Take advantage of that extra hour of sleep, Lincoln, but take care in shifting sleep cycles. Judging by Lincoln's two newest sleep programs, many will need that extra hour tonight. And many probably won't han
MARK ANDERSEN / Lincoln Journal Star | Posted: Thursday, October 30, 2008 7:00 pm
Take advantage of that extra hour of sleep, Lincoln, but take care in shifting sleep cycles.
Judging by Lincoln’s two newest sleep programs, many will need that extra hour tonight. And many probably won’t handle the time change well.
Saint Elizabeth Regional Medical Center opened its five-bed Sleep Disorders Center in October, expanding its existing two-bed lab.
Coordinator Chris Akers hopes to see the center expand accredited services to treat a wider range of sleep disorders — of which there are plenty. An estimated 30 million Americans — 1 in 10 — are at risk for insomnia.
Sleep apnea — poor sleep due to breathing halts while asleep — is a common center diagnosis.
People often don’t recognize the problem in themselves and seek help only after chronic sleep debt harms their life or at the insistence of somebody who suffers from their loud snoring.
Denice Aten, 52, who has both restless legs syndrome and sleep apnea, said her sleep disorders often caused her to wake up tired and with headaches. The bottom fell out following surgery for ovarian cysts four years ago and she never got better. Fatigue led to depression, which entwined with chronic pain — something she’s still working to straighten out.
Practicing Lincoln attorney Bill Peters, 69, has used his CPAP device — air pressure keeps the throat inflated during sleep to enable breathing — since a diagnosis of apnea in 1990.
“Guys wouldn’t hunt with me if they had to share a room” because of his horrible snoring, Peters said.
Over the years, he’s become an activist for CPAP, encouraging users to share information that can help them adjust to the devices. Many people have trouble initially, grow frustrated and quit, he said.
Lincoln now has four sleep centers: Saint Elizabeth; Somnos Sleep Disorders Center; Sleep Diagnostics Study Lab at the Nebraska Heart Institute Heart Hospital; and the Sleep Medicine Department at Bryan-LGH Medical Center.
Earlier this year, BryanLGH opened a new program of Cognitive Behavior Therapy — Insomnia, or CBT-I. The lingo translates to think sleep.
And nobody had a greater need to learn how to think sleep than 43-year-old Jon Kunce.
“I can’t shut my brain off at night,” the traveling salesman said recently, describing his problem before therapy.
The local CBT-I program flows from the work of psychologist Michael Perlis of the University of Rochester Sleep Research Laboratory in Rochester, N.Y.
A counterintuitive concept of CBT-I is that what you think you know about sleep may be causing you to lose it.
It’d be a decent punch line if chronic sleep debt didn’t factor in depression, moodiness, absenteeism, injury accidents and poor work performance.
Last January, Kunce either had those problems or worried about having them.
That’s when he began CPAP for his own apnea, but as his head hit the pillow it filled with anxiety, stress over his divorce, worries about falling asleep while driving, job problems due to some transposed numbers on some orders.
So even with CPAP he did not wake feeling rested. His doctor referred him to psychologist Mary Kathryn Durante for CBT-I.
In several published articles, Perlis theorizes that what starts with a run-of-the-mill episode of poor sleep gets exacerbated by what people do to recover. The next afternoon, they nap, setting themselves up for another bad night.
A 20-minute nap, Durante said, may delay the body’s desire for sleep by about two hours.
So, the next day they sleep late, and pretty soon, it’s: Oh, here we go again. This stinks.
Can’t sleep.
Soon, the brain fires up its anxiety center just when it should be shutting down.
And according to Perlis’ research, insomnia may not only be a symptom of depression but a precursor of it. Whether chicken or egg, depression alters sleep cycles in ways that also change brain chemistry, causing the poor sleep-deprived dope to spiral inward.
CBT-I therapy often begins by restricting sleep further to produce better quality sleep.
In six to 10 sessions over a period of months, each patient takes a guided tour of their personal sleep pattern, also learning to avoid bad habits like watching TV in bed, drinking alcohol to sleep, lying there pointlessly for hours.
Kunce said he’s doing much better since his therapy last spring. Professionally, he’s ahead of his sales goals. Life looks all around better.
Durante, who went to Rochester, N.Y., for training a year ago, said the bulk of patients referred for CBT-I have multiple sleep issues.
Everything is interrelated, she said. People need help sorting things out, but once they’ve learned their patterns and the techniques, they can use that knowledge to avoid or reduce future problems.
For Kunce, therapy was “almost like an intervention.”
And it’s worked, he said.
“I’ve not had to pull over for a nap since June.”
Reach Mark Andersen at 473-7238 or mandersen@journalstar.com.