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Up all night
Getting enough sleep? Most people donít, but you can turn your yawns into Zs with easy advice from the pros.



How did you sleep last night? Did you wake up feeling refreshed? Perhaps you felt fatigued and tired. If you did, youíre not alone. In fact, 50 to 70 million American adults suffer from sleep and wakefulness disorders, according to a new report from the United States Centers for Disease Control and Prevention.

Sleep is more than just a period of time when youíre not awake. Studies conducted over the past several decades have revealed that sleep has distinctive states that cycle throughout the night. Your brain stays active throughout sleep, but different things happen during each stage. For instance, certain stages of sleep are needed for you to feel well rested and other stages help you to learn.

"Adequate sleep is as important as diet and exercise, and only a relatively small percentage of people are getting what sleep experts believe is an adequate amount of sleep," says Steve Gardner, director of marketing for the Sleep Wellness Institute and executive director of the Reggie White Sleep Disorders Foundation in West Allis. "Adults need at least seven to eight hours of sleep each night and teenagers and children need more."

Not only does the quantity of our sleep matter, but the quality is important, too. People whose sleep is interrupted or cut short might not get enough of certain stages of sleep, leading to health and performance problems. Not getting enough sleep has been tied to depression, obesity, hypertension, diabetes, high cholesterol and certain risk behaviors like cigarette smoking, physical inactivity and heavy drinking.

If you arenít getting enough rest, your bedroom could be the culprit. "You want to make sure to create a restful environment," Gardner says. "Remove anything that is distracting from sleep, such as a TV, computer or even a radio. Make sure your window coverings are adequate and keep the temperature down."

With any luck, creating a more conducive sleep environment will help you get the rest you need. "If you are still waking up tired or feel very sleepy during the day, you might have a sleep disorder," says Karen Block, a respiratory therapist and owner of Endeavor Therapy Sleep Center in Mequon. In fact, more than 18 million Americans have sleep apnea or sleep disordered breathing. Sleep apnea occurs when a person stops breathing while asleep, for a few seconds or more up to 30 times in an hour, due to throat tissue collapsing and the airway becoming blocked. It can also happen because the brain is not sending consistent messages to the body to breathe, Block says.

The symptoms of sleep apnea include loud snoring, choking during sleep, morning headaches, memory impairment, mood disturbances, daytime fatigue and excessive daytime sleepiness. "Obese men over 50 are the most common sufferers of sleep apnea, but we are finding a growing number of men and women of all ages and all sizes with sleep apnea," Block says.

There are a variety of treatments for sleep apnea, depending on an individualís medical history and the severity of the disorder. "The first step is a sleep study, typically ordered by a physician. We can usually determine their problem in one night," Block says.

Most treatment regimens begin with lifestyle changes, such as avoiding alcohol, losing weight and quitting smoking. Some people are helped by special pillows that keep them from sleeping on their backs, or oral appliances to keep the airway open during sleep. If these methods donít work, doctors often recommend continuous positive airway pressure, in which a face mask is attached to a tube and a machine that blows pressurized air into the mask and through the airway to keep it open. 

Ironically, Gardner was one of the millions who suffer from sleep apnea, but didnít realize it. "I had been working at the Sleep Wellness Center for a short time and my wife told me that I was a prime candidate for a sleep study because I was snoring loudly at night. I had the sleep study and discovered I had moderate to severe sleep apnea," he says. "I didnít realize how bad I felt until I was fitted for a CPAP mask and started using it. I have so much more energy now."

For people who have a snoring problem or mild sleep apnea that does not require a CPAP device, a mouthpiece or oral appliance may help. Dr. Sandra Casper of Milwaukee is a dentist who works with the medical community to custom fit patients for these oral appliances. "After we have an accurate diagnosis, we do a comprehensive oral exam to determine if the patient is a candidate for an oral appliance, and that can depend on their oral and dental health. Then a decision is made as to what appliance is appropriate for the patient," she says.

The oral appliances made by Casper are FDA-approved and look similar to an orthodontic retainer. "The mouthpiece attempts to open a personís airway by adjusting the position of the lower jaw and tongue. Patients find these appliances very easy to get used to, which is not always the case with the CPAP devices," Casper says.

"Very often people with sleeping disorders donít even realize they have a problem until a loved one tells them that they snore, snort or stop breathing for short periods, which brings them to the doctor," Casper says. "Although sleep disorders can be serious, itís important to remember that they can be treated."

Time to Medicate?

If you have trouble sleeping, you might be tempted to try some over-the-counter sleep aids from your local drug store. But do they really work? There is conflicting information about these medicines, so it makes sense to learn more before you buy.

In general, sleep medications are most effective as a temporary aid, not a long-term solution. "The main ingredient in over-the-counter sleeping pills like Tylenol PM or Excedrin PM is an antihistamine like Benadryl," says Steve Gardner of the Sleep Wellness Institute in West Allis. "Antihistamines have the effect of making you feel very sleepy. These particular sleep aids also include a pain reliever, which you might not need or want, especially if you are taking other medicines."

Be sure to read the labels. All OTC medications are required by law to list side effects and precautions for using the medication.

On the other hand, a dietary supplement like melatonin, which is also used as a sleep aid by many people, is not regulated by the FDA and contains no such precautions. "Melatonin is a naturally occurring hormone made by the brain that tells us when to sleep and wake, but melatonin supplements can also be taken," Gardner says. Not much is known about melatoninís side effects when taken with other medicines.

Best advice: Talk to your health care provider before trying any of these OTC sleep aids.