Tips on Sleeping Better from the Sleep Foundation

April 8, 2003 – A study released earlier this month said 37 million senior citizens and baby boomers 55 and older have problems sleeping. The Sleep Foundation has released the following tips on avoiding sleep disruptions, especially when caused by anxiety and stress.

"Not getting enough sleep impairs our work performance, increases the risk for injuries and makes it more difficult to get along with others," says Mark Rosekind, PhD, an expert on fatigue and performance issues. "Without sufficient sleep it is more difficult to concentrate, make careful decisions and follow instructions, we are more likely to make mistakes or errors, and are more prone to being impatient and lethargic. Our attention, memory and reaction time are all affected. But while we may recognize these symptoms, we do not always associate them as being symptoms of sleep loss," he adds.

Dr. Rosekind also notes that while one night of significant sleep loss can affect alertness the next day, accumulated sleep loss over multiple nights is a problem that must be dealt with. Dr. Rosekind, president and chief scientist of Alertness Solutions in Cupertino, CA, is a member of the National Sleep Foundation's board of directors. He is former director of NASA's Fatigue Countermeasures Program.

In order to help people address their need for sleep and sleep problems, the National Sleep Foundation (NSF) offers the following information about sleep problems and symptoms that can signal inadequate sleep, and tips for helping people maximize the sleep they do get during these times of high stress and anxiety:

· Don't expect to fall asleep immediately after hearing or watching disturbing news. Stop watching or listening to news programs at least an hour before trying to go to sleep. Leave the war news (or other bad news on the TV or radio) in the living room or den and out of the bedroom.

· Engage in a relaxing, non-alerting activity at bedtime such as reading or listening to music. For some people, soaking in a warm bath or hot tub can be helpful. Avoid activities that are mentally or physically stimulating.

· Do not eat or drink too much before bedtime. Alcohol is not a sleep aid; don't use it to try to help you sleep.

· Only get into bed when you're tired. If you don't fall asleep within 15 minutes, get out of bed, go to another room and engage in a relaxing activity such as reading. Return to your bed when you're sleepy.

· Create a sleep-promoting environment that is quiet, dark, cool and comfortable.

During the day:

· Consume less or no caffeine. Excess caffeine has the potential to disturb sleep at night. If you feel tired during the day, substitute a short nap of about 15-20 minutes for caffeine. Naps can relieve acute sleepiness and restore alertness, but for people suffering from insomnia, daytime naps should be avoided.

· Avoid alcohol and nicotine, especially close to bedtime.

· Exercise, but not within 3 hours before bedtime.

Anytime:

· Talk to other people. Many people think their symptoms of sleeplessness are unique to them. If you talk to others, you will find that many share your problems. Learning how others have coped can be helpful.

· Seek professional help. If you are unable to deal with the sleeplessness and it is becoming a problem for you, you might benefit from professional help. Your family doctor will know about medications that can help you fall asleep without a hangover the following day.

· Remember - sleeplessness associated with an acute stressful situation usually improves on its own. Be patient.

Common sleep problems during times of stress:

· Insomnia is characterized by difficulty falling asleep, waking up frequently during the night, waking up too early or feeling unrefreshed upon awakening. If these symptoms persist for more than a few days, seek help from a physician or other health care provider. Be cautious about self-treatments such as alcoholic beverages that may worsen the problem or not be effective.

· Nightmares can increase during periods of great stress for all people, though they occur most frequently in children age 3-6. Avoid eating or taking high-dose vitamins before bed, which can increase brain activity and the onset of nightmares. Also avoid alcohol, caffeine and other stimulants. Exercise and relaxation techniques may be helpful.

· Excessive Daytime Sleepiness (EDS) and Fatigue, with symptoms such as difficulty concentrating or dozing off while watching TV or reading, is best handled by stopping what you are doing and taking a nap, or retiring early and going to sleep. Be cautious about treating EDS with caffeine or over-the-counter stimulants as they temporarily mask sleep loss and can cause sleep disruption. If EDS persists for more than a few days, speak to a physician or other health care provider.

Symptoms That Can Signal Inadequate Sleep:

· Dozing off while engaged in an activity such as reading, watching TV, sitting in meetings or sitting in traffic

· Slowed thinking and reacting

· Difficulty listening to what is said or understanding directions

· Difficulty remembering or retaining information

· Frequent errors or mistakes

· Narrowing of attention, missing important changes in a situation

· Depression or negative mood

· Impatience or being quick to anger

· Frequent blinking, difficulty focusing eyes, or heavy eyelids

Helping children

At times of acute stress or trauma, parents and guardians should expect children to experience sleep problems, regardless of their age. It may take a few weeks for them to get back to their normal routines, but if the problems continue beyond that time, consider seeking further help from your child's physician or other health care provider, the school psychologist, or your child's teacher.

There are things parents can do to help minimize the impact of stressful events on their children, and help them get a restful night's sleep.

For all children:

· Your child's anxiety may affect falling asleep. Find out about his/her concerns and talk about them. While you should try to avoid these conversations at bedtime, don't shut off the conversation; talk briefly and offer to continue the conversation tomorrow.

· To avoid insomnia, try to maintain your child's usual bedtime and bedtime routines.

· Avoid foods and beverages containing caffeine at least four hours before bedtime, and exposure to news broadcasts at least an hour before bedtime.

Middle School and Younger Children:

· If your child has trouble falling asleep alone, avoid a drastic response (e.g. everyone sleeping together). Stay near until your child falls asleep. Provide reassurance by telling him/her you will check in.

· Turn on a light in the hallway or next room, but not the bedroom. Music can provide some soothing noise. The presence of a family pet in the bedroom (even a goldfish!) is often reassuring.

· If your child has nightmares and wakes up in the middle of the night, don't have a long discussion about the dream; be reassuring and help your child fall back to sleep. In the morning, if they tell you about a bad dream, that's a good time to talk either about the dream or the events that may have precipitated it.

· If your child is significantly anxious at bedtime, relaxation techniques (familiar tapes, deep breathing exercises) can be distracting and anxiety-reducing.

Adolescents:

Teens may be more affected by events than we realize and, therefore, at higher risk for sleep problems. Their greater understanding of events can be accompanied by a greater degree of worrying, making them more at risk for insomnia than younger children.

· Show teens the extra support, doting, and soothing that is given to younger children.

· Teens may experience insomnia or phase delay…going to bed later than usual because of talking on the phone, watching television, e-mailing friends, etc. Parents must set limits on this behavior, and keep their teen on a normal bedtime routine.

For more help, visit their Web site - http://www.sleepfoundation.org/