Wellness Report

"Drowsy driving" causes more than 100,000 crashes a year--and kills more than 1500 people. In this week’s Wellness Report: "Sleep Deprivation." It's not just a problem on the road.

At least 10% of adults now say they don't get enough sleep and nationwide up to 70 million people have some kind of sleep disorder. We now know it can lead to a long list of serious problems---from diabetes to heart attack. Here's how to get back on track.

Restless Leg, Narcolepsy or Sleep Apnea. The list goes on and on. There are now 82 diagnosable sleep disorders, but there is one that is--by far--the most common.

“It’s called Acute Situational Insomnia or Sleep Deprivation," says Dr. Sarah Stolz. She is the medical director for Sleep Medicine Associates in Seattle—which is associated with Swedish Medical Center.

“Your going to have trouble maintaining alertness, and you're going to have trouble with your concentration and memory,” she says “but it can also lead to serious problems such as other disorders, high blood pressure, heart attacks, heart failure and stroke.”

Also: Weight gain. When we sleep we produce a hormone called leptin--which tells the brain we're "full." But studies show when we're sleep deprived leptin levels drop and our appetites grow.

She says: “It's been found that if you sleep deprive even normal healthy volunteers they feel more hungry and therefore eat more and it was interesting that the foods that were chosen to eat were more what we call junk food.”

Dr. Stolz has some advice on what’s called good “sleep hygiene.”

When ever possible--keep a regular schedule. Sleep regulates chemicals, hormones and temperatures in our body

She says *any* exercise is helpful, but for most of us late afternoon is the best time.

“In general, getting regular exercise, 3-4 times a week is very helpful for people to improve the quality of their sleep,” says Stolz, “ for reasons that have to do with our circadian rhythms. Exercising in the afternoon, not too late because it can disturb your sleep if it's within a few hours of going to bed but late afternoon, will increase the depth of your sleep. It will allow you to have more of that deep stage 3-4 sleep. If you exercise around the point in the day when your temperature is the highest you enhance that, you make your body temperature a little higher and you make the rhythm stronger so it’s more dramatic drop at night which puts you into a better deep sleep.”

I’m sure you've heard "no caffeine" close to bedtime, but Dr. Stolz says you may need to stop as early as noon or 2pm. For some, caffeine stays in the body for up to 10 hours.

"No alcohol" is a big one and here's why:

“Because alcohol close to bedtime can cause sleep apnea,” says Stolz. “Many people don't realize that.”

Sleep apnea is where something blocks or constricts your airwaves and you can't breathe.

She says: “Alcohol contributes to the problem because it paralyzes the muscles in the tongue which causes your tongue to flop into your airwaves more easily.”

Next: do something to wind down such as meditation, a bath or light reading, but here's where Stolz says so many of us go wrong.

“There's the exercise equipment, and the huge TV all the other paraphernalia that doesn't belong in the bedroom. That's for the living room,” she says.

Make your bedroom a sanctuary -- only for sleep or intimacy.

“We want your brain, when you enter the bedroom, to think ' I'm going to sleep. I'm here to fall asleep.'”

Web Extra: Napping

“ Napping is one of those things that is really per individual. There are people that are really lucky. The can sleep for 10-15 minutes and feel recharged-- and that's great. Other people find they sleep longer and it doesn't help them as much because they get into a deeper sleep when we go through the process of falling sleep. We start with light sleep, then we get into medium sleep and then deep sleep and finally REM or rapid eye movement. That’s where we dream.”

“Once you get into the deep sleep, when you wake up if you've awakened before you've finished the cycle you tend to feel really groggy and for some people that just lingers, and so napping makes them feel worse.”

“So for the average person, if we wanted to give them some advise, they wanted to give napping a try, what's a reasonable time where they would hopefully avoid getting into the deep sleep?”

“I would say start with a half an hour and then see how it goes. Some people can tolerate longer naps, some people can't, but half an hour should be a good starting point.”

“But if we were talking about someone with insomnia, we usually recommend avoiding napping or if you're going to nap keep it short and keep it earlier in the day--preferably before say 2 o'clock.”

“It's important to be sleeping in an environment that's condusive for sleep, so not having noise in the background, if you do, then use ear plugs, keep the light level low, or keep it cool.”

“For people who have trouble waking up in the morning having an east facing bedroom works better. If someone who is what we call a 'lark' who has lots of energy in the morning but not the life of the party at night then having a west facing bedroom would be better. That’s because as the light comes up in the morning as the sun comes up, most people wake up really easily.”

Web Extra: Avoiding Mid-Day Drowsiness

“ Usually that's the problem is in the afternoon. To some extent that's normal. It has to do with the way our circadian rhythms are structured. There's just a period where we are vulnerable to being sleepy.”

“So you can structure you're day so you're not as sedentary during the period after lunch--it's probably not the food that's making you sleepy it's just the time of day.”

“If you can structure it so you don't have that boring meeting at 2 o'clock, and that you're doing something at little more active if you are at you're desk and can't stay awake, getting up and taking a short walk, go to the water cooler and get some water-maybe a little caffeine-remembering that you don't want to drink it too late. Just try to vary what you are doing-maybe a little bit of physical movement to keep yourself wake.”

Web Extra: Melatonin

“ Melatonin is an interesting substance. It's not FDA approved so have to be careful when you recommend it as physicians, because you don't even know if the bottle has melatonin in it because it's not regulated.” But that aside, melatonin is related to, it's a hormone that are brain produces when it's dark. So it's kind of a timing mechanism for the brain it isn't a sleep inducer.”

“For example: Rats make melatonin at night, they are nocturnal. They have more activity at night than during the day. So melatonin doesn't put a rat to sleep and it probably doesn't put a person to sleep directly. But it tells the brain it is nighttime and nighttime is when you should sleep.”

“So melatonin is useful if people are having trouble with the timing of their sleep, jetlag, or shift work. It's not a very powerful hormone, but can work with other things combined.”