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Vital Signs

Summer 2010

Lack of Sleep Can Lead to Serious Health Problems


VS-Summer10-Lack of SleepEveryone needs to sleep, but in this country an estimated 50- to 70-million people fail to get the nightly rest they need. And nearly 10 percent experience chronic insomnia, according to the Centers for Disease Control and Prevention.

“If you don’t feel refreshed after a typical night’s sleep and are sluggish during the day, you’re probably not getting sufficient sleep,” says neurologist and sleep-disorders expert Frisca Yan-Go, M.D., director of the UCLA Sleep Disorders Center in Santa Monica.

The consequences of not getting enough sleep can be severe. Insufficient sleep is associated with memory and cognitive impairment, decreased performance and alertness, increased risk for cardiovascular disease, diabetes, obesity, depression and other chronic conditions, and increased risk for motor vehicle accidents. The signs of insufficient sleep are fairly easy to recognize, but often overlooked.

According to Dr. Yan-Go, what is considered sufficient sleep for each person depends on factors including basal sleep need (the amount of sleep the body routinely needs to perform well) and sleep debt (the accumulated sleep lost to poor sleep habits, awakening during the night and other causes). Dr. Yan-Go says the timing of a person’s sleep is also important. Shifting the bedtime by more than two hours each night may disrupt the circadian rhythm, or “internal body clock,” and cause difficulties falling asleep, staying asleep, waking up on time and feeling restored by sleep.

When patients have primary insomnia, in which the inability to sleep is not caused by other health problems, the two key treatments are medication and cognitive behavioral therapy (CBT), says Alon Avidan, M.D., Ph.D., associate director of the Sleep Disorders Program at UCLA. He says some people initially attempt to address insomnia on their own by taking over-the-counter medications with a sedative effect or by using herbal compounds or dietary supplements. These medications may help with temporary insomnia in some patients but should be used only intermittently and only for a short duration, according to Dr. Avidan. “We also have newer prescription medications that can safely and effectively treat both short-term and chronic insomnia, including new, non-habit forming compounds that do not cause drowsiness the next day,” he says. “Patients should always solicit the assistance of their physicians for help addressing sleep problems. Likewise, primary care physicians should include sleep disorders in their review of system inventory.”

Sarosh Motivala, Ph.D., a clinical psychologist specializing in sleep disorders at the Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, says CBT is often more effective than medications for treating insomnia, without adverse side effects, and some patients may begin to see improvements after only a few therapy sessions. “Cognitive behavioral therapy addresses the stress-related and behavioral aspects of insomnia and provides long-term benefits by helping patient change the thoughts and actions that interfere with the ability to get restful sleep,” Dr. Motivala explains. Night-time anxieties, dealing with day-to-day stresses and spending excessive amounts of time in bed awake are all behaviors that can be targeted with CBT.

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