Sleep Deprivation
Sleep Deprivation
Get Your Rest and Feel Good Again
Constant daytime sleepiness is the hallmark of chronic sleep deprivation. But some of us are so accustomed to plodding by on too little sleep that we don't even recognize it.
"People may not realize what's going on until they go on vacation and allow themselves the sleep they need," says Margaret L. Moline, Ph.D., director of the New York Hospital-Cornell Medical Center Sleep-Wake Disorders Center in White Plains, New York. "They'll come back feeling great, so relaxed. We ask them how many hours they were sleeping, and they'll say eight hours. It turns out that they usually sleep only six hours."
MAKING UP A SLEEP DEFICIT
Sleep is like money: The longer you go without adequate supplies, the worse your situation gets.
"As the days go on, a sleep deficit accumulates like interest on an unpaid credit card balance," says Mary A. Carskadon, Ph.D., professor of psychiatry and human behavior at Brown University School of Medicine and head of the sleep research lab at E. P. Bradley Hospital, both in Providence, Rhode Island. "Say you don't get enough sleep on Sunday night. You may not feel the effects on Monday. But keep it up, and by Friday, you'll feel awful."
One night's insomnia won't hurt you, says Dr. Moline. But running up a sleep debt can take a heavy toll. You can't concentrate. Your memory is shot. You feel edgy. Your coordination suffers. You risk falling asleep on the job or driving and causing an accident. And you're also less adept at fighting off illness.
When To See A Doctor If you're running up a sleep deficit, you may need medical help to resolve the problem, depending on the cause. See a doctor if: * Night sweats from menopause awaken you and leave you exhausted come morning. Hormone replacement therapy may help, says Margaret L. Moline, Ph.D., director of the New York Hospital-Cornell Medical Center Sleep-Wake Disorders Center in White Plains, New York. * Nighttime allergy symptoms or asthma wake you and wear you out. Control the allergies, and you'll sleep better. * You work a night or rotating shift and are struggling with daytime sleepiness. Light therapy--exposure to bright, full-spectrum light--may help your body adjust. * You snore and feel tired even after spending eight or so hours in bed. You may have a sleep disorder called sleep apnea. If so, your doctor may refer you to a nearby sleep disorders clinic. * Your arms and legs twitch throughout the night. Called periodic limb movement, this tendency may not wake you fully but may still disrupt your sleep enough to leave you haggard come sunup, says Dr. Moline. A clinic can help.
* You have daytime sleepiness but don't know why.
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If you've been shortchanging yourself an hour of sleep a night for a week, you don't need to sleep an extra seven hours, says Dr. Moline. But you do need to get a couple extra hours of sleep a couple of days in a row, she explains.
Try the insomnia remedies on page 317. If you're still not sleeping better, here's what to do.
Listen to your internal clock. You can get too little sleep if you go to bed too early or too late, says Sonia Ancoli-Israel, Ph.D., professor of psychiatry at the University of California, San Diego, School of Medicine and director of the sleep disorders clinic at the Veterans Administration Medical Center in San Diego. Go to bed when you feel tired--not before or after.
When you're a teenager, your body clock is set so that you tire around midnight and want to waken at 8:00 or 9:00 a.m. By your thirties, forties and fifties, you're getting sleepy closer to 10:00 or 11:00 p.m. and waking at 6:00 or 7:00 the next morning. In your sixties and seventies, an 8 o'clock bedtime sounds most appealing, and you're up by 4:00 or 5:00 come morning. (Contrary to popular belief, you don't need less sleep as you age, says Dr. Ancoli-Israel. You just tend to fall asleep and awaken earlier.)
Shift with your shift. If you work a night or rotating shift, you're forced to sleep during the day, when your body clock is set on alert, and that makes quality sleep harder to come by. Researchers say it could take up to three years to adjust to daytime bedtimes, and there are some people who never adjust. So those on rotating shifts may have it hardest of all.
If you work nights, ask for a permanent, not a rotating, shift if it's at all possible, says Dr. Moline. Or ask for a shift that rotates from days to evenings to nights rather than the reverse--it's easier than trying to adapt to a night-to-evening-to-day schedule.
Pregnant? Sleep on your side. Nine months is a long time to go without a good night's sleep. Yet many women find it difficult to get comfortable in bed when they're expecting, especially during those last few months of pregnancy. Obstetricians suggest sleeping on one side with a leg propped up on a pillow.