To Sleep, Perchance…to Dream…

From the Healing Bridge Physical Therapy
Summer 2005 Newsletter

AHHH, sleep. After a long day, sinking into a comfortable bed for a night of peaceful slumber is a ritual that many of us eagerly anticipate. However, people who suffer from sleep problems may find the evening and nighttime hours to be anxiety-provoking, at best. Approximately 70 million people in the US are affected by sleep problems, with the large majority of disorders undiagnosed and untreated4.

According to the National Sleep Foundation, before Thomas Edison’s invention of the light bulb, people used to average ten hours of sleep. In contrast, Americans today average closer to seven hours during the week, a bit more on weekends4. Sleep experts observe that most adults need seven to nine hours of sleep for optimum performance, health and safety4. Approximately two thirds of Americans get significantly less sleep than optimal 4,5.

Some of the negative effects of sub-optimal sleep include: an increased risk of diseases such as obesity and high blood pressure, depression, reduced productivity, difficulty performing mental and physical tasks, decreased quality of life, and safety issues at home, at work and on the road 4,6. The National Highway Traffic Safety Administration estimates that at least 100,000 automobile accidents are caused by drowsy drivers each year4. In fact, 17% of Americans admit they have actually dozed off while driving4.

Healthy sleep is not only important in preventing injury, it is essential for recovery and pain management. Insomnia is associated with increased pain and distress in individuals with chronic pain8. It appears that disturbed sleep may influence the management of painful medical disorders3. More than 75% of Americans experiencing frequent pain also report a sleep problem5. Traumatic accidents may also be a precursor for non-restorative sleep in certain people7. Although it is unclear whether the painful conditions contribute to or are exacerbated by poor sleep, it appears that people with painful conditions and sleep problems must address both issues. Sleep problems have also been found to be a predictor for long-term work disability2.

Sleep questions should always be discussed with your physician, as they can be a sign of a serious medical disorder. Many people’s sleep problems go untreated and undiagnosed. Some sleep disorders include snoring, insomnia, sleep apnea (pauses in breathing during sleep), and narcolepsy (a condition that causes a person to fall asleep uncontrollably)6. Other medical problems, such as lung conditions, obesity and ambulatory limitations can affect sleep5,6. People with multiple medical conditions tend to have more sleep problems, as there is a correlation between the number of diagnosed medical conditions and a person’s quality of sleep5.

After you’ve received treatment or suggestions from your physician, your physical therapist can set up a regular exercise program, which will help you manage pain, and learn relaxation techniques (such as biofeedback, Feldenkrais, Yoga, or Tai Chi). These can all help you sleep1. See “Take it from the Pros” on page four for more suggestions for improving your sleep. Also we’ve put a free audio Progressive Relaxation exercise online…just click here to access it!

An excellent local resource for sleep issues is the Saint Charles Medical Center/High Desert Sleep Disorders Laboratory (383-6905). The National Sleep Foundation has a well organized and informative website covering a wide range of sleep issues (http://www.sleepfoundation.org/).

References

1 Benlucif S, Orbeta L, Ortiz R, Janssen I, Finkel SI, Bleiberg J, Zee PC. Morning or evening activity improves neuropsychological performance and subjective sleep quality in older adults. Sleep. 2004 Dec 15;27(8):1542-51.

2 Eriksen W, Natvig B, Bruusgaard D. Sleep problems: a predictor of long-term work disability? A four-year prospective study. Scand J Public Health. 2001 Mar;29(1):23-31.

3 Moldofsky H. Sleep and pain. Sleep Med Rev. 2001 Oct;5(5):385-396.

4 National Sleep Foundation. Sleep Facts and Stats. www.sleepfoundation.org/hottopics/index.php?secid=9&id=34.

5 National Sleep Foundation. 2003 Sleep in America Poll. www.sleepfoundation.org/press/index.php?secid=&id=94.

6 Saint Charles Medical Center. High Desert Sleep Disorders Laboratory – Overview. www.scmc.org/view.cfm?page=SleepLab_Overview.

7 Saskin P, Moldofsky H, Lue FA. Sleep and posttraumatic rheumatic pain modulation disorder (fibrositis syndrome). Psychosom Med. 1986 May-Jun;48(5):319-23.

8 Wilson KG, Eriksson MY, D’Eon JL, Mikail SF, Emery PC. Major depression and insomnia in chronic pain. Clin J Pain. 2002 Mar-Apr;18(2):77-83.