Awake and Refreshed

Article excerpt

Byline: Randi Bjornstad The Register-Guard

If you sometimes snap awake for no apparent reason at 3 a.m., lie there sleepless for an hour or two before nodding off again, and then awaken feeling exhausted when it's really time to get up, you can take some comfort in being among the majority of adults in this country.

The National Sleep Foundation says that 58 percent of adults occasionally experience at least one of the four symptoms of insomnia; besides middle-of-the-night wakefulness, the others include difficulty falling asleep, repeated waking during the night and feeling unrefreshed when it's time to get up.

When these sleep disturbances happen only occasionally, it's called "transient insomnia" and usually has its cause in the stresses and strains of the daytime hours. But if it happens night after night until it's practically a foregone conclusion, it may be "chronic insomnia" that takes medical intervention to ferret out and fix.

"There are two kinds of people with sleep problems - people who get too little sleep and people who need to sleep too much," says Karthik Mahadevan, physician and medical director of McKenzie-Willamette Hospital's Sleep Solutions Center in Springfield.

"Usually, for the people who can't stay asleep, we can identify the reasons (such as) cramps or leg movements or other difficulties that can be treated more easily," often through changing pre-bedtime routines, trying relaxation techniques or using medication.

People who experience insomnia shouldn't read or watch television in bed, Mahadevan said.

"It's good to wind down before bed by taking a warm bath or listening to music, but bed should be the place for sleep."

To prevent wakefulness, it's a good idea not to go to bed either too hungry or too full, he said. The bedroom should be kept at a cool temperature during the night, and it should be dark.

Mahadevan admits he doesn't always practice what he preaches to his patients. Besides the common bad habits he warns them against, "I have two little kids crawling in and out of bed with me all hours of the night," Mahadevan admits. "My sleep is not that great."

But for those like himself who just occasionally awaken during the night - or know what it is that disturbs their sleep - deciding if they have a sleep problem is fairly easy: "If you wake up refreshed and don't feel tired during the day, you're probably getting enough quality sleep," Mahadevan said.

On the other hand, among people who are very sleepy all the time, which includes up to 25 percent of adults, many are likely to be suffering from obstructive sleep apnea, in which something - tongue, enlarged tonsils or fatty tissue in the throat - partially blocks the body's airways, causing snoring and a precipitous drop in the amount of oxygen in the blood.

When the blood oxygen level becomes dangerously low, the brain responds, sending impulses to bring the sleeper awake, at the same time tightening the airway muscles and opening the windpipe so normal breathing can resume, according to the U.S. National Heart, Lung and Blood Institute.

However, the mechanism in turn causes the body to release stress hormones, which raise the heart rate and over time can increase the risk of high blood pressure, heart attack, stroke and heart arrhythmia, even heart failure.

If that weren't enough, the institute says, sleep apnea also can change the way the body uses energy, or fat, leading to obesity and diabetes. …