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TIME FOR BED

Five Dream-Stealers
Part 3 of 3

Fred was fed up with his sleeping problems. Despite his best efforts, his asthma continued to periodically keep him awake, and his occasional mild indigestion had developed into full-blown heartburn and acid reflux. When Fred recently woke up with that familiar burning sensation, followed by nausea and a bout of vomiting, he knew he had to start taking more aggressive measures. His usual mountain of pillows sometimes helped him to breathe, but the resulting awkward position left his body sore and stiff the next morning. And, obviously, it wasn’t helping the acid reflux!

If you have an underlying physical condition that disturbs your sleep on a regular basis, you can probably relate to Fred’s predicament.

When you have a major disturbance, or even if you’ve just started to suspect there’s an underlying condition, you should see your health practitioner who can help you determine the problem. But you can also help yourself. Experts suggest several things you can do to alleviate many of your sleeping difficulties on your own, especially if you want to avoid taking medications. 

Many illnesses and physical conditions can rob you of your sleep. Let’s take a look at five ailments particularly associated with sleep deprivation and some of the methods you might use to reclaim your restful nights and your peaceful dreams.

1. Indigestion and GERD: Rude Awakenings

Waking up with heartburn may signal GERD—gastroesophageal reflux disease—often simply called acid reflux. That unpleasant burning sensation occurs when acid from your stomach backs up into your esophagus. When the acid makes it all the way back to your throat, you might wake up coughing, choking, or regurgitating. Even if you experience only the occasional nighttime indigestion, it seems worth it to heed advice from the National Sleep Foundation (NSF) and other experts in order to avoid this distasteful sleep-wrecker.

Over-the-counter medications might provide temporary relief, but they won’t solve the problem. And some medicines even worsen your symptoms, explain WebMD. Any or all of the following tips will probably do more to restore better sleep.

  • Many health professionals emphasize the importance of elevating your head while sleeping. You can try pillows, but according to the Mayo Clinic, this method might not help. Instead, try raising the head end of your bed six to nine inches by placing wood or cement blocks under two legs of the bed. You can also purchase a wedge made to fit between the mattress and box springs, which will elevate your upper body. With a quick internet search, you’ll also find more expensive options, such as adjustable beds and bases and inflatable wedge-shaped mattresses.
  • Don’t eat right before lying down. Try to finish your evening meal or snack at least two or three hours before bedtime.
  • Avoid wearing tight-fitting clothes while you eat.
  • Eat small meals and eat only in an upright position (no more snacks in the recliner!)
  • Don’t try to eat while you are angry or otherwise upset.
  • Smoking aggravates GERD symptoms. So if you’re still hanging on to that habit, make an effort to stop (see the article series, The Choice to Stop Smoking).
  • If you take any pills, especially bedtime supplements, take them in an upright position and drink plenty of water.
  • Certain foods tend to irritate the esophagus and overall digestion. Try avoiding those on the list below, as well as any other foods you suspect might be bothering you. 

    Chocolate
    Alcohol
    Tomato-based foods and other acid-based foods
    Citrus
    Coffee and other caffeine
    Peppermint
    Spicy and fatty foods
    Garlic and onions

    See several favorites on the list? You might be able just to limit your intake rather than completely eliminating them, especially if you’re more careful with your evening meals. Try keeping a food journal to discover which foods cause your symptoms. 
  • Try sleeping on your left side. In this position, your stomach remains below your esophagus, making it more difficult for the acid to rise upward.
  • Lose weight, if needed. The Mayo Clinic staff note that extra weight puts pressure on the abdomen and pushes up the stomach, which encourages the acid to back up.

Speaking of weight loss…losing those extra pounds can also help solve a sleep disorder you might not realize you have…

2. Sleep Apnea: When Snoring Becomes Serious

If sleep apnea causes you to wake up choking or gasping, you’re well aware of the problem. But you might not suspect this condition until your roommate complains about the obnoxious snoring or until your spouse expresses concern about the long pauses in your breathing. In this most common form of apnea—obstructive sleep apnea (OSA)—the muscles in the back of the throat fail to keep the airway open, explain experts at the NSF, causing you to stop breathing multiple times during the night.

Even if you don’t wake up completely, apnea will disrupt your deep sleep, leading to daytime drowsiness, fatigue, and other symptoms of inadequate sleep. So, if you’re always tired, in spite of evidence that you’re sleeping through the night, OSA might be the culprit.

Sleep apnea and GERD seem to be closely related. Although one hasn’t been proven to cause the other, the treatment of one will likely improve the other. Much of the advice for GERD also applies to OSA: stop smoking (which swells the airways), lie on your side rather than your back, and avoid alcohol (which relaxes the airway muscles and encourages OSA episodes). Losing weight is particularly effective for OSA and will often completely eliminate the condition.

If you have severe apnea, your doctor might suggest a more drastic option—the use of a CPAP (continuous positive airway pressure) device. You might not like the idea of wearing a mask while you sleep, but this machine keeps your airways open and might provide the answer to your problem. 

3. Asthma and Allergies: A Disruptive Duo

These two conditions often stick together; many people suffer from both. The same substances can trigger episodes of both, and the same measures will often improve both. So let’s consider this unpleasant pair together.

Dealing with allergies can be challenging enough during daylight hours without losing sleep from a stomach cramp or from sinus congestion dripping down the back of your throat. And if you’re an asthma patient, you certainly don’t want the added misery of the coughing, breathlessness, and wheezing that often accompany nocturnal asthma. When these symptoms continually steal your sleep, it’s time to give nighttime some extra consideration.

As you and your doctor work to control your asthma and allergies, you can do a few things at home to address your sleep issues.

Number one? Clean up! If you’re a little lax in the housecleaning department (as many of us are), your bedroom might be dusty—which means you’re probably harboring dust mites, a common trigger for nocturnal asthma, says the NSF. In addition to dust, other common allergens such as pet dander, mold, and pollen from outdoors can wreck many nights of slumber when you neglect your cleaning duties.

And don’t assume that dusting the furniture once a week will do the trick. In addition to keeping the surfaces clear of dust, you’ll need to clean walls, window sills, and floors. To make the workload easier, you might consider replacing your carpet with wood or tile. Like carpeting, curtains harbor dust, so consider using blinds or other window treatments. Wash bedding often, at least once a week, and for the best protection against allergens, encase your mattress and pillows in hypo-allergenic covers.

It’s hard work, especially if you hate housecleaning. But it’s worth it if you can reduce those sleep-disturbing symptoms.

More tips for allergy and asthma-free sleep…

  • As in the case of those with GERD, many asthma and allergy sufferers find relief by sleeping in an inclined or upright position, which can prevent sinus drainage. 
  • Are you allergic or sensitive to certain foods? Then don’t give in to temptation. Remember that food can affect you many hours after eating it. Is it really worth having a clogged nose and breathing through your mouth all night because you ate ice cream two days in a row? Are you really willing to wake up with a bloated, cramping abdomen because you disregarded your gluten intolerance?
  • Purify the air in your bedroom with an electronic air purifier. Or you might prefer something a little more affordable. Did you know that many green plants can purify the air? Golden pothos and English ivy are popular choices, as well as spider plants, snake plants, and the Chinese evergreen.
  • Keep the air in your bedroom moist with a humidifier, and keep air conditioner filters clean.
  • Shower before going to bed to remove any allergens from your body.
  • Keep the room free of animals—live ones as well as the stuffed variety.  t’s sad, but if you’re a stuffed animal lover, you’ll need to keep your dust-gathering teddy bear collection somewhere else.

4. Restless Leg Syndrome: The Unsolved Case

If your legs keep you from sleeping, you might have Restless Leg Syndrome, or RLS. And unfortunately, scientists have found neither a cause nor a cure. The National Sleep Foundation defines RLS as an “overwhelming urge to move the legs when at rest,” often accompanied by “unpleasant sensations” in the legs. Although this condition remains a bit of a mystery, you might find considerable relief of symptoms from home remedies or other therapies, according to the National Institute of Neurological Disorders and Stroke (NINDS). 

Since lack of sleep can trigger RLS episodes, notes the NINDS, it’s important to practice good general sleeping habits as much as possible (see part 2 of Time for Bed). In addition, consider the following…

  • Start by addressing any other medical concerns. Research has not determined the reason for RLS, but scientists think it could be related to other underlying conditions and illnesses such as diabetes. 
  • Incorporate walking or other regular exercise into your daily routine.
  • Massage the legs.
  • Take a hot bath.
  • Apply a heating pad or an ice pack to the legs.
  • Some health professionals believe that RLS may be related to certain deficiencies and will suggest supplements of iron, folate, magnesium, or vitamin B12. 
  • Eliminate or decrease intake of alcohol, caffeine, and tobacco. 
  • Evaluate any medications you take that could possibly be making it worse.
  • Look for certain habits that worsen your condition, for example, sitting for long periods.
  • Some medications relieve symptoms, but no one drug helps everyone, says the NINDS. Even helpful medications tend to lose effect after awhile and need to be changed.
  • Consult with your physician to determine other available options, especially if you have severe symptoms.  

If you wake up with involuntary jerking or twitching of the legs, you might have a condition very closely related to RLS called periodic limb movement. The above suggestions might help with this condition, as well, especially since these movements often occur along with RLS.

5. Hormonal Imbalance: The Balancing Act of Sleep

For women only…

If you’re a woman, your hormones have probably kept you up at night on occasion. Whether from PMS, pregnancy, or menopause, a woman’s life always seems subject to fluctuating hormones. For many women, these times of life include varying symptoms, including insomnia.

In her book, Prescription for Nutritional Healing, Phyllis A. Balch suggests melatonin supplements for regulating hormones and reducing PMS-related insomnia. Wild yam extract might also offer insomnia relief, since it provides natural progesterone, the hormone often found lacking during PMS, Balch explains.

During pregnancy, a vitamin B deficiency might encourage more sleepless nights. Ask your doctor about supplementing. Balch also suggests arranging pillows behind or under your abdomen to relieve breathlessness, which often occurs in the final stages of pregnancy.

Night sweats. Hot flashes. Nighttime awakenings. If you’re in the 40-55-age range, you might find yourself plagued with these sleep-stealing symptoms commonly associated with menopause.

Because hormone levels tend to dip in the years approaching and during menopause, women of this age often experience insomnia.

Many women choose hormone replacement therapy to restore levels to a normal range. Taking supplemental hormones can relieve symptoms of menopause quite effectively, but health professionals have conflicting opinions about their safety. Educate yourself thoroughly and consult your physician before making this choice.

As you work with your healthcare practitioner to balance your hormone levels, you can incorporate other ideas aimed at bringing about better sleep during this time in your life. 

Marcelle Pick, OB/GYN, NP, and founder of the Women to Women website writes, “Insomnia is a highly treatable condition that doesn’t necessarily need pharmaceutical intervention.”  In particular, she suggests calming teas, and herbal supplements like passionflower and kava kava. She emphasizes a balanced diet focusing on quality protein, healthy fats, and lots of fruits and vegetables for managing many menopause symptoms, including night sweats and sleeplessness.  Adding a high-quality multivitamin and mineral complex, plus an omeg-3 supplement, will help keep hormones in balance, as well.

To reduce night sweats and hot flashes, wear lightweight pajamas to bed and use sheets that wick moisture away from your skin. Keep a bowl of ice water and a washcloth by the bed for a quick fix, if needed.

If you’re male, keep reading…

Women aren’t the only ones who can suffer insomnia from hormonal imbalances, notes Dr. Marina Johnson of The Institute of Endocrinology and Preventive Medicine, “Disorders of thyroid hormone, testosterone, cortisol, and growth hormone can all cause sleep disorders,” she writes. So if your insomnia continues and you just can’t seem to figure it out, you might consider seeing an endocrinologist, a physician specializing in hormonal health.

Do You Have Other Dream-Stealers?

For any underlying sleep-disturbing condition that you can’t handle on your own, see your healthcare provider. Depending on the extent of your problems, you may even want to consider a sleep specialist. 

Sleep medicine is a relatively new field, and its existence highlights the growing problem of sleep deprivation. Cleveland Clinic, for example, has a separate Sleep Disorders Center, which provides an initial sleep evaluation and a sleep medicine physician who will craft an individualized treatment plan based on your diagnosis.

Restoring Your Dreams

As a first step toward better sleep and health, Fred has decided to lose weight, which will likely improve both of his dream stealers—his asthma and his GERD.  In the meantime, he and his wife have worked out a weekly cleaning and laundry schedule for the bedroom, and Fred has decided to try out a wedge pillow specially designed for GERD sufferers.  He’s really not happy about the foods he might have to forego to alleviate his reflux, since many of them are his favorites. But if it means no more heartburn or midnight vomiting, he’s willing to experiment.

Depending on your condition and your stage in life, successful sleep may be something you have to work on. Unfortunately, it doesn’t come easy for everyone. Keep trying, despite the underlying conditions that seem destined to ruin your dreams. Don’t give up. It isn’t a hopeless situation and lack of sleep isn’t something you should have to endure regularly. Choose to pursue a good night’s sleep as often as possible. Your best health depends on it.

Written by Beth Prassel-Sieg
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- OTHER ARTICLES IN THIS SERIES -

Part 1:
TIME FOR SLEEP
The Importance of Sleep

Part 2:
TIME FOR SLEEP
Don't Be a Sleep Failure

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A healthy outside starts from the inside. Robert Urich