Sleep : Sleep Vital to Good Health

Howard Gensler

We all know people who say they can get by with little or no sleep, folks who can burn the midnight oil, then wake early raring to go.

We hate those people.

Most people, however, need between seven and nine hours daily to refresh their minds and bodies - and most people don't get it. This lack of sleep muddles their thinking, raises their irritability levels, diminishes their joy and turns a happy face into a tired, lined one. (If you're one of the people who can get by with less sleep - actress Betty White says she needs only four hours a night - you're in just 5 percent of the population.)

Remember, the name of the fairy-tale character is Sleeping Beauty, not Tossing and Turning Beauty.

Ronald Kotler of Pennsylvania Hospital is a sleep specialist. But he's not just anyone's sleep specialist - he's Oprah Winfrey's.

Kotler's road from his office at 7th and Spruce streets in Philadelphia to Winfrey's Chicago studio in May started a few years ago in the green room of "Good Morning America," where he met Winfrey's fitness guru Bob Greene. Kotler gave Greene a copy of his book, "365 Ways to Get a Good Night's Sleep," and a few months later got a call from Greene to write the sleep section of Greene's new book, "20 Years Younger," which attempts to build a healthier, "younger" you through exercise, nutrition, skin care and good, reinvigorating sleep.

Medically speaking, Kotler is a pulmonologist who specializes in treating apnea, a potentially dangerous condition in which people stop breathing while they sleep. "Your muscles relax when you sleep," Kotler said, "but if your airway muscles relax too much, you get an apnea."

In a chicken-egg health problem related to sleep, obesity can lead to apnea and poor sleeping can in return lead to obesity.

"(The protein hormone) leptin suppresses appetite," Kotler said, "and sleep deprivation leads to decreased synthesis of leptin.

"Some patients lose weight just by treating the apnea." But Kotler's sleep practice goes well beyond apnea. His decades of research and state-of-the-art sleep center, which monitors patients whose lack of sleep is adversely affecting their health, have made him an expert on all sleep matters.

"A lot of people have sleep problems and don't realize there's help," Kotler said. The doctor said the key to getting a good night's sleep is to "go to bed the same time and get up the same time."

He's a fan of the 20-minute power nap, but said longer naps can interfere with healthy snoozing.

"The nap can be energizing," he said, "but it is not a substitute for night sleep." "All of us have a dip in our circadian rhythms from 3-6 p.m.," he said, referring to the post-lunch afternoon malaise many experience, and that afternoon sleep debt can be masked with activity or caffeine (activity is healthier and won't make you restless at night). "Often on the weekend, when you have less activity, you're also masking that sleep debt." You can't, by the way, pay off sleep debt by sleeping more.

Many senior citizens have accumulated decades of sleep debt and although they say they need less sleep, Kotler disagrees.

"They just get less sleep," he said. "You sleep less as you get older because you're more susceptible to internal (bathroom trips, aches and pains) and external disturbances." Stress can also play a role in hindering a refreshing rest.

"A lot of things that happen to us during the day carry over into sleep," he said. A bad day at work can easily turn into a bad night's sleep, with the cycle repeating daily. If your sleep is constantly interrupted around 3 a.m., you may want to see a doctor - possibly a psychiatrist.

Kotler said "3 a.m. wakening is a classic early sign of depression, although we don't know why."

But sleeping pills, in moderation, can help.

"The stigma attached to sleeping pills has changed," the sleep doctor said. "They're very good for short-term use following a traumatic event. You don't want a short-term sleeping problem to become a long-term sleeping problem."

But long-term sleeping pill use is not an answer and can mask a deadly problem such as apnea because narcotics dull the brain's ability to realize you're not breathing. That can lead to the big sleep, which we're all trying to avoid.

©2011 the Philadelphia Daily News Distributed by Mclatchy-Tribune News Service.

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