Sleep and the City

By Kristine Keller Last week I headed to Dean & Deluca, making my daily jaunt for java, until I sensed something wasn't quite right. I quickly realized my dress was inside-out, revealing every seam and stitch. I call these days a wash. The days you catch every red light and your brain feels like viscous jelly whose working memory can't hold more than your first and last name. "I'll just get some sleep and start fresh tomorrow," I tell myself. But what if something impedes us from racking up those hours of rest? The time you relinquish consciousness on your cushy pillow is surely one of your inalienable rights. But with every self-evident truth, there lie potential obstacles. In the case of sleep disorders, there are over 80 on the horizon, wreaking havoc on handfuls of tired eyes. Dysomniatic disorders, like insomnia and narcolepsy, are the most common. These ailments affect a person's quantity and quality of sleep. Acute insomniacs only suffer from sleepless nights for less than a month, and symptoms are transient. Nearly 40 percent of the population has experienced acute sleeplessness at some point. Chronic insomniacs comprise 10-15 percent of the population and problems sleeping must last longer than one month. To qualify for a diagnosis, one's sleep disturbance and daytime fatigue must cause significant impairment to one's life. Other qualifications include significant daytime fatigue, irritability and excessive anxiety about sleeping. Sleep specialists can typically discern whether the disorder is related to another ailment like depression or stress or if it's a problem on its own by conducting clinical interviews. For ideal results, the most effective treatment is a combination of cognitive behavioral therapy (CBT) and a process known as sleep hygiene. With CBT, patients are taught how sleep cycles work and techniques to change negative sleeping attitudes. Patients learn to substitute sweeping statements like "I have to get seven hours of sleep tonight, or I won't be able to go to work tomorrow" with positive and realistic views like "I can still go to work tomorrow, and I'll make up for the lack of sleep tomorrow night." Sleep hygiene behaviors also help treat insomnia. Patients are taught sleep-promoting behaviors like exercising regularly except three hours before bedtime and going to sleep at the same time each night. Clinicians also say it's important that sleep isn't forced-if it's been longer than 30 minutes and you feel restless, remove yourself from bed and retreat to a different space while undertaking a relaxing activity, like reading, until you can't keep your eyes open. Since the bedroom often becomes a source of anxiety for insomniacs, doctors also suggest techniques that help soften muscles, like yoga and meditation. Medication should be the last resort for chronic insomniacs, since the problem might persist for years. And while insomniacs wish they slept a little more, those suffering from narcolepsy would like to sleep less. You know that feeling on Thanksgiving when you feel like you've overdosed on turkey tryptophan and you might hunker down at the dining room table? Narcolepsy is like Thanksgiving every day minus the thanks. These sleepers suffer from excessive daytime sleepiness and periodic sleep attacks and usually loss of muscle consciousness, known as cataplexy. Sudden emotions like laughter or anger precipitate cataplexy, and in these instances you might be mid-argument and lose all feeling in your legs and collapse to the floor. These episodes last nearly 30 seconds and make the diagnosis easier, since cataplexy is unique to narcoleptics. Those who lack cataplexy make diagnosis trickier, and some of these narcoleptics are often left undiagnosed for years. To find out whether one qualifies, diagnostic testing in a sleep disorder center is necessary. Patients who lack cataplexy but suffer from excessive fatigue to the point where they can't perform at school or work would perhaps benefit from seeing a sleep specialist. Currently, the best treatments are stimulant medications. Our bodies need sleep like we need water, which makes finding the right treatment essential. In fact, those who are deprived of sleep for longer than 100 hours experience hallucinations, paranoia and behaviors resembling mental illness. But getting too much shut-eye isn't productive for one's social life, either. It's important to seek help in any capacity so that when the moon rises and it's a new night, we're able to attain what this nation stands for: life, liberty and the pursuit of sleep.