The Health Update
 
 
 
 
Vol 1, Issue 3
March 2007

A Practical Guide for Your Health

  cute doctor                                     
 
Greetings!
Welcome back to The Health Update, a free bi-monthly health e-zine!
 
Do you yawn just hours after waking up? Want to lay your head down on your pillow even though you have hours until bedtime?
 
If you are like most Americans, you have spent some days feeling tired and sleepy. The American Association of Sleep Medicine (AASM) recommends that adults get seven to eight hours of sleep each night. But the AASM says that one in five adults do not get enough sleep and 35-40% of the population experiences daytime sleepiness.
 
This month's issue is about sleep...or rather, the lack of sleep and why investigating daytime sleepiness is important. Feel free to contact me at www.jennifercaudle.com, or forward this email to friends or loved ones (use the "forward" link at the bottom of the page). Thank you for allowing me to share in your health!     -Dr. Jennifer Caudle
 
cute doctor
Do You Have Excessive Daytime Sleepiness?
 
-Do you doze off during routine tasks or while driving?
 
-Do you have accidents at work, school or home because of poor attention span? 
 
-
Is your sleepiness noted by others, or do you get non-refreshing sleep? 
 
-
Do you nap on most days or more than once a day?
 
Adapted from American Family Physician, Recognizing Problem Sleepiness in Your Patients, Feb 15 1999, Nat. Center of Sleep Disorders Research Working Group
Sleep Debt

Do not be fooled into thinking that you can function on a smaller amount of sleep than normal and not have it catch up with you. Even if you do not keep track of the sleep that you are missing out on, your body does. Sleep debt  is the term used to describe the amount of sleep you are deficient. For example, if last night you received one less hour of sleep than you normally require, you have a sleep debt of one hour. If you then miss out of two hours of sleep tonight, you then have a combined sleep debt of 3 hours. Thus, the need for those 3 hours of sleep does not go away and your body still requires that you obtain that deficient sleep. 


Serious Consequences
 

 The National Highway Traffic Safety Administration estimates that 56,000 automobile crashes happen every year when drivers fall asleep, and that approximately 40,000 injuries and 1,500 deaths occur as a result of sleep-related accidents.

           

In addition to motor vehicle accidents, work-related accidents have been identified as a result of a lack of sleep. The Accreditation Council for Graduate Medical Education established standards in 2003 to limit the number of hours medical residents can work to  "promote quality education and patient care." (acgme.org).

           

Decreased sleep has also been shown to hinder school performance, concentration, memory, mood and behavior.

Underlying Causes of Daytime Sleepiness
 
Problems with daytime sleepiness could be a result of stress or environmental factors, or  it could be the result of a more serious condition.

 

1) Primary Sleep Disorders include insomnia, obstructive sleep apnea, restless legs syndrome and narcolepsy.

    A. Insomnia - difficulty falling asleep or staying asleep.  
    B. Obstructive sleep apnea- the upper airway collapses repeatedly throughout sleep. Symptoms can include loud snoring, gasping or choking during sleep.
    C. Restless legs syndrome- urge to move the legs, often in response to pulling, crawling or tingling sensations.
     D. Narcolepsy- excessive daytime sleepiness, often with cataplexy (sudden muscle weakness triggered by emotional reactions), sleep paralysis (inability to talk or move upon falling asleep or awakening) or hallucinations.
 

2) Other medical conditions that cause daytime sleepiness include bronchitis, asthma, heart failure, sickle cell disease, and rheumatoid arthritis among others.

 

 3) Environmental factors such as fluctuating  work schedules, prescription and over-the-counter drugs, caffeine, alcohol, and nicotine can cause disrupted sleep patterns and daytime sleepiness.

 
 
**Information provided in this newsletter is not intended to be a susbstitute for your physician's advice. Speak with your health provider about any medical concerns you have**
Alternative Therapies for the Treatment of Insomnia
 
A Cochrane Database review of alternative therapies for the treatment of insomnia suggests that re-associating the bed/bedroom with sleep can help in getting a good night's sleep. The following are ways to do this:
 
1) Use the bed and bedroom for sleep and sex only.
2) Get into bed only when feeling sleepy.
3) Get out of bed when unable to fall asleep after 20 minutes. Engage in relaxing activity until drowsy, and then return to bed.
4) Get out of bed at the same time every morning.
5) Avoid naps. (limit naps to 30 minutes for the elderly).
 
Other alternative therapies shown to have some efficacy include: muscle relaxation, cognitive behavioral therapy, and biofeedback (such as electromyography, electroencephalography). Tai Chi, Yoga and bright light therapy may have some effect on sleep, but according to Cochrane databases, further studies are needed to establish their efficacy.
 
Keep in mind that these therapies apply to daytime sleepiness caused by insomnia. If your daytime sleepiness is caused by a condition other than insomnia, your treatment may be different. Make sure that you visit your doctor for proper diagnosis and treatment.
 
Best wishes for a good night's sleep! - Dr. Jennifer Caudle
About Dr. Caudle...
Dr. Jennifer Caudle, D.O., a cum laude graduate of Princeton University, received her Doctor of Osteopathic Medicine degree from the University of Medicine and Dentistry of New Jersey. She is now completing a residency in Family Medicine at UMDNJ-SOM.
 
Dr. Jennifer Caudle
Jennifer Caudle Enterprises
Philadelphia, Pa 19105
 
Copyright 2007 Jennifer Caudle Enterprises; Reproduction prohibited without consent.

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