Get healthy for a better night’s sleep

In In The News by Barbara Jacoby

LLH network pressby

Kendra Wright-Smith is an insomniac.

“I’ve battled it since college,” she said. Usually, it lasts three to four days, occasionally five.

“I have to have someone drive me to work when it happens,” she said. “It’s too dangerous to drive tired.”

At one point when she was so sleep-deprived, Smith caught herself once having a conversation with someone who wasn’t there.

“You have to go to work. You can’t call in tired,” she said.

The sleep medication Ambien only created more issues — sleep-eating, sleep-shopping.

“You have to laugh about it, though,” she said. “It can be quite comical, but it does cause problems.”

She’s by no means alone, according to a recent study by the Perelman School of Medicine at the University of Pennsylvania. The study found significant regional differences in sleep disturbance, with people living in the South — including Oklahoma — more likely to report sleep problems and, consequently, daytime weariness.

Oklahoma ranked No. 2 on the list — No. 1 being the worst, said Dr. Kim Coon, a professor of psychiatry and the director of psychotherapy education in the Department of Psychiatry at the University of Oklahoma School of Community Medicine.

Folks on the West Coast had the best sleep. They exercise more, eat better and smoke less.

“Sleep is closely related to health in general,” Coon said — both mental and physical health.

Considering health factors among Southern states — smoking, obesity and access to health care — you’ll find a parallel in those states to sleep disturbances. West Virginia, the No. 1 state in the study, has the second-highest rate of obesity and the highest adult population of smokers, Coon said. Oklahoma ranks 11th for obesity and third for smokers.

Ignored, insomnia can be unremitting, Coon said. Cognitive impairment and memory problems might develop. People with sleep disturbances also report job dissatisfaction, and absenteeism can increase.

Adverse health problems can include type 2 diabetes, worsened depression and high blood pressure, she said.

And it’s costly, as medications, doctors visits or even accidents from driving while drowsy can take their toll on bank accounts.

Sleep hygiene

Sometimes, Annie Coates Hall dreads nights.

“I wake up in the middle of the night pretty much every night,” she said. If she falls back to sleep within an hour or two, “it’s a miracle.”

It makes her “crabby,” she feels “off,” and doing her job becomes harder.

She might be a textbook example of insomnia, which is broadly defined as the inability to get or maintain sleep, which leads to daytime dysfunction, Dr. Bruce Barton explained. He’s a pulmonologist and co-director of St. John Medical Center’s Sleep Disorders Center.

What he sees the most among his patients, however, is sleep apnea. Obesity is strongly associated with sleep apnea, a cessation or pausing of breathing during sleep. About 5 percent of Americans suffer from it.

But just about everyone will have the occasional bout of insomnia in his or her life, said Dr. Kevin Lewis, chief quality officer for Hillcrest HealthCare System. He’s also medical director for Oklahoma Heart Institute’s Sleep Care Program.

Those basic bouts of insomnia don’t mean anything medically, he said. Only people with chronic insomnia are treated medically.

That would mean someone has fought with insomnia symptoms most days for at least a month, Lewis explained. It’s characterized by one of three patterns:

— Struggling to get to sleep

— Struggling to stay asleep and maintaining it

— Sleeping yet not sleeping deeply

Just because people experience one of these or a mixture doesn’t mean they’d get an insomnia diagnosis, Lewis said, as these struggles have to led to impairment the next day.

People may experience transient sleep problems, Coon said — sleep disturbances caused by traveling, a new baby or some kind of life transition. Or they may have acute stressors that last a little longer, like a death in the family or a colicky baby.

For these, it’s best to check your “sleep hygiene,” to borrow Coon’s phrase, as bad behaviors can hamper a good night’s sleep.

Sometimes, Hall might stay up, still in bed, reading on her phone or playing on an iPad.

That’s not the best thing to do, our sleep experts said.

Coon had a patient complaining about sleep but boasting good sleep hygiene. But even with Ambien, he still had problems.

So Coon did a little “stimulus control therapy.” Apparently, the patient had a BlackBerry, laptop computer, another computer, two or three TVs and a couple of clocks in his bedroom, she said.

“With all those LED lights, you have too much going on,” Coon told the guy. All that technology wasn’t supporting a good sleep environment.

She suggested he strip his room of excess electronics, and he bought black-out curtains and a white-noise machine. Soon, he was sleeping more soundly.

Do’s and don’ts of better sleep

Maintaining a regular schedule is important to better sleep, Lewis said. Ditto for eating right and exercise. But be careful not to exercise too close to bed, as that can make you more alert.

You want to stay hydrated, but don’t drink too much liquid before bed, Coon said. Otherwise, you’ll be getting up in the night to use the restroom, and you might have difficulty returning to sleep.

Avoid alcohol, which Coon said is the best and worst pill. Yes, it’s a depressant, but it doesn’t allow you to go into restful sleep. The same goes for marijuana.

You don’t want to have a heavy meal before bed, but you may need some form of protein in the evening to help you sleep, Coon said. A few slices of turkey, or a serving of almonds or Greek yogurt, maybe a slice of cheese, can give you enough energy to get through REM cycles.

Don’t bring your worries to bed with you, Coon said. Put off thinking about it until tomorrow when you’re thinking more clearly.

Don’t take daytime naps, she said. You only get so many hours, so an afternoon nap means you’ll sleep less at night.

Set an alarm, but don’t keep looking at the time. Coon suggested putting the alarm clock under your bed.

Still can’t sleep? Don’t languish in bed; get up and read, Barton said. Do something quiet — boring, even.

If you’ve tried these suggestions and nothing works, you should talk with your physician.

For more about sleep disturbances and how to sleep better, Lewis suggested the National Sleep Foundation’s website ( and the American Academy of Sleep Medicine’s website (

Eat your way to sleep

Can’t get enough sleep at night? What you’re eating may be to blame. Here are some tips for a diet that will help you catch some Z’s:

Bananas: Bananas are full of two nutrients — potassium and magnesium — that work as relaxants. They also contain the amino acid tryptophan, which also promotes relaxation and drowsiness. Try to eat them about an hour before bed to give the tryptophan time to reach the brain.

Protein: Two slices of lean meat or cheese could help with your restless nights. High-protein foods promote sleep and fight acid reflux, which can flare up at night and make sleep difficult. Other ideas for high-protein bedtime snacks include a hardboiled egg or some cottage cheese with fruit.

Almonds: A handful of almonds is high in protein and magnesium, both of which promote sleep.

Milk: The old wive’s tale about a glass of warm milk is true. A glass of milk is full of tryptophan, and it’s a good source of calcium, which helps with the production of melatonin. Melatonin, in turn, promotes sleep.

Cherries: A handful of cherries before bed will provide a jolt of melatonin. If you can’t get fresh cherries, try dried ones or cherry juice.

Tea: Before bed, drink a cup of green tea, which contains sleep-inducing theanine. Other teas also help with relaxation, but be sure to use decaffeinated varieties.

A few things to avoid for a better night’s sleep:

High-fat meals: Meals high in fat in the evening lead to less sleep at night, according to research. They can be especially problematic for people with acid reflux. Try to put at least three hours between heavy, fat-laden meals and bedtime.

Caffeine: This is a no-brainer, but research shows that caffeine is one of the main culprits for sleeplessness. And sodas and coffee aren’t the only things to blame; caffeine in chocolate, gum and even some medications can contribute to insomnia.

Alcohol: A few beers or glasses of wine might make you drowsy at first, but they result in fragmented rest, which leads to restlessness the next day. Stick to a moderate amount to promote better sleep.