Do you start tossing and turning as soon as you hit the mattress? Or maybe you’re a thrasher, pulling pillows over your head, kicking off the covers, pulling them back on – hoping that if you can just find the right position/temperature/noise level/type of pillow/mattress topper . . . you’ll be able to sleep through the night.

Very common, but very complex, insomnia

If this sounds like you, 30 million other Americans are keeping you company during those dark, frustrating hours, according to the Sleep Disorders Foundation. As many as 15 percent of all U.S. adults report having severe and chronic (lasting at least 30 days) insomnia that affects their daytime functioning.

Insomnia is a very complicated condition with many different causes, but it’s generally defined as “difficulty falling asleep or staying asleep, even when a person has the chance to do so.” Some people can’t fall asleep; others can’t stay asleep. Some people grapple with both problems. This lack of refreshing sleep results in fatigue that takes a toll on concentration, mood stability and performance at work and school.

Common causes of insomnia

Lifestyle issues are usually considered first when a person seeks help for insomnia at a sleep disorders center. Some sort of stressor is often to blame for the disruption in sleep cycles. Worries over jobs, kids, intimate partners and money are common, along with disappointments, unresolved anger and boredom after retirement. Identifying and addressing these issues is often done using Cognitive-Behavioral Therapy.

Sleep hygiene is also addressed when a person seeks help for insomnia — establishing good habits that include:

  •   • Getting up and going to bed at consistent times
  •   • Exercising in the afternoon
  •   • Avoiding caffeine, alcohol and nicotine
  •   • Increasing dietary fiber and decreasing sugar and saturated fat
  •   • Creating a cool, quiet and dark bedroom
  •   • Sleeping on a comfortable mattress

 

There is no “best practice” for the pharmacological treatment of insomnia, explains the Sleep Disorders Foundation. Your doctor will make this decision with you based on the risks and possible benefits. Some substances that are used include:

 

  •   • FDA-approved hypnotics
  •   • Sedating antidepressants
  •   • Certain anticonvulsant, antipsychotic or pain medications
  •   • Over-the-counter antihistamines
  •   • Melatonin
  •   • Valerian root

Three common sleep disorders

 1) Narcolepsy is a neurological disorder in which the brain is unable to regulate sleep-wake cycles, resulting in fatigue and cataplexy: physical collapse while conscious caused by muscle weakness. Although they don’t sleep more than the average person does, narcoleptics are unable to control the timing of their sleep.

 2) Sleep apnea is characterized by breathing that is briefly and repeatedly interrupted during sleep in a pause that lasts at least ten seconds. Obstructive sleep apnea occurs when the muscles in the back of the throat don’t keep the airway open, and central sleep apnea is caused by the brain’s failure to control breathing during sleep.

 The far more common obstructive sleep apnea can cause low blood oxygen levels that may lead to heart disease, high blood pressure, sexual dysfunction, depression and memory and concentration problems. Chronic snoring is a common sign that sleep apnea is present, and it’s important to contact your internal medicine physician to seek treatment for this condition, because leaving it untreated can result in other serious illnesses.

 Your internal medicine provider might suggest you visit with a sleep medicine doctor who will test for sleep apnea and determine its severity using a sleep study. Your heart rate, breathing, airflow, blood oxygen levels and other functions are closely monitored during an overnight stay at a sleep center. Most sleep apnea patients use a highly effective CPAP mask, or a “continuous positive airway pressure device,” that gently blows air into the airway to help keep it open during sleep.

 3) Restless leg syndrome affects one in 10 Americans. This neurological disorder manifests as an almost irresistible urge to move the legs when they are at rest and is often accompanied by sensations that feel like small bugs crawling on the legs, throbbing or pulling. Moving the legs relieves the discomfort.

 Are you tired of struggling with lack of sleep? Our physicians and technicians work with your primary care physician to diagnose a variety of sleep disorders, including sleep apnea, and we can help you explore a number of options to return you to restful and restorative sleep.

Are you hoping to partner with an internist who will care for you through all stages of your life? Revere Health Internal Medicine providers offer health management counseling for chronic conditions such as diabetes, high cholesterol and hypertension. We have nearly 30 providers who are specially trained in internal medicine in four locations in Utah County to serve your needs.

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