The ultimate state of relaxation arrives with a good night’s sleep, when the stress of the day gives way to our dreams. But for many, sleep is elusive.
Sixty percent of adults report sleep problems at least a few nights a week, according to the National Sleep Foundation. James Pagel, a Colorado sleep-disorder physician, is well-versed in the most common reasons people can’t sleep, along with the home remedies that can help and, determining when it’s time to seek out medication.
Pagel is president of the Colorado Sleep Society and runs two sleep labs – the Sleep Disorder Center of Southern Colorado at Parkview Medical Center in Pueblo and SleepWorks in Colorado Springs. Room checked in with Pagel to find out how people can get the best possible rest.
Q: Why is sleep so difficult for many adults?
A: A major cause is stress, and it seems to be getting worse in modern society. Many people just can’t turn off anymore. Insomnia, or the inability to sleep, is essentially a diagnosis of hyperarousal.
Psychiatric illness such as depression and anxiety and physical problems such as sleep apnea and restless leg syndrome are common causes of insomnia as well.
Q: What should we avoid to get better sleep?
A: Stop drinking so much caffeine. Caffeine has a 6 1/2 hour half-life, and it will continue to affect you long after you have it. It’s hard for anyone to fall asleep if they’ve had any caffeine during the afternoon.
Some people will take alcohol to go to sleep. It may put them out quicker, but they wake up earlier because it disturbs the sleep stages. Some will smoke a cigarette at night to relax. But like caffeine, nicotine has an agitation or arousal component. People who have ever abused narcotics, crystal meth or alcohol may have chronic insomnia for the rest of their lives – even after they quit.
Q: What steps should be taken to reclaim a good night’s sleep?
A: We ask people who have insomnia to do something boring before bed to help them transition from wakefulness to sleep. Do not watch thrillers on TV or read a mystery. The worst thing you can do is get into a fight with your significant other right before bed.
Restrict the bedroom to sleep as much as possible and make sure the environment has no extremes, meaning it’s not too hot or cold.
People with insomnia often develop a conditioned response in which they look at their bed and become agitated because they know they haven’t been able to sleep there. We tell them that if they can’t sleep within 20 minutes, they should get up and try to sleep in a different place. My wife calls this my “migratory sleep pattern.” I’ve got a little day bed in the computer room, and I’ll often end up there because I can’t turn off.
Q: When should a prescription sleep aid be considered?
A: We really don’t consider that someone has insomnia until their inability to sleep affects their daytime functioning. If that is down, they are not as alert and are more irritable or grouchy or getting depressed, then it’s time to see someone.
A lot of over-the-counter medications are fairly toxic. Those that include antihistamine, such as Tylenol PM or Nyquil, can cause daytime hangovers.
When I started out in the field 35 years ago, the medicines for insomnia were horrible. We wiped out movie stars and rocks stars like Marilyn Monroe and Jimmy Hendrix in the ’60s with sleeping pills that were mixed with other agents. The prescribed medications today are much better than the ones in the past because they are safe, non-toxic, minimally addictive and can be taken long-term.
Staff writer Sheba R. Wheeler can be reached at 303-954-1283 or swheeler@denverpost.com.
