Tips for Better Sleep, Kids and Sleep, The Stages of Sleep

by Food and Drug Administration (FDA)

(Page 4 of 4)

Doctors use an all-night sleep study to make a definitive diagnosis of sleep apnea. During the test, sensors are attached to the head, face, chest, abdomen, and legs. The sensors transmit data on how many times the person being tested wakes up, as well as changes in breathing and in blood oxygen levels.

Medications generally aren't effective for sleep apnea. There are about 20 FDA-approved devices available by prescription for snoring and obstructive sleep apnea, says Susan Runner, D.D.S., branch chief for dental devices in the FDA's Center for Devices and Radiological Health. "These work for some," she says. "The devices pull the tongue or jaw forward to open the airway." There are no similar over-the-counter devices approved by the FDA. Potential side effects include damage to the teeth and jaw joint.

The most common treatment for sleep apnea is continuous positive airway pressure (CPAP) with a device that pushes air through the airway at sufficient pressure to keep the airway open while sleeping. Radzikowski says using CPAP makes her feel rested during the day. It involves wearing a mask over the nose while sleeping. A blower attached to the mask pushes air through her nasal passages.

Surgery also is an option to treat snoring and sleep apnea. This may include removal of the tonsils or adenoids. To treat snoring, a laser-assisted procedure called uvulopalatoplasty is used to enlarge the airway by reshaping the palate and the uvula, making them less likely to vibrate. For sleep apnea, a laser procedure called uvulopalatopharyngoplasty is used to remove excessive tissue at the back of the throat.

If you're troubled by sleep problems, ask your health-care provider about how your problem should be evaluated and which treatments may be appropriate for you. Experts say it's important to know that you don't have to suffer through sleep problems. Radzikowski says she had never heard of sleep apnea before the car accident that killed her husband.

"I was overweight and I knew I snored loudly. But snoring was like a big joke in our family," she says. "I didn't really take it seriously, and I wish I did."

Tips for Better Sleep

• Keep a regular sleep-wake cycle. Try to go to bed and wake up at the same time every day.
• Avoid caffeine, alcohol, and nicotine in the four to six hours before bedtime.
• Don't exercise within two hours of bedtime. Exercising five or six hours before bedtime may help you sleep more soundly.
• Don't eat large meals within two hours of bedtime.
• Don't nap later than 3 p.m.
• Sleep in a dark, quiet room with a comfortable temperature.
• If you can't fall asleep within 20 minutes, do a quiet activity somewhere else and return to bed when you're sleepy.
• Wind down in the 30 minutes before bedtime with a relaxing pre-sleep ritual such as a warm bath, soft music, or reading.

Sources: American Academy of Sleep Medicine; James Walsh, Ph.D., National Sleep Foundation

Kids and Sleep

When they're infants, it's middle-of-the-night feedings. When they're toddlers and school-age, it's awakening to give medicine or soothe them after a nightmare. It's no surprise that, according to the latest poll from the National Sleep Foundation (NSF), more people without kids in the house rated their sleep as "excellent" or "very good," compared to those with children.

Some sleep interruptions come with the territory. But experts say the best thing people can do for themselves and their children is to develop a regular sleep routine and bedtime for youngsters so that they get used to falling asleep on their own. Experts say school-age children generally need 9-12 hours of sleep each night.

According to the American Academy of Child and Adolescent Psychiatry, many childhood sleep problems are related to irregular sleep habits or anxiety about bedtime. Young children view bedtime as a time of separation, which is why they pull out a number of stalling tactics such as repeated requests for water and trips to the bathroom.

Here are some sleep tips for children from NSF:

Establish positive sleep habits with your child at an early age. Have a set sleep schedule for bedtime and waking. Keep the same schedule for weekdays and weekends. Know how much sleep is appropriate for your child's age.

Establish a 20-30 minute nightly "calm-down" bedtime routine that can include taking a bath, putting on pajamas, reading, and other relaxing activities. TV viewing at bedtime, especially having a television set in the child's bedroom, may interfere with falling asleep.

Other childhood sleep problems include talking during sleep and bedwetting. Many children get over sleep problems as they grow. But if you have concerns, talk with your child's doctor.

If you think your child may have a sleep problem, ask yourself these five questions (remember them by the acronym "BEARS"):

• Bedtime: Does my child have problems going to bed or falling asleep?
• Excessive daytime sleepiness: Does my child seem sleepy or overtired during the day? Is he or she difficult to get up in the morning?
• Awakenings: Does my child awaken frequently during the night or have trouble getting back to sleep?
• Regularity and duration of sleep: What time does my child go to bed and get up on weekdays? Weekends? How much sleep does he or she get? Need?
• Snoring: Does my child snore loudly? Does he or she seem to have breathing problems at night?

The Stages of Sleep

Stage 1: Light sleep. We drift in and out and can be awakened easily. Our eyes move slowly and muscle activity slows.

Stage 2: Our eye movements stop and our brain waves become slower with occasional bursts of rapid waves called sleep spindles.

Stage 3: Deep sleep. Extremely slow brain waves called delta waves appear, interspersed with smaller, faster waves.

Stage 4: Deep sleep. The brain produces mostly delta waves. There are no eye movements and no muscle activity.

Stage 5: REM sleep. Breathing becomes more rapid, irregular, and shallow. Eyes jerk rapidly, limb muscles become temporarily paralyzed. Dreams almost always happen in this stage, but may occur in other sleep stages as well.

We usually pass through five stages of sleep. Each cycle takes about two hours. Then the cycle starts over again with stage 1. As the cycles repeat, deep sleep periods get shorter and periods of REM sleep lengthen. Adults spend half of their sleep time in stage 2, 20 percent of the time in REM sleep, and 30 percent in the other stages. Infants start out spending about half of their sleep time in REM sleep.

About the Author

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FDA is A United States government body that oversees medical devices, including contact lenses, intraocular lenses, excimer lasers and eyedrops. In the US, these products must be approved by the FDA before they can be marketed.