Sleep Disorders

Short sleep pattern

03/03/2004

Question:

For the last 3-4 months I`ve been unable to sleep thru at least 6 hours at night without having to get up to urinate--but then I can not get back to sleep. Result is I`ve been sleeping in 2-3 hour snatches;awake an hour;sleep a few hours;awake again. I am of course very exhausted by 7am when I seem to have the longest sleep until 10 or 11if not disturbed. I`m a walking zombie until I take a 2 hour day nap. How dan I break this pattern?

Answer:

Waking up in the middle of the night and experiencing difficulty in getting back to sleep can be troublesome. This is a form of insomnia known as "sleep maintenance insomnia" and may result from numerous varied causes.

Some of the more common conditions or problems that may result in sleep maintenance insomnia include breathing disorders in sleep, leg jerks during sleep or wakefulness (known as periodic limb movement disorder or restless legs syndrome), depression, conditions associated with pain, side effects from medications or substances (such as caffeine, alcohol, or nicotine), circadian rhythm disturbances and a poor sleep environment.

In order to determine if you suffer from one of these conditions, or if there may be another underlying cause for your sleep disruption, you should speak with your physician about your problem. Your physician will ask for additional information that will determine if you need any diagnostic testing, referral to a Sleep Specialist or possibly treatment.

In the meantime, practicing simple "Sleep Hygiene" measures may help to improve your sleep. Rules of Sleep Hygiene: 1) Maintain a regular wake time, even on days off work and on weekends. 2) Try to go bed only when you are drowsy. 3) Keep a regular schedule. Regular times for meals, medications, chores and other activities help keep the inner clock running smoothly. 4) Avoid napping during the daytime. If you do nap, try to do so at the same time every day and for no more than one hour. Mid-afternoon (no later than 3 PM) is best for most people. 5) Do not spend excessive amounts of time in bed. Use your bed only for sleep, intimacy, and times of illness. 6) A relaxing pre-sleep ritual such as a warm bath, light bedtime snack, or 10 minutes of reading may help. Avoid heavy meals before bedtime. 7) Try to exercise regularly. Vigorous exercise should be limited to earlier in the day, at least six hours before bedtime. Mild exercise should be done no more than 4 hours before bedtime. 8) Avoid ingestion of caffeine within 6 hours per day. "Reasonable" caffeine consumption is considered to be the equivalent of about 1-2 cups of coffee per day. 9) Do not drink alcohol when sleepy. Even a small dose of alcohol can have a significant effect when combined with tiredness and alcohol tends to cause sleep disruption after the first few hours of sleep. Do not drink alcohol while taking sleeping pills or other medications. 10) Avoid the use of nicotine close to bedtime or during the night.

If you would like additional information regarding sleep and sleep disorders, you can obtain it on the American Academy of Sleep Medicine website at www.aasmnet.org. This website also contains a list of Sleep Centers across the country so you can locate one near you if need be. Good luck and here`s to better sleep!

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Response by:

Dennis Auckley, MD
Director, MetroHealth's Center for Sleep Medicine
Associate Professor
Division of Pulmonary, Critical Care and Sleep Medicine
MetroHealth Medical Center
School of Medicine
Case Western Reserve University