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One-third of all adult Americans about 50 million people-complain about their sleep. Some sleep little, some fitfully, and some too much. Although one-third of our lives is spent asleep, most of us don’t know much about sleep, not even our own. We don’t even know exactly whey we sleep, other than like an overnight battery recharge sleep promotes daytime alertness. Sleep problems profoundly disturb both sleeping and waking life. What is the significance of these problems and what can be done about them? Recent scientific research is beginning to provide some of these answers.

Most adults sleep between 7 and 8 hours. But no one knows how much sleep we need. A natural “short sleeper” may sleep for only 3 or 4 hours, and actually function worse with more sleep. A “long sleeper” on the other hand, may need more than 10 hours. “Variable sleepers” seem to need more sleep at times of stress and less during peaceful times. Changes with age also contribute to changes in the ability to sleep continuously and soundly. A newborn infant may sleep 16 hours straight, while an elderly person may take daytime naps and then sleep only 5 hours at night. With advancing age, some people switch to shorter days and some to longer ones. Such a switch may be simply a normal condition of aging.

Insomnia, the most common sleep complaint, is the feeling that you have not slept well or long enough. It occurs in many different forms. Most often it is characterized by difficulty falling asleep (taking more than 30 or 45 minutes), awakening frequently during the night, or waking up early and being unable to get back to sleep. With rare exception, insomnia is a symptom of a problem, and not the problem itself. Good sleep is a sign of health. Poor sleep is often a sign of some malfunctioning and may signal either a minor or serious medical or psychiatric disorders. Insomnia can begin at any age. And it can last for a few days (transient insomnia), a few weeks (short-term insomnia), or indefinitely (long-term insomnia).

Transient insomnia may be triggered by stress say, a hospitalization for surgery, a final exam, a cold, headache, toothache, bruised muscles, backache, indigestion, or itchy rash. It can also be caused by jet travel that involves rapid time-zone change.

Short-term insomnia, lasting up to 3 weeks, may result from anxiety, nervousness, and physical and mental tension. Typical are worries about money, the death of a loved one, marital problems, divorce, looking for or losing a job, weight loss, excessive concern about health, or plain boredom, social isolation, or physical confinement.

Long-lasting distress over lack of sleep is sometimes caused by the environment, such as living near an airport or on a noisy street. Working a night shift can also cause problems sleeping during the day may be difficult on weekends. But more often, long-term insomnia stems from such medical conditions as heart disease, arthritis, diabetes, asthma, chronic sinusitis, epilepsy, or ulcers. Long-term impaired sleep can also be brought on by chronic drug or alcohol use, as well as by excessive use of beverages containing caffeine and abuse of sleeping pills.

Sometimes, long-term sleep difficulty can result from a number of other directly sleep-related medical ailments that are more directly related to sleep. Some examples are sleep apnea, nocturnal myoclonus, or “restless legs” syndrome.

Many patients with long-term insomnia may be suffering from an underlying psychiatric condition, such as depression or schizophrenia. Depression, in particular, is often accompanied by sleep problems (which usually disappear when the depression is treated). People with phobias, anxiety, obsessions, or compulsions are often awakened by their fears and worries, sometimes by nightmares and feelings of sadness, conflict and guilt.

Insomnia is a complex problem, not given to simple solutions. Most experts agree that treatment should start with assessing and correcting sleep hygiene and habits.

Here are some things that would benefit sleep:

*Exercise tends to benefit sleep, but not right at bedtime. Vigorous exercise, especially just before sleep, can cause arousal and delay sleep. Exercising in the afternoon or early evening has more beneficial effect on better sleep than exercise in the morning.
*Daytime naps disrupt normal nighttime sleep but there are certain exceptions. Many older people, in particular, do sleep better at night when they take daytime naps.
*Nicotine stimulates the nervous system and can interfere with sleep. Sleep patterns improve significantly among chronic smokers when they abstain from smoking.
*The best way to sleep better is to keep a regular schedule for sleeping. Go to bed at about the same time every night but only when you are tired. Set your alarm clock to waken you about the same time every morning including weekends and regardless of the amount of sleep you have had. If you have a poor night’s sleep, don’t linger in bed or oversleep the next day.

By establishing a regular wake time, you help solidify the biological rhythms that establish your periods of peak efficiency during the 24-hour day.