Sleep Is Important In Times Of Crisis
Author: Robert W. Clark MD and National Sleep Foundation

FOR IMMEDIATE RELEASE September 21, 2001

SLEEP IS IMPORTANT IN TIMES OF CRISES, SAY THE NATIONAL SLEEP FOUNDATION AND THE COLUMBUS COMMUNITY HEALTH REGIONAL SLEEP DISORDERS CENTER

Foundation And Ohio Sleep Disorders Center Offer Tips To Those Having Difficulty Sleeping

FOR MORE INFORMATION: Contact Robert W. Clark, M.D.
(614) 443-7800; flamenco@netexp.net

WASHINGTON DC AND COLUMBUS, OH, Sept. 21 -- As a result of the pain, grief, and stress coming from the horrifying terrorist acts of September 11, the subsequent discovery of more planned atrocities and now, the likelihood of prolonged war, many people will experience sleep disruptions. These include trouble falling asleep, staying asleep, waking early, or having nightmares. Children are particularly vulnerable to these problems.

Lost sleep and resulting excessive daytime sleepiness magnify feelings of panic and depression. They cause individuals to feel overwhelmed and devastated by adversities with which they might otherwise have been able to cope.

To help people address their need for sleep and improve the quality of that sleep they do get during this time of crisis, the National Sleep Foundation (NSF) and the Columbus Community Health Regional Sleep Disorders Center offer the following information and tips:

Insomnia can involve difficulty falling asleep, waking up frequently during the night, waking up too early or feeling unrefreshed upon awakening.

-If these symptoms persist for more than a few days, seek help from a physician, sleep specialist or other health care provider. A psychologist or counselor skilled in relaxation training and stress management may prove to be an invaluable ally.

-Be cautious about self-treatments such as alcoholic beverages that may worsen the problem. Also, recognize that sleeping pills may worsen other pre-existing sleep disorders such as sleep apnea and breathing distress in sleep, and many can be addictive if taken for other than a very brief time.

-Engage in a relaxing, non-alerting activity at bedtime such as reading or listening to music. For some people, soaking in a warm bath can be helpful. Avoid activities that are mentally or physically stimulating.

-Do not eat or drink too much before bedtime.

-Create a sleep-promoting environment that is quiet, dark, cool and comfortable. Light barrier curtain liners can eliminate outside lights that interfere with sleep. Sources of soothing nature sounds, aromatherapy and such innovative products as small fountains for the bedroom may facilitate sleep onset.

-Keep regular sleep habits. Avoid going to bed too late (for example, many people seem to "get their second wind" after midnight).

-Consume less or no caffeine. Avoid alcohol and nicotine, especially close to bedtime.

-Exercise, but not within 3 hours before bedtime.

-Short naps (l5-45 minutes) are effective in relieving acute sleepiness, but they should be avoided in some people suffering from insomnia and should not be taken after 6 p.m. in those on a typical day shift schedule.

-Nightmares can increase during periods of great stress for all people. Relaxation training may help.

-Excessive Daytime Sleepiness (EDS) and fatigue present with such symptoms as difficulty concentrating, memory difficulties and dozing off while watching TV or reading.

-Sleepiness can arise either from poor quality sleep or impaired brain alertness mechanisms--such that the person cannot stay awake even if they sleep well (as in patients with narcolepsy or thyroid deficiency). Many individuals with insomnia are not as sleepy as one would think. In fact, insomnia has been termed a 24-hour a day problem by some workers! Hence, it is not always safe to assume that marked sleepiness is simply the consequence of sleep loss.

-The commonest cause of severe sleepiness that begins or progressively worsens in adults is sleep apnea. Snoring or indications of breathing difficulty during sleep should be considered a warning sign.

-Be cautious about treating EDS with caffeine or over-the-counter stimulants as they can cause sleep disruption and they may lead one to ignore the underlying cause. Persistent EDS should lead one to consult with a physician.

Helping children. This issue has been a serious consideration during the present crisis in our country.

-At times of acute stress or trauma, parents and guardians should expect children to experience sleep problems, regardless of their age. It may take a few weeks for them to get back to their normal routines. If the problems continue beyond that time, consider seeking further help from your child's physician or another health care provider, psychologist, or the child's teacher.

-There are things parents can do to lessen the impact of these tragic events on their children’s sleep:

* Anxiety may affect falling asleep. Find out about your child’s concerns and talk about them. While you should try to avoid these conversations at bedtime, don't shut off the conversation. Talk briefly and offer to continue the conversation on the next day

* Try to maintain your child's usual bedtime and bedtime routines. Restrict chocolate and beverages containing caffeine at least four hours before bedtime, and exposure to news broadcasts at least an hour before bedtime. Watching humorous, age-appropriate videos in the evening may be a better choice.

-For younger children:

* If your child has trouble falling asleep alone, avoid a drastic response (e.g. everyone sleeping together). Stay near until the child dozes off. Provide reassurance by telling him/her you will check in.

* Turn on a light in the hallway or next room, but not the bedroom unless the child sleeps with a nightlight.

* Music and some of the measures listed above can be soothing. Also, the presence of a family pet in the bedroom is often reassuring.

* If your child has nightmares and wakes up in the middle of the night, don't have a long discussion about the dream; be reassuring and get the child back to sleep. In the morning, if they tell you about a bad dream, that's a good time to talk either about the dream or the events that may have precipitated it.

* If a child is significantly anxious at bedtime, relaxation techniques (such as tapes and deep breathing exercises) may help.

-For adolescents:

* Teens may be more affected by these types of events than we realize and, therefore, they tend to be at higher risk for sleep problems. Their greater understanding of the recent tumultuous events (particularly if they are nearing the age of potential military service) can be accompanied by a greater degree of worrying than younger children.

* Show teens the extra support that is given to younger children.

* Teens may experience insomnia related to going to bed later than usual, because of talking on the phone, watching television, e-mailing friends, etc. Parents must set limits on how long this behavior can continue, and get their teen back to a bedtime routine as soon as possible.

Additional information can be found on The Sleep Site (www.thesleepsite.com) and the National Sleep Foundation's web site (www.sleepfoundation.org).

The Columbus Community Health Regional Sleep Disorders Center is a fully accredited sleep disorders diagnostic and treatment facility that sees patients from throughout the United States. The National Sleep Foundation is an independent nonprofit organization dedicated to improving public health and safety by achieving public understanding of sleep and sleep disorders, and by supporting public education, sleep-related research, and advocacy.








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Dr. Clark received his medical degree from Ohio State University College of Medicine in 1972. He subsequently served a medical internship and one year of medical residency at Barnes Hospital in St. Louis, Mo., before returning to OSU for a neurology residency. His involvement in sleep medicine began in 1975, at which time he was one of fewer than ten American neurologists in the international sleep society. Dr. Clark received the American Academy of Neurology’s Weir Mitchell award for his research in sleep medicine. He is board certified in both neurology and sleep medicine and holds American Board of Sleep Medicine certificate #004.

Dr. Clark has delivered talks at various sites in the U.S., Spain, Netherlands, Scotland, Brazil, Argentina and Canada and appears frequently on television and radio. Interviews with Dr. Clark have appeared in Medical Utilization Management, Science News, Small Business News, and Prevention magazine, and on CNN and The Weather Channel.

He has served on the first sleep medicine nosology committee, as a Director of the American Narcolepsy Association, on the National Institutes of Health site visit committee for accreditation of Clinical Research Centers and as a Member at Large of the Sociedade do Sono Latinoamericano. He currently is a member of both the Clinical Practice Review Committee of the American Academy of Sleep Medicine and a steering committee for the National Sleep Foundation. He serves as a reviewer for the journal Sleep.

Dr. Clark is Medical Director of the Columbus Community Health Regional Sleep Disorders Center, a fully accredited facility that stresses comprehensive, individualized care and achievement of sustained good outcomes for its patients. He designed and implemented the first comprehensive sleep medicine outcomes database in the country, to ensure verification of consistently high levels of ongoing treatment compliance and control of illness. Dr. Clark also has developed a web site, www.thesleepsite.com, to provide detailed information on sleep related illnesses to patients, family members, physicians, insurers and employers.

Dr. Clark is married and has two children. He is a flamenco guitarist and accompanies the dance group El Ritmo.

COLUMBUS COMMUNITY HEALTH REGIONAL SLEEP DISORDERS CENTER
Robert W. Clark, M.D., Medical Director
1430 S. High Street, Columbus OH 43207
Tel: [614] 443-7800 -- Fax: [614] 443-6960
E-mail: flamenco@netexp.net

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