Sleep Disorders

Everyone knows firsthand the struggles of sleeplessness--that drowsy daytime feeling of leaden thoughts mired in deep mental mud, when the mind seems to work so much harder to accomplish so much less. Indeed, researchers believe that America is a society of the sleepless, with often catastrophic consequences.

When the occasional night spent walking the floor with a crying baby or rocking a toddler becomes a common occurrence, pediatricians often advise a little pharmaceutical help. A survey of 671 mostly suburban pediatricians showed that 75% had recommended sleeping medication for a child within the last six months. But few studies have examined the effectiveness of sleeping medicines in children, and no medication has been approved for them by the Food and Drug Administration.

There was no such thing as a good night's sleep for Sharon Brontrager. For most of her life, she approached bedtime the way most people approach a date in traffic court--with lots of anxiety about the outcome. "I asked my doctor for different things. I tried melatonin, Tylenol PM, an antidepressant," says Brontrager, 53, a retired travel agent in Cincinnati.

Large numbers of U.S. workers suffer from a lack of sleep, affecting on-the-job performance, according to survey results released by the National Sleep Foundation on Thursday. The survey, conducted by pollster Louis Harris, found that almost half of the U.S. labor force--about 55 million workers--have experienced sleeplessness in the last three months. Of this group, two-thirds reported that the resulting fatigue made it more difficult to perform their daily job tasks.

Some people first suspect they have obstructive sleep apnea when their significant other complains about excessive snoring, or tells them they stop breathing many times during the night. Others figure it out when their daytime sleepiness gets so bad they fall asleep at meetings or have a car accident.

Stuttering and a serious form of snoring known as sleep apnea may be linked, and both conditions may be caused by brain damage sustained early in life, U.S. researchers said Monday. A team at UCLA found that nearly 40% of sleep apnea patients it studied also stuttered as children. Sleep apnea is a serious form of snoring in which a patient's breathing actually stops several times a night. It is linked with a high rate of heart death.

Health insurers are sometimes better known for causing sleepless nights than for creating restful ones, but in the last few months, helping consumers get a good night's sleep has become a priority for most of the top-tier U.S. health insurance companies, including WellPoint, Aetna, Cigna, Kaiser Permanente and several Blue Cross plans. Their new programs don't involve sleeping pills. Instead, insurers are advocating the use of cognitive behavior therapy.

Jan Smith woke up on the couch again, forced out of her bedroom by her husband for the fourth time that week. Jim wasn't a tyrant, nor was their marriage on the rocks. The Smiths are just two of the estimated 60 million Americans disturbed each night by snoring. Jim, a 44-year-old real estate agent, has always snored and never thought much of it. His attitude was: What could he do about it? Jan took the noise pollution that disrupted intimacy harder: "I love sleeping with him.

Tighter prescription controls proposed for some powerful drugs, including popular medications for anxiety and sleep disorders, have some lawmakers at odds with medical and pharmaceutical groups. Increased government scrutiny of dispensing certain drugs will help reduce abuse and illegal use, authors of several bills contend. But doctors, pharmacists and drug companies say the tighter regulations would make it harder for people who legitimately need medication to obtain it.

There's no such thing as a quick, foolproof list of instructions for hassle-free bedtimes. "Quick guidelines just don't exist," says Dr. Richard Ferber, director of the Center for Pediatric Sleep Disorders at Children's Hospital in Boston and the author of "Solve Your Child's Sleep Problems" (Simon and Schuster, 1986). But short of solutions, Ferber and others do have plenty of suggestions. First, parents need to figure out why their children don't want to go to bed.