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Tossing and Turning
Not Sleeping Can Play Havoc With Your Health; How Can You Help It?

March 26th, 2004

By Louis Wittig :eCureMe Staff Writer
March 24th, 2004 : Physician Approved

It may not be the worst feeling in the world, but it’s up there; when it seems like hours since you’ve turned out the lights, when your body is almost numb but your mind is still racing, when all you can do is grit your teeth, stare at the ceiling and try not to remember you have to be at work in three hours - when you can’t sleep. Occasional sleeplessness or inability to stay asleep, known as Insomnia to doctors, is a fact of life for about half of all Americans. Another 40 million Americans suffer from more serious, chronic sleep disorders.


The consequences?

A nation running on empty; poor sleeping, if it becomes regular enough, can lead to seriously impaired cognitive abilities - drowsiness, difficulty in storing memories and carrying out complex instructions, mood swings and hallucinations. In turn, this leads to a less-productive and more accident-prone population. Estimates are that American employers lose $18 billion a year in lost productivity to drowsy workers. The National Highway Traffic Safety Administration estimates drowsy drivers cause 100,000 accidents, leaving 1,500 dead and 71,000 wounded, each year: a high price for sleepless nights.

What is Sleep Anyway?

Sleeping is the most mysterious activity most people perform on a daily basis. For most of the day, the world is a well-ordered series of conscious events; things happen, thoughts occur, time moves forward. Then, for between six and seven hours (6.7 hours a day is the average for younger Americans, 7 for older), everything stops. Consciousness freezes, vivid hallucinations run their course and when the lights go back up, a surprising amount of time has passed.

Scientists don’t know exactly why humans need sleep; but they have figured out what goes on in our brains when we fall asleep, and how that affects the body.

In short, sleep is when some parts of the brain are - by the activity of neurotransmitter chemicals in the brain - rendered inactive. While the brain is partially turned off, it cycles through five stages of activity; it begins with that activity associated with the lightest kind of sleep and runs through to that associated with the deepest, dreaming sleep.

While on the surface sleepers appear to be completely inactive, their brains and bodies are silently working away. Chemicals that build up in the bloodstream during waking hours are broken down during sleep. Experts believe that during deep sleep, neurons in the brain that are active all day are shut down and repaired and purged of built up cellular byproducts. Activity in centers of the brain that regulate emotions, decision making and social interactions decrease, suggesting the relaxation allows these areas to function at their highest during the day. Throughout the body, cells increase the production of proteins that help to repair damages to the body resulting from stress and UV radiation.

Exactly how much sleep you need in order to feel fully rejuvenated depends on who you are: infants generally need about 16 hours a day, teenagers about nine and most adults about seven or eight. But guidelines are just approximations; some people can feel fine on six hours of sleep, while others can’t function on less than ten. If you’re tired during the day, it’s a sure sign you need more.

If you’re missing out on hours of vital sleep day after day, your body will accumulate a "sleep debt" so that when you finally do get to rest (on the weekends, for example) you’ll sleep more. Sleep is like water, it finds its own level. You can’t force yourself to "make up" a certain amount of sleep if you’ve been skimping; as long as your alarm doesn’t interrupt, your body will take what it needs. Similarly, you can’t "pay down" a sleep debt in advance - that is, you can’t force yourself to sleep for twelve hours and then stay up for two days.

And What’s Insomnia?

Insomnia isn’t a condition that has one cause; it’s a catch-all term for a variety of problems that can keep the brain from shutting down parts of itself. The causes can be emotional, such as grief, depression, anxiety or excitement. They can be more chemical as well; excessive intake of caffeine, nicotine or other stimulants, the side effects of a new medication, drug withdrawal or inadequate exposure to bright light during the daytime can all take a toll. Sleeplessness can also be the symptom of other, sometimes serious, medical conditions - such as an enlarged prostate, cystitis, indigestion and heart and lung problems. Generally, insomnia is a short- term phenomenon, with episodes lasting less than a couple weeks.

When sleeplessness is a more chronic condition, sleep disorders are usually the culprit. There are more than 70 types of disorder, but two keep millions awake. Sleep Apnea is estimated to be the most common, affecting about 18 million. During sleep, it’s ordinary for the body’s muscles to relax, but those with Sleep Apnea the relaxation goes too far; while asleep, their windpipes collapse. This inhibits proper breathing, and as they oxygen levels in the blood drop, the brain reacts by waking the body just enough to re-open the airway. While sleepers remain unconscious, the cycle can repeat hundreds of times a night. Apnea sufferers never reach sustained, deep sleep and thus are rarely well rested.

Almost as many Americans, 12 million, have their sleep interrupted by Restless Leg Syndrome (RLS). Most common among the elderly, RLS causes uncomfortable tingling or crawling sensations in the legs, causing sufferers to constantly move their legs - both when they’re awake and asleep. The constant movement leads to frequently interrupted sleep, and frequent drowsiness during waking hours.

Sleeping Through It

Chronic insomnia requires medical attention; effective treatments exist - medication for RLS and lifestyle changes and surgery for Sleep Apnea - but can’t be administered without a doctor’s attention. Recovering from just a couple of sleepless nights usually just requires that insomniacs make minor adjustments in their sleep- wake routine.

Some important ones are as follows:
  • Cut down on caffeine and alcohol, especially in the hours before bedtime.
  • Exercise daily, preferably during the afternoon. Working out too close to bedtime can overstimulate the body and interfere with sleep.
  • Stick to a set sleep schedule; sleeping in and staying up late can throw off the body’s biological clock.
  • Try to engage in relaxing activities - such as a taking a warm bath or shower, reading or watching television.
  • If you’re having difficulty sleeping, don’t just lie in bed. Distract yourself with other, relaxing activities. Focusing on your difficulty will only make you more anxious, making it even harder to sleep.
  • When you wake up, make sure you’re exposed to the strong lights (preferably sunlight) for at least an hour. Sleep researchers have found light, at this time of day, helps reset biological clocks.

Pills, Pills, Pills

When simply trying to relax or reset your biological clock hasn’t worked, medication is often the next step; 25% of Americans either take prescription or over- the-counter (OTC) varieties at least once a year.

According to the National Sleep Foundation, prescription medication shouldn’t be an insomniac’s first resort. Behavioral methods, like those outlined above, should be given a try. If they haven’t worked, if the insomnia is an expected part of a medical condition (such as depression) or if the lack of sleep is starting to interfere with a person’s daily routine - medication be a short-term solution. Four weeks is recommended limit.

Addiction, while a worry for many who are considering using sleep aids, hasn’t proven to be a serious risk. Research has shown that most sleep-aid users don’t abuse them or take higher than prescribed dosages. When abuses do occur, most are linked to inappropriate dosage increases or co-existing alcohol or drug problems.

However, sleep aids should be avoided by both the elderly and those whose insomnia results from Sleep Apnea. The deeper sleep drugs provide can cause seniors to become disoriented should they awake during the night, and increases their risk of falling. For Apnea sufferers, drugs can slow down their already disrupted breathing patterns.

Valerian Root and Melatonin

As public’s appetite for herbals and supplements has increased, two non- pharmaceutical sleep-aids have had an increasingly high profile over recent years: Valerian (or Valerian Root) and Melatonin.

Valerian extracts - derived from a plant native to much of Europe and Asia - have been known to healers for at least two thousand years and for much of the time have been used to combat nervousness and insomnia. Extracts most commonly come in the form of extracts or teas. Studies have shown that Valerian, when administered to animals, can promote sleep. Similar tests done on humans, on the other hand, haven’t turned up any proof of its effectiveness.

Valerian is presently sold in the U.S. as a dietary supplement - meaning that it’s not subject to the same rules regarding consistency and effectiveness as most of what you’d buy at a drug store. So, while no damaging side effects of Valerian therapy have been widely reported, consumers should be wary of extracts that promise instant insomnia relief.

The same applies for Melatonin, a popular sleep-aid supplement. Melatonin is a hormone produced naturally by the body in the pineal gland. As melatonin levels in the body go up in the evening, people begin to feel less alert and their body temperature decreases - both prerequisites for sleep. The melatonin sold to consumers is a synthetic form of the natural hormone.

Like Valerian, little research has been done on Melatonin’s effects. The research that has been done has come up with conflicting results. Lab tests have found that it doesn’t improve sleep. Surveys have found that people who took Melatonin regularly for two weeks reported getting more sleep and encountering less daytime sleepiness. Until more studies are completed, the jury will still be out and buyers should still beware.

No matter how you may try, simply going without sleep isn’t an option. If you’ re nighttime tossing and turning is starting to affect your waking hours day after day, and nothing seems to be helping, heading to your doctor for advice should always be a priority.

But until their office opens, just lie back, breath deep and try to get some sleep.

Contact Louis Wittig at

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