Sleep Disorders For Dummies


When the last dinner dishes have been put away and the evening news is over, most of us think about going to bed. But for the millions who suffer from a chronic sleep disorder, going to bed doesn’t necessarily mean going to sleep. And for millions more who experience occasional sleep disturbances, nighttime might not be such a picnic, either.

Now there’s an easy-to-follow guide to help you get a good night’s rest.  Sleep Disorders For Dummies is for anyone who has trouble ...

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When the last dinner dishes have been put away and the evening news is over, most of us think about going to bed. But for the millions who suffer from a chronic sleep disorder, going to bed doesn’t necessarily mean going to sleep. And for millions more who experience occasional sleep disturbances, nighttime might not be such a picnic, either.

Now there’s an easy-to-follow guide to help you get a good night’s rest.  Sleep Disorders For Dummies is for anyone who has trouble sleeping—or has a loved one who suffers from a sleep disorder. Written by a sleep specialist and a medical reporter, this no-nonsense guide helps you:

  • Prevent and manage sleep disorders
  • Improve your sleep habits
  • Find relief from your symptoms
  • Ask your doctor the right questions
  • Enhance the quality of sleep

This fact-packed guide walks you through the different types of sleep disorders, includin g sleep apnea, insomnia, narcolepsy, and restless legs syndrome. You’ll discover the causes and symptoms of each disorder, the various medical conditions that can disrupt sleep, and the most common treatments. Plus, you’ll see how to use good nutrition and exercise to promote sounder sleep and avoid known sleep disrupters such as caffeine and problem foods. The authors also give you solid, reassuring advice on:

  • Finding the right doctor to diagnose and treat your sleep disorder
  • Managing stress and anxiety
  • Turning your bedroom into a sleep sanctuary
  • Choosing between the different types of sleep clinics
  • Handling sleep disorders in children

Featuring savvy tips on preventing jet lag, sleeping well if you work the night shift, and getting kids to bed without fuss, Sleep Disorders for Dummies will help you get your zzzzzzzzs!

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Product Details

  • ISBN-13: 9780764539015
  • Publisher: Wiley
  • Publication date: 4/26/2004
  • Series: For Dummies Series
  • Edition number: 1
  • Pages: 384
  • Sales rank: 624,685
  • Product dimensions: 7.42 (w) x 9.28 (h) x 0.85 (d)

Meet the Author

Dr. Max Hirshkowitz, PhD, DABSM (Houston, TX) is the Clinical Director of the Methodist Diagnostic Hospital Sleep Disorders Laboratory in Houston, TX and also Director of the Sleep Disorders and Research Center of the Veterans Affairs Medical Center (VAMC). In addition, he serves as an Associate Professor in both the Department of Psychiatry and the Department of Medicine at Baylor College of Medicine. He is an elected Fellow of the American Sleep Disorders Association and in 1990, was certified as a Sleep Specialist by the American Board of Sleep Medicine. He received his Masters and Ph.D. in Psychology  from Tufts University. Dr. Hirshkowitz serves on the editorial board for Sleep Medicine and Sleep Magazine. He is a member of the American Psychological Association, Association for the Study of Dreams, and Sleep Research Society. He has presented more than 200 lectures on sleep disorders throughout the world, including an address at the World Federation of Sleep Research in Dresden, Germany.

Patricia B. Smith (The Woodlands, TX) is a freelance medical writer who has been working for the Houston (now Austin) bureau of People Magazine since August of 1996. During her tenure, she has received the 1999 2nd place Henry Luce Award for co-reporting a People Magazine cover story on anorexia and the 1998 Peter Lisagor Award for co-reporting a People Magazine cover story on breast cancer. Ms. Smith is a graduate of Washington University in St. Louis.

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Table of Contents



Part I: I Couldn’t Sleep at All Last Night.

Chapter 1: Sleep, Blessed Sleep.

Chapter 2: Evaluating Your Sleep.

Chapter 3: What’s Up, Doc? Getting a Diagnosis.

Part II: Insomnia: The Most Famous Dyssomnia of Them All.

Chapter 4: I Can’t Sleep a Wink: Examining Insomnia.

Chapter 5: Dealing with Secondary Insomnia.

Chapter 6: Adopting a Sleep-Well Lifestyle.

Chapter 7: Adjusting Your Bedroom Environment for a Better Night’s Sleep.

Part III: Everything You Need to Know about Other Troubling Dyssomnias.

Chapter 8: Mixing Up Day for Night: Circadian Rhythm Disorders.

Chapter 9: There’s Snoring, and Then There’s Snoring: Dealing with Sleep Apnea.

Chapter 10: Falling Asleep Standing Up: Narcolepsy and Hypersomnia.

Part IV: Walking, Talking, and Other Parasomnias.

Chapter 11: While You Were Sleeping: Walking, Talking, and Other Strange Nighttime Activities.

Chapter 12: Night Terrors and Other Frightening or Unpleasant Sleep Problems.

Chapter 13: Living with a Parasomnia.

Chapter 14: Battling the Midnight Blues: Pediatric Sleep Disorders.

Part V: The Part of Tens.

Chapter 15: The Top Ten Sleep Disrupters — And How to Deal with ’Em.

Chapter 16: Ten Signs That Your Bedmate Has a Sleep Disorder.

Chapter 17: Ten Tips to Help You Turn Your Bedroom into a Sleep Sanctuary.

Appendix: Resources and Products.


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First Chapter

Sleep Disorders For Dummies

By Max Hirshkowitz Patricia B. Smith

John Wiley & Sons

ISBN: 0-7645-3901-9

Chapter One

Sleep, Blessed Sleep

In This Chapter

* Understanding sleep

* Reviewing the benefits of healthy sleep

* Knowing the consequences of sleep deprivation

* Identifying common sleep disorders

Nearly every human being falls asleep at least once daily and ideally sleeps soundly for six to eight hours. After a good night's sleep, most people wake up feeling refreshed, energized, alert, and ready to take on the new day.

Perhaps you take your ability to sleep well for granted; if so, you may be one of the lucky ones who lays down your head and sails quickly and peacefully away to la-la land each night. But for the estimated 40 million Americans who suffer from a sleep disorder, falling asleep and staying asleep doesn't come so easily. A person with a sleep disorder usually sleeps poorly or not enough. So, without understanding why, a person with sleep apnea or periodic limb movement disorder or any one of the more than 80 recognized, defined sleep disorders wakes up feeling lousy, sometimes as if he or she hadn't slept at all.

As far back as early Greek plays, the Bible, and even your caveman ancestors, people probably had sleeping problems. Of course, in prehistoric times, having someone stay awake to maintain the campfire all night long was a good idea. Maybe the guy who couldn't sleep because he worried about being eaten by a saber-toothedtiger volunteered for the night shift. Today your saber-toothed tigers take the form of financial worries, problems at home or at the office, or a specific physical ailment, but they may keep you awake just the same.

Too frequently, sleep disorders go unrecognized, undiagnosed, and untreated. The cost to individuals and to society is huge; more than 100,000 automobile accidents, many fatal, are directly attributed to sleepy drivers each year. In addition, experts say that many on-the-job accidents are caused in part by poor decisions and responses made by sleep-deprived workers. Because sleep-deprived people tend to be irritable and have short fuses, they aren't much fun to be around, which can profoundly affect both personal and work relationships. In addition, a lack of sleep adversely affects both memory and concentration, which can negatively influence a person's job performance. And this list of problems caused by lack of sleep goes on and on.

If you or your significant other, child, a family member, or close friend has a problem sleeping, the first step is to identify the problem and then seek treatment as quickly as possible. There is no reason why one should continue suffering. You need your sleep, and we intend to help you get it. Remember, chronic sleep deprivation, no matter what the cause, is dangerous and potentially fatal. One way or another, if left untreated, being sleep deprived can cost you your life.

Before you can understand sleep disorders, first you have to understand sleep, what it is, and what functions it serves for the human brain and body. In this chapter, you find out most everything you ever wanted to know about sleep, but were too sleepy to ask, and also get a broad overview of the various sleep disorders discussed in more detail later in this book.

Sleep: Recharging Your Brain and Body

Webster's New World College Dictionary defines sleep as "a natural, regularly recurring condition of rest for the body and mind, during which the eyes are usually closed and there is little or no conscious thought or voluntary movement." But that brief definition hardly scratches the surface when understanding the importance of regular, high-quality, restorative sleep to the continued health and vitality of the human animal.

If you don't get the sleep you need, you don't restore and refresh your brain and body. You're basically running on empty. You know what happens when a car runs out of gas, right? It stops running. Well, that's an apt analogy. Sleep is the gas that fuels your brain, and when you don't get enough, you may end up on the side of the road, literally, or figuratively. Alternatively you could think of sleep as something that charges up your battery. Without sleep, your battery goes dead.

Even though all animals sleep, researchers don't agree on exactly why. They also don't understand all the many functions and benefits of sleep. Researchers do, however, have a fairly accurate picture of what happens when animals and people don't get enough sleep, and it's not pretty. Animals that undergo sustained total sleep deprivation die. Thus, sleep is required to sustain life.

While you were out

Ever wonder what your brain and body do while you're sleeping? Well, sleep is the time the brain directs the body to heal and repair itself, rebuild damaged or worn-out tissues, and restore chemical balance. If that's not enough, your immune system also manufactures more NK or natural killer cells to fight off infection and disease while you're sleeping, and your pituitary gland produces growth hormone. (In children, growth hormone promotes growth; in adults growth hormone helps repair and renew tissue.) And you thought nothing really happened while you were sleeping!

Although your body may be essentially motionless for much of the night, your brain is active, busily cycling through the five stages of sleep (see the "Stages of sleep" sidebar in this chapter for the scoop on each sleep stage). Each cycle occurs several times throughout the night. Among other things, your brain is organizing and storing memories. Interestingly, one type of sleep occurring each night is accompanied by rapid eye movements (REM). REM sleep is the time when most dreaming takes place. However, you generally won't recall the content of your dreams unless someone or something awakens you during the dream, and you remain awake long enough for memory to activate.

Even with all this activity, your brain still manages to recharge during a good night's sleep so that you awaken feeling energized and ready to go. However, if you don't sleep well, you awaken groggy and feel irritable because poor sleep interferes with your brain's ability to prepare itself for another day of physical and mental activity.

Telling time - your brain's internal clock

At the end of the sleep period, which is usually morning, we awaken. Awakening at this time occurs for two reasons. First, the drive to sleep has dissipated across the night. Second, a biological clock tells the brain that it's morning. The combination of relieved sleep drive and internal alarm system regulates the timing of sleep cessation, unless you have a sleep disorder.

Your own unique biorhythms and your brain's internal sleep-wake clock located in the suprachiasmatic nuclei (SCN) also determine the timing of when you fall asleep. The SCN responds to light and darkness in the environment and can reset your sleep-wake cycle. In addition to the internal clock, another factor helps control your sleep-wake cycle, homeostasis. Homeostasis is the force that attempts to maintain a balance between sleep and wakefulness. When you stay awake long past the point when your brain told you it was time for bed, you begin building up what is known as a sleep debt. Sleep debt is the difference between the number of hours you actually sleep and the number of hours you should have slept (see Chapter 2).

Your brain is a very precise and demanding bookkeeper when it comes to sleep; it figures out a way to make you pay back the sleep you owe, so don't think you can get away with depriving yourself of adequate sleep for too long. Your brain always collects on sleep debts, devalues your wakeful time while you're in debt, and sometimes charges a high interest rate (interest being in the form of an illness like a cold or flu that makes you stay in bed).

Deciding how much sleep is enough

The amount of sleep people require varies, but numerous studies suggest that for most people a minimum of seven hours of good quality sleep nightly is necessary for optimum health. Ideally, you should sleep seven or eight hours a night; people who sleep this amount tend to be the healthiest. That amount of sleep isn't a suggestion; it's a physical requirement. To consistently get less seriously compromises both your physical and mental health. Unless, of course, you're a rare short sleeper, which we discuss in the "No, really ... I'm not sleepy ... z-z-z-z-z" sidebar in this chapter.

All too often, when you're pressed for time, sleep is the first thing you cut back on, right? You reason that you can get by with a little less, and then a little less, and before long, you may find yourself snapping at your spouse or your children, making a bad decision at work, or forgetting an important meeting, or worse yet, falling asleep at the wheel of your car and waking up (if you wake up) wrapped around a telephone pole.

Why do people suffer so many negative consequences when they cut back on their sleep? Because you can't change your need for sleep any more than you could sprout wings and fly. The human brain and body require a daily period of rest in order to

  •   Achieve a high energy level
  •   Have sharp mental function, the ability to concentrate, and good decision-making skills
  •   Improve memory
  •   Maintain a positive mental outlook that helps you manage stress
  •   Strengthen your immune system to help keep you well

When you're properly rested, you stay physically and psychologically healthier, your brain and body recharge, remain healthy, and function at an optimal level. That's how the human animal evolved.

People who get too little sleep tend to have more health problems than people who get an adequate amount of sleep. For example, the Nurses Health Study followed more than 71,000 women for ten years to observe a number of health indicators. One unexpected result (at least to the researchers) of the study was concrete evidence that long-term sleep deprivation increases the risk of heart disease. Women who averaged five hours of sleep per night had a 39 percent higher risk of heart disease than women who slept seven to eight hours each night.

But you may be surprised to discover that people who sleep nine hours or more also have more health problems. Researchers aren't yet sure if people with health problems sleep more as a consequence of their poor health, or if people who sleep more than eight hours a night have a higher risk of chronic health problems.

Recognizing the Dangers of Sleep Deprivation

If you regularly get less sleep than your brain requires, then you are, by definition, sleep deprived. Every year, thousands of sleep-deprived people are involved in automobile and industrial accidents, and their sleepiness is frequently cited as a contributing factor in the accidents. The National Sleep Foundation believes the problem is so pervasive that it has established a national Drowsy Driver education program to inform people about the dangers of driving while sleep deprived. (Check out drowsydriver. org for more information.) But an increased risk for accidents is just one part of the consequences you may suffer if you continue to deprive your brain and body of the sleep they require to keep you healthy.

Problems associated with poor sleep

If you're sleeping poorly on most nights, we probably don't have to tell you how badly you feel. Go ahead and read the following list of problems associated with chronic sleep deprivation anyway, so you can prove to your other half that there's a real reason why you've been so crabby lately.

If you're sleep deprived, you may

  •   Age more rapidly
  •   Be more susceptible to colds, flu, and other infections
  •   Display an increased risk of accidents due to sleepiness and poor coordination
  •   Experience more emotional problems, including depression and anxiety
  •   Feel irritable and experience mood swings
  •   Forget important information
  •   Have reduced ability to deal with stress
  •   Increase your risk of obesity, heart disease, diabetes, and death
  •   Show poor judgment, poor concentration, and an inability to make decisions

Unfortunately, if you're stumbling around like a zombie during the day because you're sleep deprived, your sleepiness could pose a real danger for you and those around you. As we mention earlier in this section, sleepy people have poor coordination, impaired judgment, and slow reaction times. In other words, they're accidents looking for a place to happen.

Sleepiness and driving

U.S. roadways and highways are littered with the corpses of drunk and sleepy drivers and their victims. The National Highway Transportation Safety Association reports that sleepy drivers are involved in as many crashes as drunk drivers. And sleepy driving accidents tend to be more violent than drunk-driving accidents because even the drunkest driver has some sort of ability to react and respond to an emergency situation, even if that ability is impaired. A driver who is asleep doesn't react to the emergency situation at all because he or she is completely unaware.

Public awareness of drunk driving is high, but sleepy driving is barely on the radar. Sleepy drivers cause more than 100,000 traffic accidents every year, accidents that could all be prevented if everyone made sure they had enough sleep before operating a motor vehicle. According to the National Sleep Foundation, drowsy-driving accidents cause 1,550 unnecessary deaths, 71,000 injuries, and $12.5 billion in property losses and lost productivity every year. The National Highway Traffic Safety Administration reports 1 million accidents are caused annually by driver inattention. Two of the highest risk factors for inattentiveness behind the wheel are sleep deprivation and fatigue. Sleepy drivers aren't just putting themselves at risk by getting behind the wheel; they're putting their passengers as well as other drivers and their passengers at risk. They are also a threat to pedestrians.

People who drive for a living have an even higher risk of being in an accident while driving. Approximately 47 percent of all truck drivers report that they've fallen asleep at the wheel at least once during their driving careers.

Sleepiness and industrial accidents

The list of industrial accidents caused, at least in part, by sleepy workers in key positions reads like a "Who's Who" of disaster headlines over the past several decades.

Pilot fatigue and the resulting diminished judgment were given part of the blame for the 1999 American Airlines crash in Little Rock, Arkansas. Sleep deprivation was also involved in the accident with the Staten Island Ferry that crashed into the dock at full speed in October 2003. The assistant captain piloting the ferry made no attempt to slow the boat down because he was sound asleep at the controls.


Excerpted from Sleep Disorders For Dummies by Max Hirshkowitz Patricia B. Smith Excerpted by permission.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.

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