SLEEP SOUNDLY EVERY NIGHT, FEEL FANTASTIC EVERY DAY SLEEP SOUNDLY EVERY NIGHT, FEEL FANTASTIC EVERY DAY A DOCTOR’S GUIDE TO SOLVING YOUR SLEEP PROBLEMS Robert S. Rosenberg, DO, FCCP Visit our website at www.demoshealth.com ISBN: 978-1-936303-72-4 e-book ISBN: 978-1-61705215-6 Acquisitions Editor: Julia Pastore Compositor: diacriTech © 2014 by Robert S. Rosenberg. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the publisher. Medical information provided by Demos Health, in the absence of a visit with a health care professional, must be considered as an educational service only. This book is not designed to replace a physician’s independent judgment about the appropriateness or risks of a procedure or therapy for a given patient. Our purpose is to provide you with information that will help you make your own health care decisions. The information and opinions provided here are believed to be accurate and sound, based on the best judgment available to the authors, editors, and publisher, but readers who fail to consult appropriate health authorities assume the risk of injuries. The publisher is not responsible for errors or omissions. The editors and publisher welcome any reader to report to the publisher any discrepancies or inaccuracies noticed. Library of Congress Cataloging-in-Publication Data Rosenberg, Robert S. (Robert Steven), 1948-author. Sleep soundly every night, feel fantastic every day : a doctor’s guide to solving your sleep problems / Robert S. Rosenberg, DO, FCCP. pages cm Includes bibliographical references and index. ISBN 978-1-936303-72-4—ISBN 978-1-61705215-6 (e-book) 1. Sleep—Popular works. 2. Sleep disorders—Popular works. I. Title. RA786.R67 2013 616.8’498—dc23 Special discounts on bulk quantities of Demos Health books are available to corporations, professional associations, pharmaceutical companies, health care organizations, and other qualifying groups. For details, please contact: Special Sales Department Demos Medical Publishing, LLC 11 West 42nd Street, 15th Floor New York, NY 10036 Phone: 800-532-8663 or 212-683-0072 Fax: 212-941-7842 E-mail: [email protected] Printed in the United States of America by McNaughton & Gunn. 14 15 16 17 18 / 5 4 3 2 1 To Christine Feltman Rosenberg, my wife of thirty years, mother of my wonderful children, my executive producer, accomplished businesswoman, and occupational therapist. She inspired me to write this book and has been by my side every step of the way supporting my medical career, dreams, and now my mission to educate the world about sleep medicine. Author’s Note The names and identifying characteristics of all patients have been changed to protect their privacy. Contents Introduction: Moving into Health Together How to Use This Book Share Sleep Soundly Every Night, Feel Fantastic Every Day 1 Identifying Your Sleep Problem Sleep Disorder Checklist Part One: Sleep Foundations for Your Best Life 2 The Cornerstone of Health Sleep Stages and Cycles The Effect of Too Little Sleep on Your Health Fatigue and Brain Fog Take the First Step and the Rest Falls into Place 3 How to Get a Good Night’s Sleep Identify Your Motivation Create an Ideal Bedroom Environment No Blue Lights at Night Break Habits That Hinder Sleep Habits to Aid Sleep Dismiss a Worry or Dump an Attitude Superb Sleep through Progressive Muscle Relaxation What’s Next? Sleep Diary Part Two: Impaired Sleep or Dyssomnias 4 Restless Legs Syndrome What Is Restless Legs Syndrome (RLS)? Symptoms Treatment Options The Difference between RLS and Periodic Limb Movements Answers to Your Questions Foot Pain at Night RLS and Antidepressants Why Do I Rub My Feet Together? Are Gambling and RLS Related? Relationship between RLS and Obsession A New Medication and Leg Tingling RLS Pain after New Medication RLS Correlation to Attention Deficit Hyperactivity Disorder (ADHD) RLS and Sleep Attacks RLS and Exercise RLS and Nonpharmacological Treatments RLS or Fibromyalgia? RLS and Varicose Veins Self-Check: Restless Legs Syndrome Checklist: URGE 5 Insomnia Primary Insomnia Sleep Hygiene Stimulus Control Cognitive Restructuring Symptoms Transient Insomnia Insomnia with Multiple Causal Factors Chronic Insomnia Indications Why You Suffer from Insomnia Do You Have a Vulnerability to Insomnia? Insomnia and Women Treatment Options Good Sleep Hygiene Stimulus Control Sleep Restriction Cognitive Behavioral Therapy (CBT) Cognitive Restructuring Online Cognitive Behavioral Therapy Release Tension and Relax Before Going to Bed Medications Preparing for an Appointment with a Sleep Specialist Answers to Your Questions Sleep Maintenance Chronic Insomnia Paradoxical Sleep Drinking Coffee Sleep Deprivation Stress and Sleeping Smoking Husband Denying Insomnia I’ve Tried Everything! No Luck with Sleep Aids Stop the Caffeine Valium Singulair Self-Check: Insomnia Severity Index Scoring and Interpretation 6 Circadian Rhythm Disorders Circadian Biology and a Normal Circadian Clock Blue Light Pollution Circadian Rhythm Disorders Jet Lag Disorder Symptoms Checklist Getting Help Delayed Sleep Phase Syndrome Symptoms Getting Help Advanced Sleep Phase Syndrome Free-Running Disorder