Stress, age lead to sleep disorders

BOULDER – Considering how long we’ve been sleeping, logic would seem to hold that we’d be pretty good at it by now. But for the majority of us, that’s not the case.

One in three Americans has trouble sleeping, according to recent Gallup polls, and restless nights can cause more than just grouchiness the following day. Poor sleep is associated with heart disease, high blood pressure, diabetes, stroke, anxiety, depression, work absenteeism and alcoholism, not to mention that it carries a price tag of around $80 billion a year, according to the National Sleep Foundation.

Have you ever talked to anybody who hasn’t had a sleep problem? Even those who wouldn’t describe themselves as having insomnia – a word sleep expert Richard Shane shies away from using – probably could describe at least a few sleepless nights.

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The reason Shane, who was a psychotherapist for 20 years before deciding to focus on sleep disturbances, hesitates to use the word insomnia is that “many people who have trouble sleeping think that insomnia is worse, more serious, than what they’re experiencing.”

Shane says sleep disorders increase with age – starting at about 40 – and with increasing use of cell phones and e-mail, it’s no wonder. “People don’t stop.

“Imagine seeing a red light but waiting until you’re almost on top of it to stop. It can’t be done smoothly. When you see the light, you’ve got to slow down, and then you gradually come to a stop.”

Shane began researching sleep disorders in the early ’90s. He started with his own insomnia, which developed during a stressful period in his life. He used his own experience to develop a three-session treatment that involves showing people how to use a “master switch” to give them direct entry into sleep. It’s not a form of meditation, he emphasizes, but a way of quieting the mind and teaching sleep breathing while awake.

Shane says the method doesn’t require a lot of training. “It’s a way of opening passageways and calming the heart. It relaxes the body without trying to make it relax.”

Half of Shane’s referrals come from physicians and half from people with whom he’s worked. One client, a triathlon competitor, was so pleased with her improved sleep and resulting competitive performance that she referred her trainer to him.

For some, getting help for a sleep disorder can be a life-saving choice. Information from a 1979 study in the American Journal of Psychiatry showed that the rate of alcoholism among insomniacs was twice the rate of good sleepers. Approximately 16 percent of alcoholics who claimed, in a study almost a decade later, that they used alcohol as a sleep aid said that a sleeping disorder preceded their alcohol abuse.

People who don’t sleep well also have two to three times as many car accidents as the general population, according to a 1993 article in the British Medical Journal. Shane points to research showing that among youth between the ages of 15 and 18, poor sleep causes more accidents than drunk driving.

The Department of Transportation estimates that as many as 200,000 reported automobile accidents each year may be sleep-related. In the trucking industry, the National Transportation Safety Board says fatigue accounts for 31 percent of all accidents that are fatal to the driver.

Besides the personal hazards that can result from insomnia, economic problems can arise, as well. In an article in the Journal of Clinical Therapy, the researcher calculated a performance impairment of 4 percent associated with insomnia. Extending this rate to the 42 million working Americans at that time who reported insomnia, he estimated the cost of reduced productivity due to insomnia was $41.1 billion annually.

Employees’ sleep difficulties also have been linked to their receiving fewer promotions, recommendations and pay increases.

A University of Chicago study reported this year in the Journal of the American Medical Association correlated a decrease in deep sleep with a decrease in the production of growth hormone, which is correlated to obesity and loss of muscle mass. While it’s still not known whether low growth hormone causes sleep disorders or sleeplessness causes low levels in the hormone, an increase in sleep increases levels of the hormone.

Shane points to another JAMA study to explain why his method is superior to using drug therapy to treat sleep problems. In the study, subjects treated with behavior therapy were able to sustain their clinical gains when followed up, while those treated with sleeping medications alone did not.

Rather than getting locked in the struggle that involves worrying about sleeplessness to the point of preventing sleep, sleep experts encourage investigating behavioral therapies that can help. After all, when you’re tossing and turning at 2 a.m., what better option is there?