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How to Recognize Sleep Disorders
Though many people experience sleeping problems, that isn’t the same as having a sleep disorder. Disorders are more complicated, often requiring the help of a sleep specialist or doctor, whereas simple sleeping problems can often be chalked up to poor sleep hygiene.
Sleep Hygiene
Sleep hygiene basically means your sleep habits. Poor sleep hygiene can stem from anything from lifestyle practices (such as drinking too much coffee) to environmental factors (such as too much light in your bedroom) to psychological stressors (such as a job crisis). If you think you have just a temporary sleep problem, follow these tips to try to improve your sleep hygiene:
- Use your bedroom for sleep and sex only: This means no TV, no eating, no computers, and certainly no working in bed or the bedroom—even reading in bed is arguable. If you obsess about time in bed, turn the alarm clock away from you so that you won’t see it. The goal is to make your bedroom a peaceful oasis.
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Create a sleep-friendly environment: Your bedroom should be dark, quiet, comfortable, and cool. Curtains, eye shades, earplugs, white noise devices (such as fans), humidifiers, good mattresses, and allergen-free pillows can help eliminate common environmental distractions.
- Avoid nicotine and caffeine before bedtime: Both nicotine and caffeine are sleep-inhibiting stimulants. Avoid smoking and caffeine, whether from coffee, tea, soft drinks, or chocolate, within 5–6 hours of bedtime.
- Avoid alcohol at night: Contrary to the idea of a “relaxing nightcap,” alcohol actually interferes with the body’s ability to maintain deep, restorative sleep. Avoid alcohol within 4–6 hours of bedtime.
- Avoid eating at night: Avoid eating within 2–3 hours of bedtime. If you’re hungry late at night, have a small snack, such as cheese and crackers. Big meals can cause stomachaches or heartburn at night.
- Avoid exercise at night: Avoid strenuous exercise within a few hours of bedtime. Though regular exercise does contribute to sounder sleep, a workout leaves you more alert and with a higher body temperature for up to 5–6 hours afterward. Exercise early to ensure that your body calms down to more sleep-conducive levels by bedtime.
- Establish a regular bedtime routine: Replace stressful nighttime activities, such as work, bill-paying, or emotionally taxing discussions, with relaxing activities, such as baths or light reading. Also avoid exposure to bright light shortly before bedtime, including light from computer screens.
- Maintain a regular sleeping and waking schedule: Your body’s circadian rhythm becomes confused when you disrupt it by sleeping in on weekends, napping during the day, or traveling across time zones. Try to avoid these irregularities in your sleep schedule—even daytime naps. A consistent morning wake-up time supports the circadian function and can help with regular sleep onset at night.
Do You Have a Sleep Disorder?
If you practice good sleep hygiene but still consistently have problems sleeping, you may want to consult your doctor about sleep disorders. There are many types of disorders, but a few general questions can help you narrow your problem down. See whether you answer “yes” to any of the following:
- Are you often sleep-deprived? (see How to Evaluate Your Sleep)
- Do you snore or ever awake suddenly, gasping for breath?
- Do you kick or thrash during the night?
- Does your family have a history of sleep disorders?
- Do you regularly have trouble falling and staying asleep?
- Do you have unusual sensations in your legs at night that disturb your sleep?
- Have you experienced unusual behaviors (such as walking, eating, or acting out dreams) that have disturbed your sleep or caused injury to yourself or others?
- Do you have inconsistent or irregular sleeping and waking times?
- Have you experienced persistent sleeping problems for more than three months?
You may also want to try keeping a sleep diary for two weeks, which will help you look
objectively at your sleeping patterns and habits. Fill the diary out shortly after you get up each morning so that you remember details. A sleep diary can take a variety of forms—a simple one could consist of a table like the following:
Sun |
Mon |
Tues |
Wed |
Thurs |
Fri |
Sat |
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Number and length of naps |
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Medication taken before bed |
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Quantity/time of alcohol and caffeine intake |
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What you ate and at what time |
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Time you went to bed |
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Number of minutes it took to fall asleep |
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Number and duration of awakenings |
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Final out-of-bed time |
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Total amount of time slept |
When to Seek Help
If you think you practice good sleep hygiene yet you still regularly have trouble falling or staying asleep, or feel consistently unrefreshed even after a good night’s sleep, you should see your doctor. Suppress the impulse to prescribe yourself an over-the-counter sleep aid or herbal remedy such as melatonin—though these agents may help get you out of a rut, it’s best to discuss all medication options with your doctor. He or she will ask you about your sleep history and either recommend treatment or refer you to a sleep specialist or sleep center.
Polysomnograms
If you report frequent daytime sleepiness, even if you think you generally sleep well at night, your doctor may recommend a polysomnogram, or overnight sleep study. Excessive daytime sleepiness is a major symptom of such disorders as narcolepsy and sleep apnea, both of which can be diagnosed and treated following overnight evaluation. And though polysomnograms aren’t necessary to diagnose insomnia, they’re often still helpful in revealing sleep habits that you aren’t aware of—including how many hours of sleep you actually get.
A polysomnogram records your physical state during different stages of sleep and wakefulness. A technician
attaches electrodes to specific parts of your body to monitor the following while you sleep:
- Blood oxygen levels: An oximeter is placed over your fingertip or ear lobe to measure blood oxygen levels, which can help determine whether apneas, or periods of stopped breathing, are creating drops in oxygen during your sleep.
- Body position: You may be videotaped while sleeping to identify unusual body movements or positions.
- Heart rate: An electrocardiograph (EKG or ECG) records heart rate and rhythm.
- Muscle tone: An electromyograph (EMG) records muscle movement and tone, helping to distinguish sleep stages and measure random limb movements.
- Respiratory events: Airflow is recorded to reveal whether there are interruptions in your breathing during your sleep.
- Sleep stages: An electroencephalograph (EEG) records brain waves, which indicate the various stages of sleep as they are reached. An electrooculograph (EOG) records eye movements, identifying REM sleep.
- Snoring levels: A small microphone on your neck records snoring.
Monitoring these vital signs and movements throughout the night provides essential clues that can be used to help diagnose and treat sleep disorders.
| Acknowledgments & Disclaimer |
