What Are Sleep Disorders?

May is the season of spring and rainy weather in South Florida. It heralds the start of summer and usually the time to take it easy and relax. The month of May ends with Memorial Day. While in this country, Memorial Day is celebrated with barbeques and days spent at the mall shopping, it really is the time to remember those who have fallen so that we can live in the freedom and life style we have become accustomed to. We too easily forget the great sacrifices our parents, grandparents, and peers made to keep our country free and to provide liberties to those groups who now exploit these freedoms for one cause or another.

Imagine what it would be like if you had to immediately stop what you were doing, to leave your family and friends, and to give up your leisure time activities to take up arms to protect our country. What would it be like if you had to give up your cars or clothing or other possessions to provide raw materials for a war effort if our country was attacked. Imagine what that would be like. Can you imagine it and even do it?

Yet millions of men and women through the centuries have had to do just that. Some have had to pay the ultimate price to protect our country and some still do. Would it behoove us to take some time next week to remember and give gratitude for all those who have given up their lives so that we can enjoy our entitlements?

It was George Orwell who said “People sleep peaceably in their beds at night only because rough men stand ready to do violence on their behalf.” And Thomas Jefferson wrote: “The tree of liberty must be refreshed from time to time, with the blood of patriots and tyrants.”
So this Memorial Day, take the time to remember those who have fought and died for our country in all its wars. If you see a soldier, stop and thank him or her for risking his or her life so that we can enjoy ours.

In this May E-Letter, we present information about Sleep Disorders, our Ask the Doc question relates to allowing parties at home when the parents are not present, and our email of the month is about how to slow down your life even for just one day a week. We hope you find the enclosed information helpful. As always, we appreciate your questions and feedback.

Testings. We have recently been called by several parents who are concerned about their child’s school placement for next year. Their questions have ranged from should my child be retained to whether they are gifted to whether they have a disability that can qualify for accommodations at school. Our practice does different types of evaluations to help answer those questions and information about these evaluations can be found on our website. If you have more specific questions, please contact Dr. Kimmel who would be happy to answer them.

Qualified Supervisor. Dr. Joel Kimmel has been certified by the State of Florida to supervise mental health counselors seeking supervision to meet the licensing requirements. If you or anyone you know needs a qualified supervisor to meet these requirements, contact Dr. Kimmel for further information.

Parent Education and Family Stabilization Course. We have been certified by the Department of Children and Families, State of Florida, to offer the Parent Education and Family Stabilization Course. Sometimes referred to as the Divorce Class, this 4 hour class is state mandated for divorcing parents of involved children. This course is intended to teach parents about the effects divorce has on children, to lessen the impact of difficult transitions, and to improve the ways they communicate with each other and their children. Our course is provided live and in small groups. Please contact our office at 954 755-2885 for further information.

Low cost counseling. Denise Champagne, M.S., is offering low cost counseling as a mental health intern. She is currently seeing patients and is available to take on new patients. This allows those individuals who cannot afford treatment to obtain it and allows her to get the required training. If you or someone you know is in need of counseling but just cannot afford it, please call the office and ask for Denise. All treatment provided by Denise will be reviewed and supervised by Dr. Kimmel.

Our E-Letter this month focuses on sleep disorders. What we have found amazing in our practice is the number of people who have trouble sleeping and are taking Ambien, Lunesta, Trazodone, Xananx, or over-the-counter sleep aides. It almost seems that everyone has a sleeping problem. Yet while it is easier to just take a pill, what really may be the problem is poor sleep hygiene and a lack of understanding of what causes sleep problems. Poor quality sleep can have a negative impact on your energy, emotions, productivity, relationships, and health. Getting enough sleep and rest can be crucial to good mental health. Ignoring sleep problems and taking a pill to avoid facing these problems can lead to accidents, impaired job performance, arguments in relationships, lowered tolerance for frustration, and a general malaise. If you want to stay healthy and feel fit, a good night’s sleep is a necessity.

If you feel tired during the day, need several cups of coffee a day, have difficulty going to sleep or staying asleep, or wake up unrefreshed, you can learn to sleep better. You can start by keeping a sleep diary and learning about your sleep patterns. You then can change your lifestyle, habits, and bedtime routines so that you wind down at night and allow yourself to fall asleep. If you still have difficulties, there are professionals who can help you plan a program to improve your sleep patterns.

Common sleep disorders include:

• Insomnia which is the inability to get enough sleep to wake up rested and refreshed. It may be due to stress, depression, health problems, medications, too much coffee, and lack of exercise.
• Sleep Apnea where breathing temporarily stops during sleep due to blockage of the upper airways. The many awakenings that occur during the night can cause exhaustion, irritability, depression, and decreased productivity. This can be potentially life-threatening and can be helped with a CPAP machine, losing weight, elevating the head of the bed, and sleeping on one’s side.
• Restless Leg Syndrome which is an almost irresistible urge to move one’s legs or arms while they lay down or are asleep. The urge to move is usually due to uncomfortable, tingly, aching, or creeping sensations in one’s limbs and can cause thrashing around during sleep.
• Narcolepsy involves excessive, uncontrollable daytime sleepiness. It is caused by a dysfunction in the brain’s arousal system which controls alertness. “Attacks” can occur while talking, working, or even driving.
• Jet lag is a temporary disruption in our internal biological clock, our circadian rhythms. It occurs when one travels across usually two or more time zones and manifests in fatigue, daytime sleepiness, headaches, stomach problems, and insomnia. It usually takes one day per time zone to adjust to local time.
• Shift Work sleep problems occur when your work schedule doesn’t coincide with your sleep schedule. This is becoming a more frequent problem in our society as more people have to work at night in our global economy. Your body is telling you to sleep while your job is telling you to wake. Most shift workers get less quality sleep than those who work regular schedules. Shift workers struggle with sleepiness, lethargy, impaired productivity, and risk of injury.
• Delayed Sleep Phase disorder occurs when one’s biological clock is pushed back and delayed. A person goes to sleep late and wakes up late if they don’t have daytime activities that interfere with sleeping. One’s pattern shifts and it’s hard to keep normal hours. They find it difficult to get to sleep before 2 AM and struggle to get up at the regular time. This pattern is most common in teenagers.

To overcome sleep disorders, try to keep a regular sleep schedule where you go to sleep and get up the same time each day including weekends. Make sure you set aside enough time for sleep, approximately 7 to 8 hours to feel good. Change your bedroom so that it is restful, dark, quiet, and conducive to relaxation. Disconnect from all electronics including the TV, the cell phone, and the computers. Use ear plugs and a blinder to cover your eyes to minimize distractions. Give yourself permission to relax and let go of what ever you are worrying about or is on your mind. Keep your pets out of your bed. Exercise and do not abuse drugs or alcohol. Don’t have any caffeine before you go to sleep or do any exercise that may stimulate you. Finally, consult a professional if you are still having difficulty with sleep.

We offer the following information on Sleep Disorders:

• The ability to sleep is often viewed as a barometer of one’s overall health
• Poor sleep adversely affects one’s energy, emotions, health, and work
• People with sleep problems have more accidents, health problems, impaired job performance, and relationship stress
• Signs of a sleep disorder include feeling irritable, feeling tired, having difficulty staying awake when sitting still, and fading out while driving
• Other signs include difficulty concentrating, reacting sluggishly, needing caffeine to keep functioning, and others telling you that you look tired
• Insomnia, one of the most popular sleep disorders, is the inability to get the proper amount of sleep to awaken rested and refreshed and can be due to anxiety, stress, depression, medications, or a health issue
• Sleep apnea, another common sleep disorder, occurs when breathing temporarily stops due to blockage of the upper airways. This causes many awakenings which leads to exhaustion, irritability, and depression.
• Restless leg syndrome is a sleep disorder that causes an irresistible urge to move legs or arms and is usually due to uncomfortable, tingly, aching, or creeping sensations when lying down
• Narcolepsy, or uncontrollable sleepiness, is a sleep disorder caused by a dysfunction of the brain arousal system that affects sleeping and waking
• Jet lag, a temporary disruption in sleep cycles, occurs when one travels across different time zones and can include fatigue, headache, stomach problems, and insomnia
• Shift work sleep disorder is a disorder that occurs when a work schedule conflicts with one’s internal biological clock or circadian rhythms
• Delayed sleep phase disorder occurs when you stay up for long periods of time and your circadian rhythm or cycle of sleep and wakefulness is significantly delayed

• Keep a regular sleep schedule and set aside enough time for sleep
• Keep a sleep diary
• Ensure your bedroom is quiet, dark, cool and turn off the electronics
• Use ear plugs, blackout shades, and relaxation techniques
• Allow yourself to rest and “let go” of your worries
• Seek professional help if you have difficulty falling or staying asleep

SL writes: My daughter is 18 and graduating high school. She did pretty well and will be going to UCF. She hardly gets in trouble but does defy my wife and I periodically. She wants to have a party at our house while we are in New York for a wedding. We have told her no but I’m not sure she will listen to us. We do not want strangers in our home or going through our stuff. What do you think about letting her have the party and are we being too protective?

Dr. Joel Kimmel replies: The fact that you even ask this question raises the whole issue of trust. If you trusted your daughter completely, you would believe she would listen to you. Her past defiant behaviors have caused some damage to your ability to trust her. Her success in high school, notwithstanding, you still have concerns that she won’t listen to you and have that party.

Now one may question why having that is party a bad idea? Because today’s parties are not like years ago. Often, kids invite other kids or others hear that a party is happening and hundreds of kids, mostly uninvited, show up. The ability of your daughter to manage the party becomes compromised. Drugs, alcohol, and even weapons can be brought to your home with a high possibility of someone getting hurt. In fact, you may even be responsible if it happens.

We can understand that she wants to exert her independence and have a party without your presence. However, call me old fashioned, but I believe the upside is low and the downside risk is high. She may behave well but she has no control over others. While she is still under your roof, she needs to respect your words and listen to you. I would suggest that you tell her she can have a party only if an adult you trust is present, even if it’s just a deterrent to others. This is still your home and you have the right to make any decisions you want. But be prepared with a significant consequence for her if she violates your words and has that party.

This may just be “growing pains” but it’s better to be safe than sorry.

We would like to thank S.M., a creative project designed to slow down lives in an increasingly hectic world for at least one day, for the following:

Ten Principles To Slow Down Your Hectic Life

1. Avoid technology
2. Connect with loved ones
3. Nurture your health
4. Get outside
5. Avoid commerce
6. Light candles
7. Drink wine
8. Eat bread
9. Find silence
10. Give back