Sleepless in Seattle...Kalamazoo and Tulsa too--does food play a role?

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If, when bedtime comes, you find yourself wrestling with crumpled sheets or waiting wide-eyed for the effects of that cup of espresso to wear off, you're not alone. Half of all Americans have occasional problems sleeping. About 30 to 40 million more have severe sleep disorders that affect not only sleep but overall health.

Others are sleep-deprived from being chronically time-crunched. Overloaded work schedules, family obligations, late-night TV and graveyard shifts keep many of us rockin' around the clock. Our bodies still need the same amount of sleep our grandparents got, but today's Americans sleep 20% less than they did 100 years ago.

How Much Is Enough? The amount of sleep you need is thought to be passed down by your parents and programmed into your "internal clock." But generally, most of us need seven to eight hours of sleep to feel up to par.

Our need for sleep remains about the same throughout adulthood. But because older people spend less time in the deep stages of sleep, starting in middle-age we get less quality sleep. You're probably not getting enough rest if you feel sleepy during the day, sleep late on weekends or can't awaken without an alarm.

The Consequences of Insomnia. Insomnia is defined as having trouble falling or staying asleep, or even waking up too early. It can be transient, lasting just a few days or weeks, or chronic, lasting more than a month.

While occasional insomnia is no cause for alarm, if frequent it can leave you irritable. Productivity and concentration decline. Relationships suffer. Moreover, inadequate sleep can compromise the body's ability to fight disease and can raise the risk of accidents.

What Causes Insomnia? Like pain or fever, insomnia is usually a symptom of a deeper problem. Stress is the leading cause of short-term sleep problems. Medical conditions, such as depression, pain, asthma, osteoporosis and digestive disorders, can all interfere with sleep as well. Some prescription and over-the-counter drugs, including steroids, antidepressants, blood pressure medications and anti-asthmatic drugs, can trigger trouble too.

Sleep can also be compromised by lifestyle, from jet lag or an irregular schedule to too much caffeine, nicotine or alcohol. A lack of exercise can be just as detrimental as exercising right before bedtime. An uncomfortable bed or a room that's too hot, cold, loud or bright can keep you from sleeping well.

Nutrition-Related Remedies to Help You Get Your ZZZ's. Here are EN's tips for a good night of shut-eye:

Reduce or eliminate caffeine. This stimulant is found in sleep-depriving quantities in coffee, tea, many soft drinks and some over-the-counter medications for pain, allergy and cold relief. Caffeine stays in the body for several hours, so ingesting it just before bedtime is asking for trouble.

However, caffeine withdrawal can cause headaches, depression, drowsiness, irritability and fatigue, so if you want to cut back, do it gradually. Or, try limiting your intake to morning hours.

Avoid alcohol before bedtime. Alcohol may be considered the world's oldest sleeping aid, but ironically, it disrupts the normal stages of sleep, diminishing sleep quality. Alcohol increases body movement and temperature, causing sudden awakening in the middle of the night. To prevent this, avoid alcohol several hours before bedtime.

Trade sleeping pills for sneakers. Along with improving overall health, physical activity can promote deeper, more restful sleep. A recent study from Stanford University found that regular, moderate-intensity exercise enhanced both sleep quality and quantity.

In the study, more than 40 sedentary adults between the ages of 50 and 76, who had voiced mild to moderate sleep complaints, were randomly assigned to an exercise group or a nonexercise control group. The exercise group worked out for 30 to 40 minutes at moderate intensity four times a week. After 16 weeks, they fell asleep 15 minutes faster and slept for almost an hour longer than the nonexercisers. They also reported improvements in both sleep quality and daytime alertness.

Watch what and when you eat.

Eat light at night. While you may think a heavy meal before bedtime will help you doze, an active digestive system can make it harder to sleep. It's best to eat a large breakfast, moderate lunch and light dinner.
To nix those nocturnal trips to the bathroom, don't drink liquids close to bedtime.
If heartburn keeps you up, the following measures can help:
Raise the head of your bed four to six inches, by placing blocks under the legs of the head of the bed. It's more effective than extra pillows.
Eat small, frequent meals instead of large meals.
Drink liquids one hour before or after meals to avoid overly distending the stomach during mealtime.
Limit alcohol, coffee (regular and decaf), chocolate, peppermint, spearmint and excessive fat. All can prevent the sphincter separating the stomach and esophagus from staying closed, permitting acid reflux.
Try chewing gum after meals; it stimulates saliva, which eases acid's effect on your esophagus. (Make it sugarless.)
Watch your weight. Obesity increases your risk for sleep apnea, a potentially life-threatening sleep disorder that affects 10 million Americans. It is characterized by loud snoring interspersed with gasps for breath. Symptoms during the day include sleepiness, lack of concentration and memory loss.

Calm those legs. If the condition known as restless legs syndrome prevents you from getting a good night's sleep, and the usual flexing, walking or massaging doesn't work, discuss possible nutrient connections with your doctor. Iron supplementation may help, but shouldn't be initiated without some precautions (see EN, April 1997).

Be mindful of melatonin. A hormone produced by the pineal gland in the brain, melatonin regulates the sleep/ wake cycle. In one study, 0.3 milligrams of melatonin two to four hours before bedtime appeared to improve sleep quality and help 12 young men fall asleep faster. Theoretically, however, melatonin is more likely to aid older people, who produce less of the hormone. However, taking too much melatonin or taking it at the wrong time could make you drowsy and confused during the day or could interfere with sleep at night. Our advice? Use with caution, if at all.

Help yourself to safe herbal remedies. While much less powerful than sleeping pills, herbal remedies have been used for centuries to help people sleep. Common herbs that have some basis for promoting sleep and relaxation include: valerian, chamomile, St. John's wort, passion flower and hops. Try drinking a tea made from one of these herbs right before bedtime or soak in a warm tub that has been infused with herbs.

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By Ellen Albertson, M.S., R.D.

PUTTING THE MYTH OF MILK TO BED
What about Mom's advice to drink a warm glass of milk to help you fall asleep?

"It probably doesn't have a physiological or pharmacological effect," says Timothy Roehrs, of the Henry Ford Hospital Sleep Disorders and Research Center in Detroit.

Milk is particularly rich in the amino acid tryptophan, which can be converted to serotonin, a brain chemical known to promote relaxation and sleepiness. But milk and all high-protein foods are even richer in other amino acids, which crowd out the larger tryptophan molecule and prevent it from entering the brain.

As the theory goes, it's high-carbohydrate foods that have the best chance of boosting brain tryptophan levels, because carbs provide less competition. Theoretically, pretzels, popcorn, crackers or toast with jam are the type of foods most likely to make you sleepy.

On the other hand, if you find warm milk soothing and have made it part of your nightly ritual, that may be enough to help you relax and fall asleep anyway.

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