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ALERT for patients on Hormone Replacement Therapy:

Please be aware that as of August 1, 2010, all female patients that elect to have their Hormone Replacement Therapy prescribed through our office will be required to maintain their annual exams (pelvic/pap, breast exam, etc.) and mammograms directly through our office.

Sleepless In Seattle? How about SPOKANE??!!
Ten Tips to Improve Your Sleep

Sleepless in Seattle: 10 Tips to a Peaceful Night?s Sleep


By David Chang, MD and Gina H. Chen, MD
The Polyclinic Sleep Medicine Center

It?s often noted that you spend a third of your life sleeping, but for many, that?s wishful thinking. Trouble sleeping is one of the most common complaints people have. Whether the problem is falling asleep, staying asleep, or not feeling rested when waking up, sleep deprivation can wreak havoc on your body, mind and health.

Here are 10 tips to help you improve sleep. (These suggestions are intended for ?typical? adults, but not necessarily for children or persons experiencing medical problems.)

1. Maintain a regular bed and wake time schedule including weekends.
Our sleep-wake cycle is regulated by a ?circadian clock? in our brain and the body?s need to balance both sleep time and wake time. A regular waking time in the morning strengthens the circadian function and can help with sleep onset at night.

2. Establish a regular, relaxing bedtime routine such as soaking in a hot bath or hot tub and then reading a book or listening to soothing music.
Avoid arousing activities before bedtime like working, paying bills, engaging in competitive games or family problem-solving. If you are unable to avoid tension and stress, it may be helpful to learn relaxation therapy from a trained professional. Finally, avoid exposure to bright light before bedtime because it signals the neurons that help control the sleep-wake cycle that it is time to awaken, not to sleep.

3. Create a sleep-conducive environment that is dark, quiet, comfortable and cool.
Design your sleep environment to establish the conditions you need for sleep. Consider using blackout curtains, eye shades, ear plugs, ?white noise,? humidifiers, fans and other devices.

4. Sleep on a comfortable mattress and pillows.
The mattress you have been using for years may have exceeded its life expectancy?about 9 or 10 years for most good quality mattresses. Have comfortable pillows that are free of allergens that might affect you.

5. Use your bedroom only for sleep and sex.
It is best to take work materials, computers and televisions out of the sleeping environment. Use your bed only for sleep and sex to strengthen the association between bed and sleep.

6. Finish eating at least 2-3 hours before your regular bedtime.
Eating or drinking too much may make you less comfortable when settling down for bed. Try to restrict fluids close to bedtime to prevent nighttime awakenings to go to the bathroom, though some people find milk or herbal, non-caffeinated teas to be soothing and a helpful part of a bedtime routine.

7. Exercise regularly. It is best to complete your workout at least a few hours before bedtime.
In general, exercising regularly makes it easier to fall asleep and contributes to sounder sleep. However, exercising right before going to bed will make falling asleep more difficult.

8. Avoid caffeine (e.g. coffee, tea, soft drinks, chocolate) close to bedtime.
Caffeine products, such as coffee, tea, colas and chocolate, remain in the body on average from 3 to 5 hours, but they can affect some people up to 12 hours later. Avoiding caffeine within 6-8 hours of going to bed can help improve sleep quality.

9. Avoid nicotine (e.g. cigarettes, tobacco products). Used close to bedtime, it can lead to poor sleep.
Nicotine is also a stimulant, so it can cause difficulty falling asleep, problems waking in the morning, and may also cause nightmares. When smokers go to sleep, they experience withdrawal symptoms from nicotine, which also cause sleep problems.

10. Avoid alcohol close to bedtime.
Although many people think of alcohol as a sedative, it actually disrupts sleep, causing nighttime awakenings. Consuming alcohol leads to a night of less restful sleep.

If you continue to have sleep problems, try keeping a sleep diary. Note when and how your sleep is disturbed, what substances you?ve consumed and when, and note your daily activities, then look for patterns. If problems continue, see your doctor and bring your sleep diary. There may be an underlying cause that you will want to be properly diagnosed. Your doctor will help treat the problem or may refer you to see a sleep specialist.

Dr. Chang and Dr. Chen practice at The Polyclinic Sleep Medicine Center. They work closely with each patient to evaluate lifestyle and sleep patterns with the goal of developing an effective and thorough treatment plan. Dr. Chang was recently featured on the radio show Patient Power. To listen: ?Sleep Disorders: Obstructive Sleep Apnea and Snoring.?




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Happiness does not depend upon outward things, but on the way we see them.
Leo Tolstoy