In Search of Sleep
You want it. You need it. Here’s how to get more of it …

By Stacey Stapleton

Under cover of night, here’s what’s really going on in people’s homes when they should be sleeping: Men and women are sacrificing sack time to watch more television, drag work into bed, do the laundry, finish their kids’ projects … Are you, too, guilty as charged?

Most of us are no strangers to the occasional bout of sleep deprivation (it is estimated that 70 percent of adults don’t get enough sleep), but what you may not realize is that losing even a little sleep can be harmful. Studies show that missing just one hour of sleep can decrease your alertness the following day by up to 25 percent. Don’t know how to get more—and better—sleep? The answer has nothing to with counting sheep.

The Science of Sleep

If you think that when you’re sleeping you’re sedentary, you may be surprised to learn that as you slumber, your body engages in a complex five-stage cycle that repeats itself throughout the night. In the first stage of sleep, just as you’re beginning to drift off, muscle activity slows and you can be easily awakened. In stage two, brain activity and eye movement decrease, and you fall into a deeper state of sleep. During stages three and four, brain activity slows to a crawl and there is no eye or muscle movement. This is the most restorative stage of sleep and the most difficult from which to be roused. In fact, many people describe it as trying to escape from quicksand. Lastly there is rapid-eye-movement sleep, or REM sleep, in which breathing becomes faster and shallower, the heart rate drops, and there is plenty of eye movement. This is also the stage of sleep during which we dream.

Why We Need Sleep

“Sleep is so essential we could never list all the benefits,” says Alex Harris, director of clinical operations for Sleep Tech, a sleep-disorder diagnostics and services provider at numerous facilities, including Overlook Hospital. “However, it’s fairly easy to see how important sleep is when you don’t get enough.”

While we snooze, our bodies reset their vital systems (reinvigorating muscles, for example, and rebooting the immune system), but a sleep-deprived body is at increased risk for a host of unwelcome problems. These include:

• Irritability. Sleep deprivation can leave you cranky and impatient, and can exacerbate the symptoms of depression. “What’s more, sleepiness can inhibit your concentration and reaction time, which is a big safety concern,” adds Harris. In fact, the National Highway Traffic Safety Administration estimates that nearly 100,000 car accidents each year can be linked to driver fatigue.


• Increased illness. Sleep strengthens your immune system; when you don’t sleep well, you’re less able to fight off colds, flus, and other viruses.


• Weight gain. When you’re exhausted, your body craves carbohydrates. And not sleeping soundly can cause increased levels of the hormone ghrelin, which triggers appetite, and decreased levels of the hormone leptin, which controls appetite. Ultimately, this leaves you hungrier—and less able to burn calories.

For a large number of people, minor sleep issues (like trouble falling or staying asleep) are temporary and can be solved with a few easy lifestyle tweaks.

• Keep your bedtime and waking times as consistent as possible.


• Stop smoking. Studies show that smokers get less REM sleep and often wake every few hours because of nicotine withdrawal. Pass up alcohol (at least close to bedtime). Although having a drink after dinner may feel relaxing, it can actually prevent you from falling into a deep, restorative sleep.


• Stay away from coffee. Caffeine is a known stimulant, so avoid it at least two hours before bed. Also steer clear of tea, soda, chocolate, and certain pain medications.


• Opt for morning workouts. Exercise can cause an adrenaline rush, which is a surefire way to keep from sleeping.


• Don’t hit the sheets with too full or too empty a tummy. Instead, have a light snack like cheese and crackers.


• Sleep in loose cotton nightclothes. When a good night’s sleep is your goal, comfort is key.


• Stay cool. Experts agree that your bedroom temperature should hover around 70 degrees.


• Make sure your bedroom is dark and quiet. That means turning off the TV—or, better yet, banishing it from the bedroom. If you can’t stand the silence, try a white-noise machine or a fan.


• Don’t hop into bed right after doing dishes, folding the laundry, or paying bills. Relax and clear your mind for 15 minutes instead. Many people find doing crossword puzzles does the trick.

When You Need Help

Turning off the television and turning down the heat can’t solve every sleep issue. Some problems require medical intervention. But how can you tell if your snoring, leg twitching, or insomnia calls for a doctor’s attention? “If the problem has been going on for several months and can’t be linked to one episode, like a death in the family or losing your job, you should get help,” says Federico Cerrone, MD, director of the Center for Sleep Medicine at Overlook Hospital. Other signs that you may need medical help include:

• Constantly waking up during the night;


• Going to the bathroom every night;


• Sleeping restlessly for a prolonged period of time;


• Snoring regularly, accompanied by high blood pressure;


• If you’re always tired, can’t concentrate, or are forgetful;


• If you’re waking up with headaches.

If you’re in search of sweeter slumber, you can start by discussing sleep-related problems with your general practitioner, or you can go directly to a sleep specialist who will take a detailed history of your lifestyle and sleep habits. Cerrone explains that patients who show signs of such conditions as sleep apnea (a chronic disorder in which you repeatedly stop breathing during the night), restless leg syndrome (abnormal sensations in the legs, including aches, burning, or tingling, that lead to leg movements), narcolepsy (falling asleep at inappropriate times), or seizures will most likely be sent for a sleep study.

The Lowdown on Sleep Studies

Although the concept of sleeping in a clinic with a stranger watching can seem oddly surreal, a sleep study is actually a very easy diagnostic test. If your doctor enrolls you in a asleep study, you should expect to report to the clinic about an hour before you plan to go to sleep. During this time you’ll answer lots of questions about what you ate that day, naps you might have taken, medications you take, and other lifestyle factors. You’ll be outfitted with multiple wires to your head and chest. Then you’ll be put to bed in a comfortable, private, hotel-like setting, complete with a television and bathroom. As you snooze, a technician will watch you sleep and monitor your brain and body functions, including the brain waves that indicate the stage of sleep you’re in. The technician will also track breathing patterns, heart rhythms, oxygen levels, sounds of snoring, eye movements, and muscle activity.

Now What?

If the results of a sleep study reveal a sleep disorder, your doctor will recommend treatments or therapies that set you on the right path for getting the rest you need. For snorers, this can be as simple as obtaining a mouthpiece that positions your lower jaw in such a way that you won’t snore, or getting a sleep positioner to keep you off your back at night. Patients suffering from insomnia are often prescribed temporary medications in conjunction with cognitive therapies to find out why they can’t sleep and help them learn to fall asleep. And if restless legs are at the root of disrupted slumber, your doctor will try to determine what’s causing the movements and then use medications to stop the twitching.

Sleep apnea, the most common sleep disorder, responds well to several different treatments and lifestyle changes. “You’ll be asked to avoid sedatives like alcoholic beverages,” says Cerrone, “and since obesity has been linked to sleep apnea you may also be asked to shed some weight.” There are also appliances, like the C-PAP (continuous positive airway pressure) machine, which increases air pressure in the throat so the airway does not collapse when you inhale.

“The good news is that these devices work for about 99 percent of apnea patients,” says Harris.

Other treatments include surgically removing the tonsils or adenoids, or inserting upper palate implants to prevent the upper palate tissue from collapsing and obstructing breathing.
“Your doctor may suggest you have a thorough cardiac evaluation,” says Cerrone, “since recent studies have shown that developing sleep apnea may be a warning sign for cardiac disease.”

For a referral to a sleep specialist or to learn more about the Center for Sleep Medicine, call (866) 460-8673.