Newsletter - Oregon Sleep Associates

VOLUME 4, ISSUE 3
BETTER
BETTER
SLEEP
HEALTH
3RD QUARTER 2010
INSOMNIA: WHY CAN’T I SLEEP?
You’re lying in bed. It’s the middle of the night and you’re wide awake. No matter how hard you try, you
can’t seem to fall asleep. Many of us have experienced this frustrating scenario, for some it occurs nightly.
But what causes insomnia and how can it be alleviated?
INSIDE THIS
ISSUE:
ALTERNATIVE TO
SLEEPING
PILLS: CBT
2
VISION AND
SLEEP APNEA
2
SHIFT WORK
LOWERS
PRODUCTIVITY
3
KIDS WHO
SLEEP MORE
SCORE HIGHER
IN SCHOOL
3
SPOTLIGHT ON
OSA: KENNA
GROAT
4
THINGS TO
CONSIDER:
• Insomnia is
especially common
in women and can
be brought about
during menopause.
• Insomnia can be a
symptom of a
serious underlying
sleep disorder.
Insomnia is the inability to fall asleep or remain asleep. 30 to
40 percent of the population experience insomnia symptoms at
some time during any given year and 10 to 15 percent report
having chronic insomnia. (National Sleep Foundation) The condition
can occur at any time during a person’s life and is often a
symptom of another underlying or related problem.
There can be many reasons for insomnia. Transient Insomnia
occurs occasionally and is usually brought on by a stressful
event in your life. This could be something as simple as stress at work or as serious as the death of a loved
one. Transient insomnia usually will go away after the stressful time has passed. Insomnia is considered
Chronic Insomnia if it occurs regularly for a month or longer.
Generally there are two distinct categories of insomnia symptoms: Sleep Onset Insomnia and Sleep
Maintenance Insomnia. Sleep onset insomnia means you have trouble falling asleep. Many times you may
feel that you “just can’t turn your mind off” or wind down for the night. This type can be related to a
stressful period in your life and often is transient, disappearing when that stress goes away.
Sleep maintenance insomnia occurs when a person has difficulty falling asleep after waking up in the
middle of the night. Many times this type of insomnia is directly connected to another sleep disorder such
as Obstructive Sleep Apnea. Sleep Apnea causes multiple awakenings throughout the night; sometimes
these awakenings are accompanied by surges of adrenaline in the body. Once awake, the person suffering
from these events can’t fall back asleep easily.
What can I do to stop my insomnia?
The first thing a person should do is work on improving their sleep hygiene. Establish a healthy bedtime
routine. Bright lights and activities or conversations that are stressful or too engaging should be avoided
within 1 hour of bedtime. A calming activity such as reading or meditating is beneficial. Remove the
television and computer from the bedroom. Also, avoid alcohol and over-the-counter sleep aids, as these
actually end up disrupting sleep. If your problem persists, consult a sleep specialist for help.
What are the treatments for insomnia?
Despite the many advertisements in the media for sleeping pills, good sleep hygiene and a regular bedtime
are the best first steps, beyond that cognitive behavioral therapy is still the most effective treatment for
insomnia. However, if your insomnia is being caused by an underlying sleep disorder such as Sleep Apnea
or Restless Legs Syndrome, that needs to be identified and treated first. Often if those causes are
addressed, the insomnia goes away. A sleep specialist can use many methods to address your problems
sleeping . If you have problems with insomnia, please contact Oregon Sleep Associates at 503-288-5201
for assistance.
BETTER SLEEP BETTER HEALTH
Page 2
AN ALTERNATIVE TO SLEEPING PILLS: COGNITIVE
BEHAVIORAL THERAPY
As explained in the lead article, many people around the world suffer from insomnia. There are treatments
such as pharmaceuticals, but often concerns over cost and side effects turn people off of using them. But
now individuals who cannot sleep have a safe and effective alternative: Cognitive Behavioral Therapy.
Cognitive Behavioral Therapy (CBT) is a novel approach to dealing with insomnia without the need for
medications. Instead of masking the problem, CBT focuses on addressing the factors that cause chronic
insomnia. These factors can be personal, physiological, cognitive, and behavioral. The therapy is based on
two premises. First, that some of the underlying personal and physiological factors can be directly altered.
Second, that maladaptive thoughts and behaviors are learned and that they serve to perpetuate insomnia.
If they are learned, then they can be “unlearned” by the CBT process. (AASM CBT Booklet) The process of the
therapy typically consists of individual meetings with an insomnia specialist over several weeks. The
specialist may use multiple techniques to help the patient. These techniques can include alternative
medications, relaxation methods such as meditation and biofeedback, adjustment of sleep schedules, and
bright light therapy. When performed correctly, CBT can be as effective in treating insomnia as
medications.
Many doctors are still not aware of the existence and efficacy of CBT for insomnia. It’s best to find a sleep
specialist that is specifically trained in administering CBT. Oregon Sleep Associates currently offers
Cognitive Behavioral Therapy for insomnia. For more information call 503-288-5201 or visit us online at
www.oregonsleepassociates.com.
OCULAR PROBLEMS MAY INDICATE SLEEP APNEA
Obstructive Sleep Apnea is widely known as a danger because of its association with increased
cardiovascular complications, stroke risk, diabetes, and other health problems. But not many people are
aware that OSA can lead to problems with vision as well.
Obstructive Sleep Apnea is a condition in which a person’s airway collapses during sleep, leading to
lowered blood oxygen levels and disruptions from sleep. Many complications can ensue from untreated
sleep apnea. Several conditions which affect vision may be connected with the disease:
CBT with a Sleep Specialist can
be the next step on the path to
better sleep.
When performed
correctly, CBT
can be as
effective in
treating
insomnia as
medications.
Floppy Eyelid Syndrome occurs when a person’s eyelids become exerted, or turned inside out. The patient
may awaken with their eyelids flipped inside out and can experience watering, stickiness, discomfort,
blurred vision, downward pointing eyelashes, and eyelid droop or inversion. These events can lead to
conjunctivitis and corneal injury. Most of the time this condition is benign, but it could indicate the
presence of OSA.
Glaucoma is a serious condition that can lead to blindness. It’s caused by damage to the optic nerve and is
often associated with increased pressure in the fluid of the eye. OSA is associated with both primary openangle Glaucoma and normal-tension Glaucoma. The constant variability of blood pressure and oxygen
levels caused by OSA may contribute to this disease. In fact, one study found that 20% of patients with
Glaucoma may have Obstructive Sleep Apnea. (nih.gov)
Nonarteritic Anterior Ischemic Optic Neuropathy (NAION) occurs when vision is suddenly and painlessly
lost in one eye upon awakening. It has been associated with OSA and can cause irreversible vision loss.
Papilledema is swelling of the optic nerve in both eyes. It typically occurs due to increased pressure within
the skull and can lead to progressively worsening vision and, in some cases, blindness.
These and other conditions may be brought on by OSA. It is prudent for everyone to visit an eye doctor
every 2 years and if any signs of these conditions arise, get screened for Obstructive Sleep Apnea by a
sleep specialist. For more information on sleep and vision, visit www.sleepfoundation.org.
Getting a regular vision screening
can help diagnose unnoticed sleep
disorders.
VOLUME 4, ISSUE 3
Page 3
THE PRICE OF SHIFT WORK:
LIMITED SLEEP AND LOSS OF PRODUCTIVITY
Anyone who has worked an overnight shift knows how difficult it is to adjust back to a normal schedule.
You feel like a sleep deprived zombie, never able to fully fit in during the waking hours. New evidence
suggests that the toll taken may also get passed along to businesses in the form of lost productivity.
The research, as reported by the American Academy of Sleep Medicine, found that the key for maximum
productivity is to schedule shift start times that allow the worker to sleep right before reporting for duty.
(sleepeducation.com) The study used a mathematical formula to see the effects of 24 start times, each
varying by one-hour increments. The hypothetical work schedule lasted six days. Each shift was nine
hours and started at the same time each day. The findings suggest that the best shift start times begin in
the late morning or early afternoon, whereas shifts that begin between 8 PM and 12 AM were found to be
the most limiting to both sleep and work performance.
The lead investigator on the study, Angela Bowen, suggests that government labor regulations may need
be changed to take into account different shift start times. “Shifts of equal duration differ in how fatiguing
they are depending on the time of day when they are scheduled,” said Bowen. “The same limitation on
the number of duty hours may be either overly restrictive if during the day or too liberal if during the
night.”
If you currently are an overnight shift worker, the AASM suggests taking steps to maximize your sleep
time. Wear sunglasses on the way home and minimize light and sound exposure in your bedroom. Try to
sleep immediately after your shift in the late morning until the early evening. On days off, do not switch
back completely to a normal schedule. Instead, try a compromise by going to sleep about 3 AM.
If you would like more information on sleep and shift work, check out www.sleepeducation.com.
Shift work can cause excessive
fatigue and lower productivity.
“Shifts of equal
duration differ in
how fatiguing they
are depending on
the time of day
when they are
CHILDREN WHO SLEEP MORE PERFORM BETTER
IN SCHOOL
scheduled.”
- Angela Bowen
Getting kids to bed can sometimes be a challenging ordeal. The arguments and cajoling stress out both
the parents and children. A new study shows that not getting enough sleep doesn’t just make kids
grumpy, it affects their academic achievement as well.
The research documented the bedtimes and sleep length of preschool age children. It was based upon a
larger study sponsored by the US Department of Education which followed children's’ health,
development, care, and education from birth to the start of kindergarten. (AASM) The findings showed that
children who sleep less than 11 hours per night, the minimum recommendation for preschoolers
according to the American Academy of Sleep Medicine, score lower than phonological awareness, literacy,
and math skills than those who sleep longer. The study also points out that children with a regular
bedtime tended to sleep longer and score higher on tests.
What does this mean for parents of preschool age children? The National Sleep Foundation recommends
that parents initiate a regular bedtime routine for children and encourage “good sleep hygiene”. This
means no television or computers in the evening, instituting a calming ritual such as a bedtime story, and
an ample relaxation period to wind down before bedtime.
Parents can find more tips and information about children and sleep online at www.sleepfoundation.org.
They can also contact Oregon Sleep Associates, one of the only local sleep centers to provide pediatric
services for ages 3+, at 503-288-5201 if they have concerns about their children’s sleep.
Young children should get at least
11 hours of sleep each night to
perform well in school.
2228 NW PETTYGROVE
SUITE 150
PORTLAND, OR 97210
PHONE: 503-288-5201
FAX: 503-288-0151
E-MAIL:
[email protected]
We’re on the Web!
WWW.OREGONSLEEPASSOCIATES.COM
WWW.OSABLOG.COM
2010
B E T T E R
S L E E P
F O R
B E T T E R
H E A L T H . . .
SPOTLIGHT ON OSA: KENNA GROAT
Oregon Sleep Associates recently welcomed a new member to our team, Kenna Groat.
Kenna hails from Ridgefield, Washington and is currently a student at Washington State
University. She is finishing up a bachelor’s degree program in Biology and hopes to someday
become a Physician’s Assistant. She says this interest in medicine led her to the field of
Polysomnography. “It’s a fascinating field to work in.” Kenna explains, “You get to see the
progression of someone’s sleep throughout the night. REM sleep, when patients are
dreaming, is especially interesting to witness.” She also enjoys the personal aspects of the
position, such as getting to know the patients and her coworkers. “We’re monitoring all
night, making sure the patients are okay. So you have plenty of interaction with everyone
and really learn a lot about people.”
During her free time Kenna is an avid reader, enjoys hanging out with friends, and likes to
go hiking and camping. Kenna says she is “definitely a Pacific Northwest girl” and wouldn’t
want to live anywhere else, though she’d like to travel more eventually. “I really like going to
Mexico and after I graduate I’d love to see Hawaii and Europe.”
Oregon Sleep Associates
sleep technician, Kenna
Groat.