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How to Sleep Better

The Jefferson Sleep Disorders Center's Medical Director runs down some common sleeping problems and issues you can correct for a better night's sleep

Do you have difficulty sleeping? If so, you’re not alone, says Karl Doghramji, MD, Medical Director of the Jefferson Sleep Disorders Center in Philadelphia. Insomnia, excessive sleepiness and parasomnias (unusual behaviors such as sleepwalking, sleep talking and seizure-induced thrashing about in bed) are common.

“Insomnia is particularly common,” notes Dr. Doghramji, who is also Professor of Psychiatry and Human Behavior at Jefferson Medical College of Thomas Jefferson University Hospital. “A third of the U.S. adult population suffers from transient problems with insomnia, and about 10 to 15 percent have chronic insomnia that can go on for months, if not years. Insomnia is also a recurring problem.

“Excessive sleepiness is also a big problem,” he continues, “because it affects people at the workplace or while they are driving. Excessively sleepy patients also have memory lapses and difficulty in relationships.

“As for parasomnias, they can have dangerous consequences such as falling down steps while sleepwalking, or commission of violent acts.”

First steps to take before consulting a doctor
Specific types of sleep disorders are numerous and may, after consulting with your primary care physician, require diagnosis and treatment by a sleep disorders specialist such as Dr. Doghramji and his colleagues at the Jefferson Sleep Disorders Center, Fredric Jaffe, DO, Assistant Medical Director, and Dimitri Markov, MD. But first, Dr. Doghramji recommends addressing any of the following “sleep hygiene issues and alterations” that, if applicable, may improve your prospects of a good night’s sleep:  

• Irregular bedtimes – Don’t vary the time you go to bed and, more importantly, the time you get up. Stick to a regular routine – even on weekends, holidays and vacations. Once you do get out of bed, expose yourself to as much bright light as possible immediately. “Going outside and taking a walk right after getting out of bed can be a wonderful therapeutic maneuver,” Dr. Doghramji says.    

• Napping – Napping is recommended for people who suffer from excessive sleepiness or sleep deprivation because of work demands or a late night out. It is not usually recommended for insomniacs because it diminishes the natural tendency to fall asleep at night.    

• Caffeinated beverages – Stimulation from caffeine can last up to 12 hours. So, if your bedtime is, for example, 11 p.m., don’t drink coffee, tea or certain sodas after 11 a.m.  

• Bedroom temperature – Cool temperatures have a positive effect on sleep. Before retiring, lower the thermostat rather than raising it, or crack open a window. 

• Avoid exercise within four to five hours of bedtime – Do not work out within four to five hours of bedtime, as it can induce poor sleep. Exercise earlier.

• Noise, light and dust –Pull down dark window shades and close your drapes at bedtime. Use earplugs while sleeping – even slight noises may have a negative impact on the quality of sleep you get. Dust and vacuum your bedroom weekly to reduce risk of choking and breathing obstructions while sleeping.

• Bedroom as “hangout” – Other than for dressing or housework, avoid your bedroom when you’re not sleeping. This will help you associate it psychologically with the express purpose of sleeping. So, for example, don’t lie on your bed during the day or for lengthy periods of time in the evening to read or watch TV. If you awaken during the night, don’t lie in bed for more than half an hour trying to go back to sleep; get up for awhile, go into another room and do something relaxing until you feel sleepy.

• Have a downtime period before bedtime – Devote an hour right before bedtime to relaxing and doing something pleasant, like listening to music, reading for pleasure or watching TV. Avoid grim or frightening stories, programs or movies.

If none of these measures help, see your primary care physician, who may refer you to a sleep disorders specialist. Possible problems include sleep apnea syndrome (characterized by a stoppage of breathing during sleep), circadian rhythm disorder (a shift in sleep rhythm in relationship with that of most others, due to unusual work shifts, frequent jet lag, etc.), gastroesophageal reflux, asthma and chronic obstructive conditions, or the effects of various prescribed medications, as well as different types of insomnia, excessive sleepiness (narcoleptic conditions) and parasomnias, all of which require expert diagnosis and treatment.

The Jefferson Sleep Disorders Center

Karl Doghramji, MD

The Jefferson Sleep Disorders Center is Philadelphia’s first (established in 1978) and one of the first in the nation to be accredited by the American Academy of Sleep Medicine (in 1986). Dr. Doghramji, Dr. Jaffe and Dr. Markov collaborate closely with Jefferson clinicians and scientists from such disciplines as psychiatry and human behavior, pulmonary and critical care medicine, otolaryngology-head and neck surgery, dentistry, pediatrics, urology and neurology, to provide patients with accurate diagnosis and comprehensive, multidisciplinary care. 

The center recently relocated to a new facility in the Ninth Street Offices at Walnut Towers, 211 South Ninth Street – Suite 500, Philadelphia, PA 19107. Along with expert, accommodations and high-quality treatment, the new facility offers leading-edge technology, accommodations comparable to those of a fine hotel, and ample availability to serve patients’ individual needs rapidly and efficiently.

Make an appointment at the Jefferson Sleep Disorders Center online or by calling 1-800-JEFF-NOW.