How Did You Sleep Last Night?
Your sleep personality may reveal why you may not be getting enough sleep.
Charlotte Grayson, MD
For most of her life, Carol Smith has never had much trouble with sleep . But all of that changed when she began working a 12-hour graveyard shift -- from 6 p.m. to 6 a.m. -- as a 911 dispatcher.
At times, she says she's had to struggle to stay awake and alert on the job. "It was very difficult for me," she recalls. "I'd get real fidgety, and doing any kind of paperwork was hard because it was so tough to concentrate. At times, I felt so uncomfortable that I just wanted to crawl out of my skin."
But then Carol found relief. She participated in a sleep study at Henry Ford Medical Center in Detroit, and was diagnosed with "shift work sleep disorder" (SWSD), a condition that affects people whose sleep-wake and lifestyle demands are out of sync with their normal biological (circadian) rhythms. It consists of symptoms of insomnia or excessive sleepiness that occur as transient phenomena in relation to work schedules.
She now takes a prescription medication called Provigil (modafinil), which promotes wakefulness in people with debilitating excessive sleepiness associated with SWSD.
"I can breeze through my 12-hour shifts these days," Carol tells WebMD. "I only take the medication on the nights I work, and now I love working nights."
A Hard Day's Night
Sleep deprivation and related problems have become as American as caffeine-rich Starbucks coffee and 24-hour pharmacies. In the last 100 years, there has been about a 20% decline in total daily sleep time, says Gary Zammit, PhD, director of the Sleep Disorders Institute at St. Luke's-Roosevelt Hospital in New York City. The blame for that sleep deprivation rests with the fast-paced culture we live in, with more demands on everyone's time and the emergence of an around-the-clock, 24/7 society.
So whether it's your lifestyle or your personality traits, you may have joined the ranks of the bleary-eyed who are not getting all the shuteye their body needs. "Many people are staying up late surfing the net, or going to the supermarket at night because that's the only time they can get there," says Sonia Ancoli-Israel, PhD, professor of psychiatry at the University of California San Diego School of Medicine. "We've become so busy that something has to give, and for many people, it's sleep that they sacrifice."
In fact, sleep disruptions can provide clues to your health, both physical and psychological. These disruptions can help reveal whether you're burdened by stress or overwhelmed with high anxiety. Sleep disruptions also give hints on what medications you're taking, or whether you're experiencing chronic aches and pains. They can make you unproductive on the job, and moody and irritable at home, or as with Carol Smith before she found Provigil, they can be a sign that you're forcing yourself to stay awake when your internal body clock is desperately seeking slumber.
If depression is part of your personality profile, you might find yourself tossing and turning, and not only because the depression itself might keep you from drifting off. John Herman, PhD, associate professor of psychiatry at the University of Texas Southwestern Medical Center at Dallas, notes that some popular antidepressants such as the SSRIs (selective serotonin reuptake inhibitors) can disrupt your snoozing.
"You can use sleep as something of a barometer," says Meir Kryger, MD, director of the Sleep Disorders Centre at St. Boniface General Hospital Research Centre in Winnipeg, Manitoba, Canada, and author of A Woman's Guide to Sleep Disorders. "If someone's sleep is abnormal -- if they're having a lot of trouble falling and staying asleep -- or if they're extremely sleepy during the daytime hours -- a doctor can use these symptoms as a clue that there may be something wrong with the person that requires checking out."
Punching the Internal Time Clock
The body's own circadian rhythm or sleep wake cycle wages enormous control over when it's time to rise and shine, and when it's time for shuteye. The fact is that there's some persuasive evidence that whether you're prone to being a morning person or a night person -- it is programmed in your genes.