CONSULTANTS IN NEUROLOGY
WILLIAM M. LEUCHTER, M.D., P.C.
Bradley Rowens, medical director
of the Sleep Center of Sinai Hos-
pital. A normal loss of sleep, —
over an exam at school, an argu-
ment with a friend — lasts a few
days and will disappear on its own.
Anything longer, however,
would indicate chronic insomnia,
probably the result of:
• Periodic limb movement dis-
order, the repeated jerking of the
leg during sleep, causing a person
to either jolt awake or suffer frag-
mented sleep.
• Restless leg syndrome (RLS),
a tingling, twitchy feeling in the
legs and calf muscles while sitting
or lying down. The sensation is of-
ten described as feeling like bugs
are crawling up the legs. The rest-
less feeling will compel the person
to stamp or walk the feeling out
— all night long.
Approximately 15 percent of
sleep disorders are caused by ei-
ther RLMD or RLS, according to
the ASDC National Case Series.
For both RLMD and RLS, the
cause may be a chemical imbal-
ance in the brain. The treatment
is regular exercise, massage and
cold compresses, or some pre-
scription drugs.
• Sleep apnea is snoring and
stopping breathing in one's sleep.
Usually, airway muscles tem-
porarily collapse, preventing
breathing for 10 seconds or longer,
up to 60 times an hour, rendering
the disorder potentially lethal. Pa-
tients complain of daytime drowsi-
ness and, Dr. Rowens says, "[they]
think they have insomnia, but ac-
tually their snoring is waking
them up."
The treatment is continuous
positive airway pressure (CPAP),
a nose mask worn during sleep
that pushes a constant flow of air
through the nose.
• Depression or other psycho-
logical disorders, such as anxiety,
can cause a patient to either not
sleep, or to sleep often during the
day, resulting in the inability to
sleep at night. Howard Bayer, a
licensed psychologist at Birming-
ham's Center for Contemporary
Psychology, adds that patients suf-
fering from seasonal affective dis-
order, or seasonal pattern, are
more prone to sleeping too much,
rather than not enough, and that
this affect, again, is a symptom of
depression.
Poor eating habits complicate
sleep patterns as well, says Bev-
erly Price, a registered dietician
and exercise physiologist at Farm-
ington Hills' Living Better Sen-
sibly. Basic nutritional sense can
alleviate insomnia, she says.
"Before going to bed, eat things
with high complex carbohydrates,
such as whole-grain products like
a bagel, dry cereal or oatmeal with
cinnamon, if you want something
sweet," Ms. Price explains. 'These
produce serotonin, which causes
you to relax and feel drowsy. If you
eat real sugary things at night,
you'll wake up in the morning feel-
ing groggy."
Relaxation techniques —
stretching, meditation or sleep
glasses and tapes — are helpful,
too, she says. "Alpha and beta
waves are brain waves that we
produce. The alpha waves are our
relaxation waves that help us un-
wind. There are products that as-
sist [the alpha waves], such as
relaxation glasses and tapes."
Light and timing also can affect
sleep, says Dr. Rowen. Circadi-
an rhythm is the body's internal
clock, which is often affected by
sunlight or jet lag. The body will
eventually catch up on its own.
All of these possible causes of
chronic insomnia, with the ex-
ception of depression, could be di-
agnosed by an overnight sleep
study (polysomnograph). The pa-
tient would sleep overnight in a
private room, while the electri-
cal activity of the brain, eye and
leg movement and breathing pat-
terns are recorded.
Often, what begins as acute can
snowball into chronic insomnia,
says Dr. Rowens. "Say [a patient]
has gotten into a car accident." It
is a traumatic incident that would
naturally shake a person up, and
affect his sleep. This is called
short-term insomnia. To relieve
it, he will maybe take a drink at
night, lay in bed staring at the
clock, or keep the TV on while in
bed.
"At the end of six months, the
patient will have chronic insom-
nia. But it is no longer a result of
the car accident. The patient has
now developed bad habits."
He then needs to practice be-
havioral modification — essen-
tially train himself to get out of
these habits. Dr. Sangal recom-
mends, first of all, to use the bed
only for sleep and sex: Don't watch
TV or read in bed, write or do
work. If this doesn't help, he may
prescribe medications.
Next time you really want to
treat yourself to a good night's
sleep, before cuddling into your
flannel sheets, eliminate the co-
coa (caffeine), skip the book (or
read elsewhere) and snack on half
a bagel with a bit of strawberry
preserves.
Your body will thank you.
❑
ANTHONY EWER, D.O.
LAWRENCE EILENDER, Ivi.D.
WILLIAM LEUCHTER, M.D.
DANNY WATSON, M.D., PH.D.
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