Dec 17, 2010

How to overcome insomnia

I myself suffer from insomnia that is why i have a special feature on this topic. Are there ways to treat this condition without having to take any medication?Let us explore insomnia together and learn how to overcome this condition.

 INSOMNIA:  causes and treatment

Are you always awake at night and cannot force yourself to sleep no matter how long you close your eyes and lay on bed? Your mind is always drifting and seem to be awake. You might be suffering from insomnia. So what is insomnia per se?

Insomnia includes any combination of difficulty falling asleep, staying asleep, intermittent wakefulness and early-morning awakening. Episodes can be transient, lasting as long as 2 weeks (short-term), or be long-lasting (chronic).

A person suffering from insomnia may be noticed having posture changes, dark circles under the eyes, disoriented, gets tired easily, irritable or having reduced energy level. Insomnia may also trigger depression.

Causes of insomnia in adults:
·        Aging
·        Physical illness ( e.g.,  enlarged prostate, cystitis, COPD, arthritis, heartburn, toxic goiter, heart or lung problems)
·        Depression
·        Anxiety or stress
·        Alcoholism or abruptly stopping alcohol after long-term use
·        Poor sleeping environment such as excessive noise or light
·        Exhilaration or excitement
·        Frequent urination
·        Medications, such as thyroid medicine, ephedrine, phenylpropanolamine, theophylline
·        Illicit street drugs, such as amphetamines and cocaine
·        Restless leg syndrome
·        Stimulants taken in the evening (nicotine, alcohol, caffeine, food)
·        Counterproductive sleep habits (sleeping too much during the day, early bedtimes, excessive time spent awake on bed)
·        Shift work
·        Jet lag
·        Lack of exposure to sunlight


Prior to opting to take medications for insomnia you should try to change your sleeping habits first. Treatment should be based on the cause of insomnia. Try some of these tips:
1  1.  Avoid emotional upset or stressful situations before bedtime. 
    2.  Avoid using alcohol in the evening. 
    3. Avoid caffeine for at least 8 hours before bedtime. 
    4.  Give up smoking; nicotine is a stimulant. 
    5.   Eat a light snack before bedtime. 
    6.  Exercise regularly, but not 2 hours before going to bed. 
    7.  Establish a regular bedtime, but don’t go to bed if you feel wide awake. 
    8. Relax by reading, taking a bath, or listening to soothing music before going to bed.
    9. Take your TV or computer out of the bedroom. 
   10. Use the bedroom for bedroom activities only.  Once in bed, use creative imagery    and relaxation techniques, e.g., deep breathing, yoga or meditation to keep your mind off unrestful thoughts. 
   11. Make sure your bedroom is dark, quiet and cool. Use earplugs or eye shades if needed.

Foods that Help or Harm Your Sleep

Here are the list of foods that you can eat at night and which ones to avoid for a restful slumber: 

1. 1. Tryptophan-rich foods
Dairy products contain tryptophan which is sleep-inducing substance. Other examples are poultry, bananas, oats and honey. 

2.   Carbohydrate-rich foods
Carbohydrate-rich foods complement dairy products by augmenting the level of tryptophan in the blood. Late night that might help you to snooze include a bowl of cereal and milk, or yogurt and crackers.

3.   Snack at bedtime
A little food on your stomach may help you fall asleep, but keep it small, otherwise it can make you uncomfortable  and prevent you from sleeping. 
4.  High fat-food
Avoid high-fat foods such as burger and fries. People who indulge on high-fat food not only gain weight, but they also experiences a disruption of their sleep cycle. 
5. Caffeine
Caffeine sources not only include coffee, but cola, tea, chocolate and decaffeinated coffee as well. Even moderate caffeine can cause sleep disturbances.

6. Alcoholic beverages
Alcohol may help you sleep faster, but you may experience frequent awakening, thus less restful sleep, headaches, night sweat and nightmares.

7. Heavy, Spicy Foods
The digestive system slows down when you sleep, that is why lying down with a full belly can make you uncomfortable. Moreover, spicy food can cause heartburn.

 8.  Protein-rich foods
Protein-rich foods are harder to digest, making it a poor choice for a bedtime snack. 

9.  Fluids
Curtail your fluid intake before bed to avoid frequent urination a t night.

References for posts on sleep disorder :
1.     American Academy of Sleep Medicine. Sleep Disorders.
2.     Centers for Disease control and Prevention.2010. Key Sleep Disorders.
5.     http://www.

Dec 12, 2010

Types of Sleep Disorders

What is sleep disorder?
Sleep disorders involve any difficulties related to sleeping, including difficulty falling or staying asleep, falling asleep at inappropriate times, excessive total sleep time or abnormal behaviors associated with sleep.

Types of sleep disorders
There are more than 100 different sleep disorders. I am just going to cite the more common sleep disorders here:

1.   1. Insomnia – a short term or chronic inability to get high quality sleep. It is a  common sleep problem and can be caused by a variety of things including stress, a change in time zones, an altered sleep schedule or poor bedtime habits.  

2.   2. Sleep apnea disorder – this is a disorder wherein breathing stops or gets very shallow while you are sleeping. Each pause in breathing typically lasts 10 to 20 seconds or more, and the pauses can occur 20 to 30 times or more an hour. This is a very serious sleep disorder, and can even be life-threatening.

Symptoms of sleep apnea include frequent gaps in breathing during sleep, gasping or choking for air, loud snoring, feeling unrefreshed after a night’s sleep and excessive daytime tiredness.

A common type of sleep apnea is obstructive apnea, wherein the causes are generally physical in nature. This includes obesity, large tonsils or adenoids, nasal congestion or blockage or a unique shaped head, neck or chin.

CPAP, a mechanical device worn while sleeping which provides continuous air pressure to keep the airway open, is the most recommended treatment for moderate to severe apnea. Losing weight, elevating the head of the bed or sleeping on your side, dental appliances and surgeries are other treatment options. 

  3.Snoring - caused by narrowing of your airway, either from poor sleep posture, excess weight or physical abnormalities of your throat. Snoring is different from sleep apnea. It may accompany sleep apnea, but not always.

Sleeping on your side, elevating the head of your bed, or losing weight are some of the self-help remedies for mild snoring.

4.   4. Restless leg syndrome (RLS) and Periodic Limb Movements in Sleep (PLMS)
Restless leg syndrome is a disorder causing an almost irresistible urge to move the legs or arms. The urge to move when lying down is due to uncomfortable, tingly sensation in the affected limbs.

Periodic Limb Movement Disorder is a related condition involving involuntary, rhythmic limb movements, either while asleep or awake.

RLS can occur on its own or related to other medical conditions like anemia, kidney disease, pregnancy or thyroid problems, Parkinson’s or alcoholism.

Lifestyle changes and nutritional supplements are among the treatment for RLS and PLMD.

5.   5. Narcolepsy – a neurological that causes extreme sleepiness and may even make a person fall asleep suddenly and without warning. People with narcolepsy lacks in hypocretin, a brain chemical which regulates sleep and wakefulness. Narcolepsy maybe genetic, but also appears to be influenced by environmental factors.
Symptoms of narcolepsy include intermittent, uncontrollable episodes of falling asleep during daytime, excessive daytime sleepiness, sudden, short-lives loss of muscle control during emotional situation (cataplexy).

6.   6. Night terror – a sleep disorder in which a person quickly awakens from sleep in a terrified state. It usually occurs during deep sleep, during the first third of the night. The cause is unknown, but may be triggered by fever, lack of sleep, or periods of emotional tension, stress or conflict. It is fairly common in children ages 3-7, but may also occur in adults.

7.   7. Sleepwalking – a disorder that occurs when a person walks or does another activity while they are asleep. Sleepwalking or somnambulism most often occurs during deep, non-REM sleep early in the night.

8.   8. Bruxism -  Involuntarily grinding or clenching of the teeth while sleeping. The cause of problematic bruxism is unknown, though several conditions are known to be linked to bruxism, including digestive ailments and anxiety.

Dec 5, 2010

Understanding Sleep Disorder

Many people nowadays are afflicted with sleep disorder.  Among them are celebrities. In fact, they are more susceptible because of the pressure and rigorous schedule they are dealing with in their daily lives. Some famous people who are known to have suffered from sleep disorder are Napoleon Bonaparte, Winston Churchill,  Isaac Newton, Thomas Edison, Abraham Lincoln, Theodore Roosevelt, Margaret Thatcher, Charles Dickens, Cary Grant, Marilyn Monroe and many more.  Michael Jackson made headlines around the world in 2009 due to his untimely death which came as a consequence of overmedication with sleep-inducing drugs. He was an insomniac. Many of the celebrities mentioned above had sleep disorder coupled with bouts of depression.

The benefits of deep, relaxing sleep every night are universally accepted. People are able to function physically and mentally more effectively and productively. There are people who sleep very little because of the demand of their work. In doing so they disregard the potential damage they are doing to their body. Insufficient sleep in the long run takes its toll on one’s health.

Contrary to popular belief, older adults do not need to sleep less as they age. Like young people, they require between seven and nine hours of sleep nightly.  However, it is the pattern of sleep that tend to change with age. Older adults spend less time in deep (slow-wave) sleep and more time in non-rapid eye movement (NREM) sleep, which causes the frequent waking throughout the night. Our internal clock also changes, causing us to wake earlier in the morning and feel more tired in the evening.

There are many causes of sleep deprivation. The stresses of daily life may intrude upon our ability to sleep well. We might also be trading sleep for more work or play. There could also be pre-existing medical conditions that could be disrupting sleep.  However, it is critically important to realize that sleep deprivation is often due to unrecognized sleep disorders.

There are short and long-term consequences of sleep deprivation.  Included in the short term-effects are decreased performance and alertness, memory and cognitive impairment, stress relationships, poor quality of life, occupational and automobile injuries.  Sleep disorder increases the risk of serious and chronic health conditions, including depression, diabetes, hypertension, heart disease and obesity. It also weakens the immune system. Based on research, the number of white blood cells decreases, leaving the body unarmed against infection. People who sleep less than four hours per night are three times more likely to die within the next six years.

To be continued…

Nov 25, 2010

Can Sleep Deprivation Lead to Sudden Death?

This post is dedicated to Paulo Layug who joined his creator on No.16, 2010.
It started like an ordinary day. When I came home after work I opened my inbox. I was surprised to see an e-mail without a subject from my friend Eva. I almost deleted it thinking it was a spam. But I was aghast upon reading the message. I could not believe what was written on it. "Paulo, my godson passed away!". He was just a young lad. He was about to graduate from college. How could have that happened? What are the probable reasons? It could only be accidents or acute illnesses like dengue, which is endemic in the Philippines could take away a young man's life so suddenly.

When we came to the wake we learned what really transpired on that fateful day. Paulo was in his boarding house in Manila. After a sleepless night spent playing his favorite game of Dota he complained of not being well. (It was worthy to note that as a computer-game fanatic he was not mindful that  having little sleep most of the time.) In the afternon while laying on a couch he was seen by his cousins displaying jerky movements. They immediately came to his aid, but  he abruptly stopped breathing. His pulse could not be palpated. His cousin who was Red Cross-trained tried resuscitating him. He was revived, though temporarily temporarily. He expired once again on his way to the hospital, a mere 15 minute drive from where they were living. Futher resuscitation efforts at the emergency room were to avail. He met his demise at a tender age of 21.

Paulo's mother Melinda, a long-time friend of mine back in our college days in Odessa, noted that several men in their family, including her father and elder brother died under the same condition, "sudden death after a sleepless night." We were bewildered. Is there any relationship between the two:
sleep deprivation and sudden death? Could sleep deprivation be a cause of sudden death? As a chronic insomniac myself , this really caught my attention. I badly needed an answer to this question. Hence, as soon as I got home I rummaged through the pages of the net. The search engines have made my task easy. I was surprised to find a multitude of scientific studies tackling the subject of sleep deprivation in conjunction with sudden death. Here are some of these:

In 1997 Deccan Chronicle's correspondent wrote about the risks techies are facing being chronically sleep-deprived. Executives and corporate employees live in a very competitive work, hence work is their top priority. He mentioned the sudden death of 42 y.o. Ranjan Das, the youngest CEO oan MNC in India. Workaholic Das was getting very little sleep.

In an article published by Soon Young Sun, et al a case of a 40 y.o. woman was mentioned presenting with squeezing substernal pain following a 72h sleep deprivation. Level of CK-MB and Troponin-T were elevated. Coronary angiography demonstrated a longitudinal dissection of the middle portion in the diagonal artery. These findings suggest Myocardial Infarction, associated with spontaneous coronary dissection.

At Wiley Online Library I came across an article by Orhan Ozer and others. They wrote about their electrocardiographic findings in relation to this subject.  They have noted that QT dispersion, which is known to be a predictor of ventricular arrhytmia and sudden death  was increased in healthy individuals with acute sleep deprivation.

Tai Sekine and others studied the impact of sleep deprivation on the coronary circulation. They used Coronary Flow Velocity Reserve (CFVR) as a parameter and measured it with transthoracic Doppler echocardiography. The results showed that CFVR was lower after slep deprivation than after normal sleep.
This finding suggests that sleep deprivation might serve as a trigger for cardiovascular risk.

In a study entitled "Erythrocyte Magnesium and Prostaglandin Dynamics in Chronic Sleep Deprivation" it was shown that mean erythrocyte Mg level was significantly lower in the state of chronic sleep deprivation than in control state and temporary sleep deprivation, while thromboxane B2 was significantly higher in the state of chronic sleep deprivation than in control and in temporary sleep deprivation. These findings support the hypothesis that decrease erythrocyte Mg content and increase in thromboxane B2 could predispose to cardiac events by inducing coronary arterial spasm or coronary arterial thrombus formation. 

Hans Meier-Ewert and his colleagues conducted an experiment in 2004 on the effect of sleep loss on C-reactive protein (CRP), an inflammatory marker of cardiovascular risk. The results showed that CRP concentration increased during both total and partial sleep deprivation, but remained stable in the controlled condition. It was also noted in this study that sleep deprivation in healthy individuals has been found to lead to increased peripheral circulation of leukocytes and interleukin (IL-6).

One hypothesis for the link between cardiovascular risk and elevated CRP is that vascular shear stress exacerbated blood pressure (BP) leads to inflammation in the vascular wall. A single episode of 50% reduced sleep resulted to an increase in systolic and diastolic BP and heart rate. All these findings support the hypothesis that inflammatory processes are activated by inadequate sleep.

Based on the above-mentioned studies we can therefore conclude that sleep deprivation could lead to sudden death by triggering several mechanisms in our system which pave the way to cardiovascular events.

Now we should have realized the importance sleep plays in our daily lives. It is not something that should be left in the back door.So for all the insomniacs, call-center agents, graveyard-shift workers and for all those who are not having enough sleep for various reasons it is for us then to take the necessary precaution to avoid this kind of incidents from happening. The solution is simple, you don't have to buy it: just change your habit, give yourself an adequate amount of sleep. It is not yet late. As an email headline said: Sleep, else you might sleep forever.


1. Techies Wake Up to the Risks of Sleep Deprivation.Deccan Chronicle 2009    Nov.18

2. Soon Young Suh, Jin Won Kim, et al. Spontaneous Coronary Dissection,Associated with Sleep Deprivation Presenting with Acute Myocardial Infarction. International Journal of Cardiology 2007;115-2:e78-79

3. Orhan Ozer, MD,Burcu Ozbala,MD, et al. Acute Sleep Deprivation Assocaited with Increased QT Dispersion in Helathy Young Adults. Pacing and Clinical Electrophysiology 2008;31-8:979-984

4. Tao Sekine, Masao Daimon, et al. The Imapact of Sleep Deprivation on hte Coronary Circulation. International Journal of Cardiology 2010;144-2:266-267

5. Kazuhiko Tanabe MD, Naohiko Osaka MD, et al. Erythrocyte Magnesium and Prostaglandin Dynamics in Chronic Sleep Deprivation. Clinical Cardiology 1997;20:265-268

6. Hans K. Meier-Ewert,MD, Paul M.Ridker,MD, et al. Effects of Sleep Loss on C-reactive-protein, an Inflammatory Marker of Cardiovascular Risk. Journal of the American College of Cardiology 2004.;43:678-683