Kevin Russell, Natasha Larivee, Cameron Ashe, and Matt Stewart, LIC Clerks, Dalhousie Medicine New Brunswick, Horizon's Miramichi Regional Hospital

Zzz … Zzz … Zzz.  

Sleeping is something we all must do to live and survive. But how many times have you had difficulty getting to sleep or staying asleep, or wake-up feeling unrested?

Today we're diving into two of the most common sleep problems: insomnia and obstructive sleep apnea (OSA).

Firstly, sleep is more critical to our health than most of us realize. A lack of restful sleep can lead to an increased risk of obesity and heart disease, immune system dysfunction, irritable bowel syndrome (IBS), and increase in chronic pain.

Poor sleep can also extend into your daily life by affecting your performance at work, increasing stress levels, or even making you drowsy at the wheel.

Have we convinced you that sleep is important yet? If you're someone who has difficulties sleeping, you should consider talking with your doctor about this.

Obstructive sleep apnea (OSA)

OSA is a common breathing-related sleep disorder where part of the upper airway repeatedly collapses during sleep.

These people are loud sleepers and snorers. Sometimes, they may even gasp/snort and it may sound like they stop breathing for a couple of seconds. You may not notice it yourself, but your bed partner sure will!

Approximately 1 to 3 in every 10 men and 1 out of 10 women in North America will deal with OSA in their life. Most commonly, people with OSA complain of daytime sleepiness, or their bed partner brings it up.

People with suspected OSA are sent for a sleep study where their oxygen levels are measured and the amount of times they stop breathing is recorded.

Treating OSA varies depending on the severity, but oftentimes a machine to keep the airways open while sleeping is used. This is called a CPAP (Continuous positive airway pressure) machine and although it can take a few weeks to get used to, it is excellent at treating this medical condition. 

Insomnia

Insomnia is a problem that family doctors hear about almost daily. In fact, 1 in 10 people in Canada have dealt with this sleep problem. That's because insomnia can be caused by a wide variety of things, ranging from stress to different medical conditions.

Insomnia means having difficulty falling asleep, staying asleep or having non-restful sleep. Insomnia occurs because our bodies' internal clocks get distorted and we start to have inefficient sleep.

People with insomnia will lie in bed for hours and not be able to fall asleep or will wake-up in the middle of the night and not be able to get back to sleep.

Lots of things interfere with sleep - stress, jet lag, work, for example - but it becomes a significant medical issue if someone has been dealing with insomnia for thirty consecutive days.

To treat insomnia, the most important thing is to have good "sleep hygiene." Briefly, sleep hygiene ensures that you keep a regular sleep schedule, which sometimes means waking up and going to sleep at the same time every day (even on the weekends!).

You should also exercise regularly (but not too late in the evening, as exercise too close to bedtime can hurt your sleep!), avoid caffeine after lunch, avoid alcohol/smoking near bedtime, and avoid light-emitting screens before sleep. A good tip is to read a couple pages of a book before bed!

Treating insomnia long-term with medications tends not to work all that well. The most common drugs prescribed for sleep problems are Z-drugs, such as Zopiclone or Zolpidem.

These medications do help promote sleep in the short-term, but they can lose their effectiveness long-term and have some negative side effects such as increased drowsiness, lightheadedness and dizziness. These side effects are particularly worrying in elderly patients as it increases their risk of falling. Moreover, these medications tend to make insomnia worse when stopped. These medications do have a role in treating short-term sleep problems that might last for 2 to 4 weeks.

The most successful treatment for insomnia is called sleep therapy, or CBT-i. This is a form of therapy that will retrain your body to get the most efficient sleep possible over a month-long period.

It's not about the amount of sleep you get but how efficient that sleep is. First you pick a time that you can get up at consistently every day. Then, you stay up later and reduce the total amount of time you sleep. You'll find that you will get to sleep quicker and stay asleep longer. Your sleep time is gradually lengthened over the month until you are getting a comfortable amount of sleep.

Ask your doctor if they can refer you to a specialist or health care professional who is familiar with CBT-i.

Here are 5 easy steps to try to treat your insomnia:

Go to bed at the same time every night for one week. Going to bed and waking up at the same time every day despite your schedule is one way to try and reset your body's internal clock. This can be difficult for shift workers or people who like to sleep-in on the weekends.

Don't lay in bed for more than 30 minutes. If you find yourself tossing and turning, get up after 30 minutes, go for a quick walk around the house and try again in 5 minutes. This will give your body a better chance of having a more restful sleep.

Leave the bedroom for bedroom things! Try to cut those unhealthy habits like eating and watching screens in bed.

Try going for a walk or getting some exercise three times a week. Remember to do this at least 4 hours before bedtime.

Try melatonin. Melatonin is a natural hormone released by your body. This can be bought over-the-counter at your local pharmacy and can help your body reset. The extended release form is best.