Sleep Tight

An in-depth look at what’s keeping you awake and how to get a better night’s rest

If you’ve seen any infomercial more than twice, chances are you are one of the approximately 100 million Americans who experience sleeping problems every, or almost every, night.

“So many people are sleep-deprived,” says Carol Ash, D.O., medical director of Sleep for Life, a sleep disorders treatment program in Hillsborough, NJ. “We’re living in a time of unprecedented sleep debt.”

Why are so many of us on night watch? Physical problems such as ulcers or back pain can be the culprits, as are asthma, allergies, certain medications and nighttime conditions such as sleep apnea. Emotional problems such as depression and anxiety may also take a toll. And then there’s plain old stress.

It doesn’t help that we’ve evolved into a 24/7 society. “Two hundred years ago, we went to bed when the sun went down,” Ash says. “Technology has allowed us to turn night into day. Human physiology can’t keep up with that. People sacrifice sleep to get more and more done.”

Your Sleep Saboteurs

A sleep specialist can determine if you have a sleep disorder and devise an effective treatment. Here are three common conditions.

Sleep apnea is a breathing disorder that occurs when the tissue at the back of the throat collapses and blocks the airway during sleep, causing you to stop breathing several or even hundreds of times a night. Most common in obese middle-aged men, it can affect women too. How do you know if you have it? You snore loudly, awake gasping for breath or feel fatigued and sleepy during the day. An overnight test called a polysomnogram confirms the diagnosis.

“The most successful treatment is continuous positive airway pressure [CPAP],” says Paul Selecky, M.D., medical director of the Hoag Sleep Disorders Center in Newport Beach, CA. This involves wearing a mask over your nose or face to deliver air to the back of the throat, keeping the airway open. Weight loss may also help decrease the amount of obstruction in the throat. Other options: staying off the back, or raising the head during sleep, wearing an oral device or having surgery to remove excess tissue.

Restless legs syndrome (RLS) causes uneasy feelings in the legs and the strong urge to move them—and it gets worse at night. This condition is more common in women than men and is associated with kidney disease, iron deficiency, pregnancy and certain medications, including most antidepressants. Symptoms include a burning, tingling or prickly sensation in the legs and the urge to move them that’s eased by motion. Regular exercise may help, but medications may be needed to suppress the sensations.

Narcolepsy is a condition characterized by excessive sleepiness that may involve sleep “attacks” during the day. Symptoms include daytime sleepiness, feeling sleepy even after sleeping all night and feeling drowsy even after a long nap. Also, you may find yourself briefly unable to move as you are going to sleep or waking up. You’ll need an overnight sleep test and a test of daytime naps to diagnose the condition. A napping schedule and certain stimulant medications are usually helpful, Dr. Selecky says. Narcolepsy affects about one in every 2,000 people.

Lifestyle & Sleep

Our round-the-clock lifestyles come at a big cost. “The ability to think, concentrate, remember and problem-solve deteriorates as we become sleep-deprived,” says James Walsh, M.D., director of the St. John’s Mercy Sleep Medicine and Research Center in St. Louis.

Worse, research shows, a chronic lack of sleep disrupts the body’s endocrine system, which regulates appetite and blood sugar, among other functions. Sleeping less than seven hours a night increases the chances of becoming obese, and women who sleep five hours or less a night have a 39 percent greater chance of developing coronary heart disease, according to data from the Nurses’ Health Study. Other data suggest skimping on sleep increases diabetes risk.

Sleep Strategies

“There are a lot of things that interfere with sleep,” says Dr. Selecky. “But most are of our own doing.” Try these good-sleep measures to turn the tide:

  1. Establish a relaxing bedtime routine, such as taking a warm bath.
  2. Make your bedroom as quiet, dark and comfortable as possible. Consider blackout curtains, earplugs, a sleep mask, fans or white-noise machines.
  3. Eliminate caffeine, alcohol and nicotine, particularly late in the day.
  4. Exercise, but not close to bedtime.
  5. Quell your worries before you try to fall asleep. To clear your mind, well before you head to bed devote a half hour to worrying.
  6. Don’t try to sleep unless you are tired. In bed, read a book or listen to music until you feel drowsy.
  7. If you don’t doze off in 20 minutes, get out of bed and do something relaxing until you’re sleepy.
  8. Get up at the same time each morning, even on weekends and holidays.
  9. Use your bedroom only for sleep and intimacy.

Ask your doctor about taking a prescription sleeping medication for short-term or occasional sleeping woes. “This can be used as an adjunct to good sleep hygiene, but not to replace it,” says Dr. Selecky. Over-the-counter sleeping aids are generally less effective than prescription pills and more likely to cause next-day grogginess.

Can Naps Help?

Napping isn’t just for babies anymore. A midday snooze not only helps you feel better if you’re hurting for shut-eye, it’s almost as restorative as nighttime sleep, says Sara C. Mednick, Ph.D., assistant adjunct professor of psychiatry at the University of California, San Diego School of Medicine and author of Take a Nap! Change Your Life.

Not a napper? Start by giving yourself permission to sleep during the daytime. “You have to believe that it’s not being lazy and will make you more effective at what you’re doing,” says Mednick. Avoid caffeine, fat and sweetened foods and drinks, which can interfere with sleep, she advises, and don’t nap too late in the day. Find a quiet place where you feel comfortable and safe. Remember to dim the lights. A 15- to 20-minute nap will make you feel more alert and refreshed. Or snooze for 50 to 90 minutes to experience the most restorative stages of sleep. These longer naps, however, may leave you feeling a bit groggy.

Publication Review By: the Editorial Staff at

Published: 22 Aug 2010

Last Modified: 06 Oct 2015