Dear Dr Rosenberg,
A: Yes, what you are describing is common in many with Insomnia. There are worriers and ruminators. This triggers the nervous system into a state of hyper arousal making it very difficult to fall asleep. One technique that has been shown to work is called Constructive Worry. In this technique, people are advised to sit down in the early evening, produce and write down solutions to their worries. I know to some it sounds simplistic, however it works. Another technique is called Savoring. When you get into bed, think about or visualize some of the pleasant experiences you have had that day. That way your mind will begin to associate pleasant and calming influences with going to bed.
Dear Dr Rosenberg,
Q: I am having trouble falling asleep at night. It started about four months ago. My friends are giving me all sorts of advice. One friend told me that being on the computer before bed time was bad for me. Is that true?
A: Actually it is one of the worst things someone with Insomnia can do. There are two reasons. First, the stimulation of being on the computer; whether it is video games or just surfing the net is not conducive to sleep. Secondly, the bright light the computer projects suppresses the production of our sleep hormone melatonin. That is why I urge my patients with an inability to fall asleep; to refrain from computer activities for at least two hours before bed time
Dear Dr Rosenberg,
Q: My eight year old son sleepwalks, three to four times a week. He sleeps eight hours a night. He usually sleepwalks about two hours after falling asleep. I have discussed this with our Pediatrician and he says he will “grow out of it”. In the meantime, my husband and I are very worried. What should we do?
A: First of all, your Pediatrician is correct about outgrowing it. Most children will stop Sleepwalking about the time of puberty. However, I note you say that your son sleeps eight hours. In his age group, 10 to 11 hours is normal. Sleep Deprivation is a leading cause of Sleepwalking in children. Don’t be surprised if his Sleepwalking decreases, if you extend his sleep time.
Dear Dr Rosenberg,
Q: My dad had a Stroke in his sleep about five weeks ago. His Neurologist wants him to have a sleep study. My dad says that he was not sleepy before the stroke, so he is resistive. Plus, he doesn’t like to sleep in a foreign environment. Do you think it is necessary for him to have a sleep study?
A: Yes, I do. The incidence of Sleep Apnea in Stroke Victims is as high as 60%; in some studies. More importantly, when the Strokes occurs during sleep the incidence of Sleep Apnea is even higher. Sleep Apnea predisposes a person to Stroke via several mechanisms such as low oxygen, increased pressure in the brain, severe drops in blood pressure during the apneas and abnormalities of cardiac rhythm. If left untreated, the overall likelihood of another Stroke is significant. I would encourage your dad to have the sleep study. If he can’t sleep in a foreign environment; find out if the Sleep Center does portable home testing. Although not as accurate as an lab study; home testing is far better than doing nothing.
Dear Dr Rosenberg,
Q: I have heard some reports of long term sleep consequences of the use of the illegal drug Ecstasy. As a high school teacher; I would appreciate it if you could be specific. I think it would be helpful in counseling my students, if I had some hard facts.
A: The use of the drug Ecstasy is now in excess of 11% in US high school seniors. Acute intoxication can result in agitation, delirium and even seizures. However, a recent study showed some alarming findings in long term Ecstasy users. The incidence of Sleep Apnea was eight times higher than that of a similar matched control group. It is believed that the drug damages areas of the brain that secrete a neurotransmitter called Serotonin. It’s depletion probably predisposes these individuals to Sleep Apnea. Unfortunately, it does not appear to be reversible. Another good reason to avoid this illegal drug that has become so popular..
Dear Dr Rosenberg,
Q: I am a loud snorer and it disturbs my wife’s sleep. I smoke a pack of cigarettes a day. Several friends have told me that smoking can contribute to my snoring. How is that possible?
A: Smoking is an irritant to the throat causing inflammation and swelling. The swelling decreases the diameter of the throat, increases resistance to airflow and makes snoring worse. In patients with Sleep Apnea, it makes the condition worse as well. Once again another good reason to give up cigarette
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Dear Dr Rosenberg, Q: I am having a hard time getting my ten month old baby to stay asleep. I rock him to sleep every night and place him in bed asleep. He wakes up every two to three hours and needs me to rock him back to sleep each time. I work and the lack of sleep is effecting my job performance. I’m at my wits end and wonder what I can do? A: What you are describing is a form of behavioral Insomnia in children called Sleep Onset Association Disorder. Basically, your infant has become conditioned to expecting to be rocked to sleep. The first thing you must do is put him into bed when he is sleepy; not after he has fallen asleep. Do not rock him to sleep. A baby who is rocked to sleep, nursed to sleep, driven in a car to sleep, or pushed in a stroller to fall asleep is going to need that exact same stimulus to fall back to sleep. The idea is to allow the baby to soothe himself to sleep. If you don’t give him a chance to do this the behavior may persist for several years.. |
Dear Dr Rosenberg,
Q: I am having a terrible time with my CPAP machine. One it reaches my prescribed pressure, I can’t tolerate it. I feel like it is too much pressure and I have a hard time breathing out against it. A friend of mine who lives in another state tells me she was having the same problem, but was switched to an auto titratable machine and is doing much better. Can you explain what this is?
A:An auto titratable machine varies the pressure during the night. It does this by sensing obstructions, vibrations and air flow limitations. It responds by putting out just enough pressure to overcome that particular event. On the whole this type of machine usually ends up delivering less pressure during the night than a machine set at a fixed amount.
Dr. Robert Rosenberg, Board Certified Sleep Medicine Specialist, will answer readers’ questions by incorporating them in furture columns. Contact him at askthesleepdoc@yahoo.com or via mail at the Sleep Disorders Center of Sedona, 210 S. Sunset drive, suite A-1, sedona, AZ 86336.
