REM behavior problems (sleepwalking, night terrors, and disruptive sleep vocalizations). All may result in decreased work performance and strained interpersonal relationships.
Sleep disruptions have biological, psychological, and cultural origins.
Warning signs
Sleep difficulties can be difficult to diagnose and there are no signals that guarantee you have a sleep disorder. Many other medical problems can have manifestations similar to those of sleep problems. A physician qualified to assess sleep difficulties is the best resource for discovering if you have such problems. Nevertheless the following symptoms may indicate a sleep disorder:
- Excessive daytime drowsiness
- Frequent nocturnal urination
- Loud or irregular snoring
- Persistent concentration and energy losses
- Sleep in inappropriate settings
- Work and vehicular accidents
- Relationship conflicts over snoring, and
- Chronic drowsiness
Contributing factors
Sleep disruptions have biological, psychological, and cultural origins. Some of us have medical problems resulting from obseity, increased aging, anatomical abnormalities, alcohol and sedative use, smoking, and family genetic influences that result in a diminished quality of sleep. Others of us may have our sleep disturbed by current stressors, interpersonal conflicts, mood disorders, distress over past traumas, and ineffective sleeping habits we have learned. Our sleeping minds—either through dreaming or nocturnal disruptions—may be more active trying to figure out our daytime dilemmas or involuntarily reliving incidents of past nighttime abuse. Our minds never truly rest.
Culture plays a pivotal role in whether sleep is a problem. Regimented and technologically-based cultures may make greater demands and provide fewer supports for quality sleep than cultures where family members all sleep closer together and are under less stress. Sleep disorders are highly complex, only newly studied, and not completely understood.
Tips on getting help and getting better sleep
To improve your sleep hygiene: keep regular bedtime and arousal schedules; don’t use alcohol, nicotine or caffeine before bedtime; go to bed early; don’t exercise or eat before bedtime; rely on quiet time or soothing rituals (relaxed reading or listening to nature tapes) before retiring; put time limits on any obsessive thinking; and don’t remain in your bed when you cannot fall asleep.
Otherwise, if you suspect that sleep difficulties are interfering with your life, it’s best to consult a physician and psychologist who specializes in treating sleep disorders. You may need to undergo a medical exam and a sleep study to precisely assess your complaints. Medical tests and treatments are accurate and well worth the effort, as you may unlock the mystery of your difficulties. Medications, breathing facilitators, and behavior re-training are among the prescribed medical treatments. Either consult your family physician and get a referral to a specialist or seek help from a sleep disorder clinic such as the Minnesota Sleep Institute.
If you have no apparent medical problems and suspect you may be under stress, it’s essential that you pursue psychological help to remedy the origins of your sleep disturbance, especially when they seriously interfere with your life. Medication and psychotherapy are the treatments of choice. When you work with a psychotherapist, you not only treat your sleep problem but you become a more whole person.
Most importantly, as cumbersome as they are, sleep disorders are true opportunities if they are treated. When you get a good night’s sleep, you discover a whole new way of living.
This article first appeared in the June 1999 issue of The Phoenix Spirit.
