Odyssey

Will we. All do it. Most of us do. But people also do work on the bus. Do we sleep. Do we sleep well enough. And what happens to us while we enjoy. National Public Radio News in Washington I'm CORBA Coleman. President Clinton has forwarded

his new budget to Congress. It's the first presidential one in 30 years with a surplus. During a White House ceremony Mr. Clinton said the budget for fiscal year 1999 marks a new era of opportunity. We can allow hundreds of middle aged Americans who have no health insurance through no fault of their own to buy into Medicare. We can still extend care to a million more children and we can balance the budget and Social Security. President Clinton pays for much of the spending with higher taxes mostly on tobacco. Republican Senator Pete Domenici says the blueprint is really choosing bigger government. House Budget Committee Chairman John Casey says it appears Mr. Clinton wants to eliminate state and local government and run everything from Washington. The United Nations secretary general is asking the Security Council to allow Iraq to sell more oil on the world market. Kofi Annan wants to double Iraq's oil sales to

allow more emergency aid into the country. U.N. agencies say that still won't be enough to truly help the plight of Iraqi civilians. The proposal comes as the United States tries to line up support for military strikes in Iraq. Should Baghdad continue to block military inspectors from working. The Texas Board of Pardons and Paroles has rejected a request for mercy by condemned killer Karla Faye Tucker. She's scheduled to die by lethal injection tomorrow night. The board chairman Victor Rodriguez said the vote was 16 to wonder reject Tucker's request. NPR's John Burnett says Rodriguez explained his own vote. Ricky Rodriguez the chairman of the board didn't believe that she had been 100 percent converted to religion. He thought he was withholding information and she was being completely honest with him. He said that he didn't let the fact that she was a woman figure into his decision. He also said that he thought it was risky and that the facts are just as true and powerful.

14 years ago with Tucker who converted to Christianity while still in prison has an appeal before the U.S. Supreme Court Australians open the Constitutional Convention today. They're debating whether to keep Queen Elizabeth as their head of state or reject her and become a republic. Many convention delegates want to create a republic Australian Prime Minister John Howard a monarchist opened today's assembly by saying it's no longer appropriate for Australia to share its head of state with several other countries. Australia has been independent since 1901 but it still recognizes the British head of state as its own no Australian can now serve as head of state. On Wall Street the Dow Jones Industrials are up one hundred forty nine points at eight thousand fifty six The Nasdaq is up twenty nine points. This is NPR. In NPR's business update Wall Street is enjoying its biggest rally of the year. Bloomberg Christner has details from New York. The market's rise is being led by drug stocks which are higher after Britain SmithKline

Beecham and Glaxo Wellcome revealed late Friday. They're in talks to create the world's biggest drug company. This is raised speculation of more mergers in that industry. The market's also being boosted by the perception that the worst of the Asian financial crisis is over. Singapore stock market rallied by nearly 14 percent overnight its biggest advance in the market's Twenty two year history. At the same time the Hong Kong market was up by more than 14 percent. I'm Doug prisoner. The government says Americans personal income rose four tenths of a percent to December spending kept up its pace to rising three tenths of a percent. The December income gain came after stronger increases of seven tenths of a percent in November and half a percent in October. The Commerce Department says for all of last year incomes rose five point eight percent. But analysts say tax and feet payments to government rose eleven point four percent and they estimate that disposable income rose just 5 percent which was a slower pace than spending was. Americans also

save less last year just three point eight percent down from 4.3 percent in 1996. This is the lowest savings rate since 1939. More than twenty five hundred maintenance and production workers are striking Honeywill in Minneapolis and St. Paul today. They rejected a contract offer yesterday and walked off the job in Midnight despite a union negotiating committee recommendation to accept the offer. Fifty eight percent of the workers voted against the offer. I'm Korver Coleman NPR in Washington. Support for NPR comes from Borders Books and Music. Putting a world of knowledge within your reach. With over 200 locations across America 800 6 4 4 7 7 3 3. Morning and welcome to Chicago I'm getting. A good night's sleep is one of life's little pleasures. But in a busy life it's often the first

thing to go. We all know that going without sleep can have negative consequences yet people managed to acclimate themselves in extreme conditions. Young doctors sleeping an hour a night young parents being jarred awake all night long by a crying infant. How much sleep should we get and how should we get it. These are some of the questions that sleep research ask. Sleep researchers ask along with many many others and we it seems are fascinated by the answers I know I am and so today we're joined by three sleep researchers from here in Chicago who are going to give us some hints as to the answers to these questions we hope by the end of the program. Dr. Phyllis Izzie is director of the Sleep Disorder Center at Northwestern University Medical School. Dr. WALLACE Mendelson is professor of psychiatry at the University of Chicago and director of the Sleep Research at vent core central hospital. And Dr. Rosalind Cartwright is director of the sleep disorder service and Research Center at Rusk rush Presbyterian St. Luke's Medical Center good morning to all of you and thank you a lot for coming in. Good morning. I certainly appreciate it. Let's start with some real basic questions. Why do we need to sleep.

If we don't have a job don't feel very good the next day and we're in terrible temper and we're grumpy and we bite people's heads off and we feel a little hung over and not very sharp and we're likely to catch cold. How about that. But those are all reasons all very good reasons. But what's going on while we sleep and we all certainly get to the end of the day get tired and certainly feel like going to bed but what is it that our body is doing while we sleep. Well one way to phrase that is that we sleep in order to be awake and clearly among the many effects of not having enough sleep is not being overheard in the daytime. And the two are very proportionate. What we're doing exactly when we're asleep is not entirely clear. Some people think that there are three states of consciousness. We each of us has not two but three different ways. And which react to being awake and being in on REM sleep and being in rapid eye movement or REM sleep and each of these three is very very different from each other.

Can you describe what deep sleep in REM sleep the differences we in a normal night do we experience both kinds if we're getting a good night's sleep to experience both kinds of proportions Yes absolutely and in fact what's going on during sleep the only major information we have about that is recordings from brain waves in which we record the brain waves and this is how we determine REM sleep versus non-REM sleep and non-REM sleep particularly the slow way sleep the really deep sleep is characterized by very slow brain waves. OK the brain was a very slow muscle tone is fairly low whereas in muscles it meaning how relaxed or tense Yes exactly or ignore you lie only relax yes fairly relax whereas in this already at more rapid eye movement sleep it's a very distinct state then this slow wave sleep where the the deeper stages of sleep the the brain waves are actually fairly active during that time in contrast to the slow waves in deep sleep.

And whereas the muscle tone also is very very relaxed it's kind of a state in which the brain is fairly activated but the body is very relaxed. What is the what is the brain doing. During Well we're not you know we're not quite sure although I would just bring out something we're dreaming. In addition to dreaming we appear at least from recent evidence suggests that we may be a consolidating memory during this stage of sleep. Really. Yes. What is what what sort of evidence is there for that how did one even determine that. Well I have to tell you a little bit the study that I did some time ago with some students I had them sleep and woke them up at about 4:00 in the morning. Now it is unusual for a professor to ask students to say this is what we might I were in charge if they were doing it for course credit. And about 4:00 in the morning I had them study for an hour. Go

back to sleep. Those that had REM sleep in the last couple of hours before morning. And we tested them in the morning had maintained what they'd learned that hour if they did not get back into REM sleep if they only had a slow wave sleep are non-REM sleep. They didn't remember as much. And if they couldn't get back to sleep at all if they were awake the last couple of hours after having been whipped up at 4:00 in the morning if they stayed awake they remembered even less. So that was a nice demonstration that REM sleep helps consolidate new learning. How fascinating. What sort of proportions are we looking at in terms of a normal night's sleep how much of it is REM sleep how much of it is slow wave sleep if you're getting you know average undisturbed sleep well in a young adult approximately 80 percent is non REM sleep and about 20 percent is REM sleep that would be considered a healthy amount. Think so. Yes and I thought of that.

It's very dependent on the age in children for instance is much more REM sleep. And in old age. There is less REM sleep is that. Well we can talk about actually what happens to us over time maybe we'll put that all together in a different conversation there's so many questions about that. What is considered a normal amount of sleep a night. Is there is there an average is there. Well what's a good way of knowing there's an average. It's about seven point nine on big study. But there are tremendous individual variability there are short sleepers who couldn't sleep more than five hours if you paid them we've tried paying them. And there are long sleepers who are just in terrible mood and shape if they don't sleep nine hours. And those are real individual differences. It's quite a bell shaped curve for most of us are in the you know 60 range. But it can go down lower and it can go up higher and be perfectly normal for that individual.

Is it known what causes the variation what causes a person to need five hours versus nine hours. I know there are some interesting personality correlates that have been. Proposed short sleepers are supposed to be preprogramed people who are in a hurry in all their life they know where they're going in their hurry to get there. They sleep in a hurry too. They don't have to reprogram themselves that night. The long sleepers do that the long sleepers are kind of people who haven't made up their mind who they want to be when they grow up no matter what age they are. And they spend twice as much RAM time in sleep as the short sleepers. Really long sleepers do. Yeah. Is it possible to get too much sleep. Do you ever do it. Do you ever have the experience. Well I certainly have the experience of having been in bed for a long time and feeling still sleepy when I got up not necessarily feeling rested when I got up never take a long nap in the afternoon and feel worse.

Yes you had too much sleep. Well but if you're But if you're getting the sleep I mean can you can you get your body to sleep when it doesn't want to you. Not really. You know if it doesn't need sleep it will keep you awake. So how does that happen that you take a nap in the afternoon that you think you need and you go to sleep but then you wake up feeling kind of well over. If you if you take a late afternoon or early evening nap it's as though you start your night too soon. And then if you wake up you feel like you've only had a short night and that that feels terrible you feel a little hung over from having gotten into deep sleep but not finished the night. So an evening nap is likely to give you a sense of grogginess. Not being very happy about having napped at all. Now I've read that if you're an eight hour sleeper you're an eight hour sleeper and there's not a darn thing you can do about it and you can't really train your body to get used to six hours or seven hours. And if you're a six hour sleeper that's what you are is that true that you just you can't

get into work any other way. There have been a few studies usually done with us of trying to reduce the amount of sleep. Time one gets and usually what happens is that these these are done by the way by having them move the alarm clock back a half hour sequentially over a period of time. Usually what happens is when the study ends the sleep bounces back very close to the original sleep time perhaps a little bit less time about one hour. Yeah you want to change about one hour. I want to hour with a long slow. As documented friend was saying and every other week. Reducing about 15 minutes works best. Then you can shift an eight hour sleep or two. You can get down to six but they'll bounce back to seven so you can save an hour. If you do it slowly and carefully that way. I want to get back to the question that you had and that Dr. Carr was trying was answering about why if you get more sleep you feel lousy.

And I think we need to go back to kind of some basic principles about sleep is that for sleep to be refreshing and free to feel well. Both the the sleep wake cycles the sleep when you have the timing of your sleep past the coin's live with your biological rhythm and I think that's what Dr. Carr was trying to get through. That there are two processes are important determining when we sleep and how long we can sleep and that is one is a sleep process which when talking about which is the sleep debt that incurs more time you're awake the more likely it is after x number of hours it tends to be about 16 hours now that we think that you will want to fall asleep. There is this process in the brain that builds up that makes you want to go to sleep. If you're really exhausted very very tired but that also has to occur a coin so I with the right time of what we call the circadian clock there's this clock in the brain that's located in the hypothalamus the regulates the sleep wake cycle and when those two are in synchrony you get really your best sleep and

the most refreshing sleep in adequate any kind of the synchrony between the internal rhythm and the external rhythm of the sleep of the urge or your need to sleep can result in really inadequate sleep. So even if you're tired you even if you're tired and it's time for you feel like it's time for you to go to sleep you may be out of sync Well think about if you're up all night have you been up all night. Doing Something. OK so you would you would you would be very tired. You would think that at the very first opportunity the next you know in the morning you would want to go to sleep and in fact you do you sleep. But can you catch up can you sleep seven or eight hours during the day. No two hours probably two or three hours max. Why because the clock the circadian clock itself the brain clock is saying stay awake. It is out of synchrony. It is actually going against your need for sleep. How can you tell where you are in your circadian rhythm other than by how tired you are. I mean I sort of thought that was your rhythm when you were tired it was time to sleep. How can you tell if you're

off. I mean obviously there are cases where you know you know you're off because you've been up for too long. But you know in more. Less extreme cases. Well one can measure circadian rhythms by measuring a number of body functions which include temperature is a very good one. A person's temperature varies about a degree and a half over the course of the day and one can follow that as other measures of that nature. The general idea though I think is that when you're ready to sleep or not depends on two factors One factor is the circadian clock. Dr. Z mentioned and the other is they give the fancy name of homeostatic mechanism and that just means that the Mar you've been awake the sleepy are likely to be. And it's the interaction of these two mechanisms at any one moment that the side whether you fall asleep. And how long you'll stay asleep. So in doctor's easy example of going to sleep let's say at 7:00 a.m. after being up all night the homeostatic mechanism wants you to go sleep very badly. But the circadian

mechanism says hey this is wake up time not sleep time. And the result is that you can only sleep for a couple of hours. And you know the bad insomniac who doesn't sleep well at all at night. Can't nap either. And that's always surprising to them why can't I just take a nap I'm so tired. I'm terribly fatigued doctor. How come I can't sleep when I lie down to you know have a restorative nap. And that's because of the the body clock and the but the it the body temperature cycle is too high often and insomniacs it's too high all night to let them rest well so their body clock is off in terms of their biological rhythm for temperature is running too high. So it's like running an awake temperature through the night and needs to be retrained to drop so they can relax and sleep.

Does that mean that your body temperature needs to come down before you can fall asleep or in order to get good sleep over the course of the night. It does it all comes down. Yeah but horse before you fall asleep. It begins so there is wind. Yes before you actually go to sleep and it's at its lowest in the early morning hours when your propensity for sleep is highest. Does it matter in terms of getting good sleep restful sleep restorative sleep does it matter whether you sleep in the dark or in the light. Some people can't sleep in the lights and people can't fall asleep but other people can sleep just fine with the lights on does it. Does it make any difference. Dark is I would imagine I want to grease is better certainly better. And part of that may have to do first of all you know it is you know the light does disturb sleep is kind of a sensory input. But there may be another biological explanation for that is that melatonin you've probably heard about melatonin the hormone that's produced by the pineal gland is kind of it's actually shut off by any type of bright light. And there and the

normally goes up during the night and is thought to be at least in some some research in the case that it is it may be important in synchronizing biological rhythms but also it's a dark signal as the body's internal signal for darkness. And that may be very important and getting also a good night's sleep. Now doctors you were saying actually before we went on the air that human beings are the only animals who do all their sleeping in one chunk that other animals sleep here and there. Is that just a societal thing or do we know whether human beings would actually prefer to sleep here and there. I think human beings still naturally prefer to sleep mainly in one big nocturnal chunk. With the addition with the exception of a small very short nap in the early afternoon I think that would be the ideal sleep schedule for a human would being whatever eight or so hours a night whatever it is wherever you're at six to eight hours and then a nap in the afternoon correct. Why what's what's why that nap.

Well it appears that during that part of the afternoon the sleepiness rhythm becomes high again therefore you're more likely to want to fall asleep during that period it's probably because you've also been awake for so that ass or the homeostatic process that Dr. Mendelson described is also building up at that time. So if you could just recover a little bit of that by an hour nap you can actually then remain awake until about 11:00 o'clock or midnight which is really the more natural time to fall asleep I think. Oftentimes we're falling asleep a lot earlier 9:00 or 10:00 o'clock too early because we had to not take that little nap if we were then we would be able to stay awake later. And that would really be a better cycle a sleep wake cycle for the running outs in your office. Gretchen first get an office. I'm going to catch an excuse. Why do you say 9:00 or 10:00 is too early to fall asleep because we often wake up then too early. Anybody who falls asleep

over TV news will tell you that they've been wake up too early. It's there and our rhythm gets tense you get reset to be early to bed and too early to rise. And it doesn't work as well as if if we did what doctors he was saying take the nap earlier in the day the short power nap and then go to sleep later and sleep the full hours. But is it does it the rhythm not work because it's not what our biology wants or does not work because it's not what our boss wants and our spouses want to families want because it's impractical or both. Both socially you know when we are all working very hard we come home and we need to get things done that didn't get done in the in the home and have some time with the kids or some time with our spouse. And if we fall asleep we're not doing our full job and

somebody gets angry at us so there is that social pressure to have more hours toward the evening to have some catch up time with our other roles. But also there are biological reasons for having that period where it belongs. In the late evening and early morning span and I wanted to make a point I think it was doctors he was talking about the effects of light on melatonin. If you wake up in the middle of the night it's not a smart idea to turn the lights on to read because you suppress the melatonin then and it is harder to get back to sleep you're training the body actually to be. By Facebook to have short sleep time wake up and other sleep time later. So it would be better just to lie there in the dark. If you wake up in the aisle and I say wake up because for whatever reason you're more likely to do better if you just lie there in the dark.

If you can relax. Not if you get angry and fight the pillow. You know that is your torture chamber. One of my patients. Oh well that's too bad. Let's talk a little bit about insomnia. What are some of the major causes I mean I imagine there are multiple many and that it varies from person to person but are there are there major reasons major groups of causes of insomnia. Well the thing to remember about insomnia is it's a symptom. It's the feeling of sleep is inadequate in quantity or quality. It's not a disease or disorder. So in that way it's like pain. And just as there are many reasons a person could have pain the same is true of insomnia. So these could include among other things psychiatric disorders such as depression could be side effects of medicine that a patient might be taking for some other reason. An example would be blood some kinds of blood pressure pills or some medicines for asthma for instance. There can be problems with the body's cause like

Dr. Z was mentioning. There can be some problems that have to do with having formed associations in one's mind. They keep a person for sleeping for instance using the bed as a place to worry about the things that happened the previous day or plan the battles for tomorrow and many other types of causes including some that are neurological and medical. How common is insomnia. Very. Can you give us a number of the big epidemiological studies. You know usually say somewhere between 20 and 30 percent of the population will respond to a question Is your night's sleep adequate. By saying no. 20 percent. Yeah. But if you ask very specific questions about you know have you consulted a doctor about it. You know what have you done about it. How disabled are you about your poor sleep you know do you really feel you can't function well the next day that shrinks to about 10 percent.

About 10 percent of the population is really in big trouble about not getting adequate sleep are the effects of insomnia or what we call what we're calling insomnia same as the effects of not getting enough sleep. Even if you're someone who can get to sleep but maybe you're working too hard and so you're getting less sleep than you need or the effects the same the lack of sex or the lack of sleep the same. Well in some forms of insomnia a person actually does have less sleep but in many forms of insomnia The two are very different and when measured in the laboratory the amount of sleep a person gets is only mildly reduced or even normal. So sleep deprivation is a little bit different than at least some forms of insomnia. What. Go ahead doctor. Yes some some forms of insomnia are really just the quality of the sleep they sleep in UP hours. But it's too light. They don't get that nice relaxed feeling that doctors he was talking about the very slow brain waves and slow down respiration lowered blood pressure lower heart

rate you know the whole physiology slowing down so that you really feel very real relaxed and re stored when you wake up. People who sleep very lightly and with sort of one eye open or one ear open that hear things even in sleep. And these studies were done at Northwestern. How many years ago did the boots and studies at least one about 20 about 20 years ago a wonderful study in which they had good sleepers and bad sleepers poor sleepers sleep in the lab and they would play a tape when they were both in stage 2 which is a kind of light sleep and then wake them up and ask what was on the tape. The good sleeper would say I don't know I was sleeping and the poor sleeper would say you were playing a tape of the poetry of Robert Frost or something. They actually are still sleeping and monitoring the outside world at the same time and mis perceive that they are awake all night they're not awake

all night. But it's a poor quality sleep. The sleep is exactly what Dr. Cartwright just described this light sleep. And in fact this one gets older that deep sleep that we talked about earlier in the show is drastically that Anish is companionship is almost completely in like after the age of 80 or so. Well I think conventional wisdom is that older people need less sleep than younger people. And you're shaking your head. That's not who you know it's a myth is a myth. But they do get less sleep or they think you get to sleep but if you wire them up all day long 24 hours a day and count all the cat naps and put them together they get as much. But they're getting it sporadically in little bits and pieces and it doesn't feel as good. What is the cause of that why does that deep sleep go away. Any idea any insight.

Well I think one way to rephrase the question is do older people have less need for sleep or less ability to sleep. And the answer seems to be the latter. They may do as Dr. Cartwright said get approximately the same amount if you can take all the sleep over the 24 hours. But they have decreased ability to take it in one large continuous chunk at night. And there's many theories why that's the case nobody is sure for certain. One active area of research that Dr Z and I guess myself as well as are engaged in this trying to see whether this may be related to changes in body rhythms as one aspect of this difference in aging. What do you mean like. Just that there are their rhythms they get a different rhythm and their sleep patterns don't match the new rhythm. Well it is as one gets older. Typically what happens is this early morning awakening they tend to wake up early or there's this sleepiness occurs earlier in the evening as well

so a schedule and ideal schedule may be going to bed at 9:00 in the evening and waking up at 4 o'clock or 5 o'clock in the morning. There are many animal studies that suggest that in fact with aging that there are changes in the biological clock itself. OK that that and that change. These changes may contribute to the sleep problems that we see at least in part. The other problem with aging is taking aside the biological the central biological clock issue is that once somebody gets older you know they have more arthritis or more pain. They're indoors a lot more they're not exposed to light bright light they're not moving around very much they're retired so they don't have the same kind of social structure as they used to when they were younger. And all of these can contribute to poor sleep and poor sleep rhythms and so that. So there may be several factors one the aging of the brain itself. But in addition to that there are social and environmental factors that influence and all of those kind of work in the same direction in which it's negative.

You know it's a negative impact on sleep. But is that shifting to going to bed earlier and waking up earlier is that necessarily in and of itself a bad sign I mean if you're still getting eight hours but you're getting you're at a different time. Can that be an OK thing. That could be OK but what Phyllis was saying about excuse me doctors you know. Say about the loss of deep sleep. Is is another problem. The loss of the deep sleep. Even if you are sleeping on your preferred schedule which is earlier does not seem to return. And then the question of whether you can get back that deep sleep is a very interesting experimental area of work now. Is there some way to really store the deep sleep for the elderly patient and there's interesting work going on in that area. It seems that the capacity may still be there. Because there are

some people who keep it. Some extraordinary elderly people and one very interesting study is the study of the nuns who do their deep sleep in their elderly years. But they have a lot of structure in their life. They don't just drift. They have they have to do things on particular schedules. Just as young adults do they also have more physical activity than many elderly people do. They get down on their knees and pray a lot and they get down on their knees and scrub floors so they stay physically active they stay scheduled and they have nice clean consciences they don't worry. Yes so they're in better shape and for some reason they do manage to keep their deep sleep. This is nuns in general or a specific group of nuns says the elderly nuns looking at a group of elderly who seem to be doing well and finding that yes they do well in their sleep as well.

Well we need to take a quick break but we've got lots more to talk about when we come back we'll take your calls if you'd like to join in the conversation the number here is 3 1 2 8 3 2 3 1 2 4 3 1 2 8 3 2 3 1 2 4. We're talking with Dr. Phyllis Zee director of the Sleep Disorder Center at Northwestern University Medical School. Dr. WALLACE Mendelsohn professor of psychiatry at the University of Chicago and director of the Sleep Research at event core central hospital and Dr. Rosalind Cartwright director of the sleep disorder service and Research Center at Rusk press but Rush Presbyterian St. Luke's Medical Center. Again the number 3 1 2 8 3 2 3 1 2 4. We'll be right back this is WBEZ Chicago. WBEZ is the radio sponsor for a concert with Ku band known as the Egyptian James Brown presented by the Old Town School of Folk Music Friday February 6th at 7:30 pm in Park West to get information at 7 7 3 5 2 5 77 93.

Don't forget to show your love for public radio during WBEZ short valentines membership drive. Everyone who calls 1 8 8 9 6 8 76 77 will be registered to win a trip for 2 to Paris courtesy of Air France the Concorde hotels in the Terra Museum of American Art for the love of public radio. Call now 1 8 8 9 6 8 76 77. This is WBEZ Chicago ninety one point five FM Chicago's Public Radio station. I'm Gretchen health and you're listening to Odyssey Today we're talking about sleep why why we need it how we should get it why we're not getting it. All sorts of things if you like give us a call a number sorry 1 2 8 3 2 3 1 2 4. Before we go on the phone. Just in one question it seems in a way that from the way you're describing sleep and what's going on all those sorts of things that it almost seems like it's more of a mental process or a mental issue than a physical one. I mean I sort of always assume sleep is about getting

rest and you know you're physically tired you go to sleep you need rest. But there's so much going on in the brain is it equal parts mental and physical. Well it's clearly you know sleep is in the brain but changes because it is a state. It is a brain state it affects physiology affects blood pressure heart rate. It affects almost every function in the body so when you're asleep your body is in a very different state than when it is awake. OK let's take some calls let's talk with Jenny good morning on WBEZ. Yes good morning. Actually it's still morning yes it is. I am I've been taking over-the-counter sleep medication for quite a few years and I'm up to like four tablets an evening and I've even on occasion mix them with alcohol just so I could get to sleep and I've consulted several doctors on it. No one will give me anything to help me sleep. And I wanted to know long term affects what's going on

with that. And is there anything that's available. Well I think there are several issues here. The first is do over-the-counter sleeping pills work. The answer is not very well. It turns out that over-the-counter medicines at least in a big study done by the Consumer Reports people this past spring folks show that they only felt benefit from over-the-counter pills about half as often as they did from prescription sleeping pills. It also turns out from some studies by a doctor Mitchell Valter done a few years ago that the rate of people stopping over-the-counter sleeping pills due to side effects was just as high as the rate of stopping prescription sleeping pills. So it's probably not true that just because you can buy it at the drug store without a prescription that one is likely to have less difficulty from it. The other part of the question is that increasing the dose to four pills a night is probably not such

a good idea. Their brick can be a point where if you keep increasing the dose of any kind of sleeping pill that a it can actually potentially be harmful but also equally importantly at these very high doses the sleeping pill can become the reason for the poor sleep instead of an aid to it. And the final part of your question probably mixing with alcohol is not such a good idea and in fact in could even in many cases be that dangerous. But what sorts of things or should a person try if you're having trouble sleeping or you're not getting good sleep even if you're sleeping for long periods of time. You know maybe you need to see a doctor but are there things that you want to try first of all to see if you can get yourself back on track. Yes lots of them. OK. There are about 10 good sleeper rolls I think I can say some of them and my colleagues remind me of the others are very leery and on the others. First thing is to regularize a schedule to set a time for bed time and up

time and not to fool around with it. Particularly you can't really assure that you're going to fall asleep at the same time every day but you can assure you're going to get up at the same time every day. And if you have a bad night or a few bad nights in a row and you get up at the same time every day you're going to be sleepier and sleepier so that that alone will help you to get to sleep at the time you set. So a regular schedule is rule number one. Rule number two is to keep track because you'll have good nights and bad nights. And if you really keep track of what's what what was going on before your good night. What was going on before your bad night. You begin to be your own detective. What leads to a good night what leads to a bad night and begin to be able to control those factors. What sorts of things should be keeping track of what kind of day you had. What kind of day you have what kind of mood you're in before you went to sleep did you argue with your husband just before you turned out the lights. Did you forget to call your mother and you promised her and it's still

on your mind and you're worrying about you know will she think that you've been hit by a car if you don't get up and call her now but she's probably asleep now and what should you do if you know that sort of thing. What's going on that day. Even things like food drink Dr. Mendelson was mentioning alcohol is a bad idea. It will make you drowsy but it's metabolized in about three or four hours so popular again. So you know if you watch what you're doing before a good night and a bad night it will help you decode what's interrupting your sleep. Then there are some other things. Well there are lots of things but how about somebody else. I mean I think exercise is important and I found that not just exercising any time and that can be helpful to sleep but also keeping it structured and again particularly at a particular time of the day if you can do it four out of the you know seven days is great. The more regular you know the better. And for younger person possibly exercising in the late afternoon very early evening

mystery late afternoon may be an ideal time to do that. For what age range are you talking and in the younger person even the older person if you're able to exercise or even taking walks just the regularity of doing that is very poor and appears to improve the quality of sleep and the ability to fall asleep. OK Jenny thanks very much for your call I hope that works. Can I just add one other thing real quick is there a reason why my doctor won't give me anything to help me sleep. Probably doesn't understand much about sleep. You should send it to somebody who does. And most doctors are afraid of giving sleeping pills because of the potential addictive properties of those medications and you should probably see a sleep specialist. That's my thought will help you there are a lot of behavioral programs that are non medical. All right thank you very much. Thank you. Thanks a lot for calling. Talk with Brenda you're on WBEZ. Hello. Hi thank you for taking my call.

You're one of your guests said earlier that you we we probably fall asleep too early and we should probably go to bed more towards like midnight. How can you get if you're at an eight hour sleeper which I am. How can you get it. You know you're eight hours if you've got to get up and get to work and if you don't go to bed until midnight. Well you really you're absolutely right and that's where part of the society comes in and really our ideal about time and our sleep time is probably a combination you know of what we need to do for our work in our social life and what our biological needs are. So instead of going to bed and or falling asleep at midnight you may want to consider going preparing for bed about eleven o'clock. And if you wake up at 6:00 or 6:30 you still are able to get about seven hours of sleep and maybe adequate seven hours may be quite adequate and that you may be able to catch up on the weekends if you need to you know that one hour less of sleep

per day. But so are you saying that even if you're feeling sleepy around 9:00 o'clock you should try to stay up a little later so that you don't go to bed till maybe 10:00 10:30. I mean if you're if you're real tired and I clock is too early and what will happen is that you'll wake up at 3:00 or 4:00 in the morning and then you won't be able to get back to sleep in my time you have to go to work you're actually quite tired already. And that has to do with the body temperature cycle because as Dr Z mentioned earlier we asked the temperature cycle starts going up to wake us up at about the time that. You know we've had our seven or eight hours of sleep and then it's hard to get back to sleep with a high core temperature. And one of the ways people can easily kind of try to reset that temperature so that they fall asleep when they want to and wake up a little later is to take a very hot bath two hours before bed time get their core body temperature up about two degrees above

normal then spend an hour and a half letting its slowly sink. And they get drowsy and fall asleep at the right time. If you're in a position where it sounds like Brenda might be worth a tradeoff between getting eight hours if she thinks she needs eight hours. But she'd have to go to bed too early. Overall do you think it's better to wait go to bed later and maybe scamping get by on 7:00 or go to bed early and try to get the full eight. Compromise compromise so instead of going to bed at nine go to bed at 10:00 or 10:30 and you still be able to get your seven hours. It would be better to get seven than to try to get eight but too early because she will wake up early. OK Brenda thanks very much for calling. Can I ask one more thing. Sure I am the mother of three one of which is a newborn. And I've been forgetting you're not sleeping at all I was about to say I really even in the eight hours that I try to sleep I don't think I'm really sleeping.

I call it I'm just resting before I have to get up and and start the craziness again. But my question is this I find myself not really being able to remember things and just sort of I could jumble through the day. Is there any advice for you know mom who sleep when the baby sleeping. But remember working mom threw a double whammy for me. Any advice on that situation what I can do to help remember because I really find the two are far from open and just retaining information and things you know throughout the day. I'm very forgetful. You need any ideas. Well what we really really need to help you deep in your sleep. And did you hear me talk about the hot bath routine. That yeah that will deepen sleep if you can manage to get even a 20 minutes. At about 8 o'clock and go to bed about 10:00 that'll help deepen the sleep. I've even thought about trying to incorporate exercise because I just.

America you know I hope I hope also but it's a matter of finding the crime. Exactly. It's not only nature as actually build in a mechanism such that right after you give birth the level of sound it takes to wake you up drops. That's a mechanism presumably to help you make sure that you hear the baby but it doesn't make you feel like you're more rested in the morning or indefinitely. So maybe a little period of lack of rest is a low survival strategy in this particular circumstance for the baby but not for the law. Well Brenda thanks very much for your call. Let's talk with Gypsy. Good morning good morning guys a gypsy. Yes I thank you for taking my call or I have a bit of history I'll try to make very simple and quick until my daughter was born in 1982. I never had any problem with going to bed getting up falling asleep getting enough with all of this. I never thought about it it just happened and it was going. And then after once he was born. Things changed for

quite awhile and I started having some time after he was born I started having trouble getting to sleep in it was so unfamiliar. I didn't try to hurry and go to sleep if going to he fell asleep that night. And you can't make that happen. So this went on for a number of years and for about three years starting maybe like 90 I was taking a rest to real because it started when I was going on a long trip on the bus on a bus overnight and I knew I wouldn't sleep well if I didn't have help. Well I continued to take that and I tried to phasing it out and I finally did phase it out a couple years ago but in between the beginning and the ending of the time I took that I went to a sleep clinic because when I when I got it back that I was starting to have real trouble getting to sleep. And it got to the point where I knew there was something wrong. So I went to a sleep clinic and one of the things they did was give a multi-phase a personality test or something and some

depression showed up there. So I saw a psychiatrist and was put on medication for depression and that first night I just fell asleep. So that part of it is phased out but I'm left with a lingering literally a terror that I won't get enough sleep. I don't feel terrified at night but it's in the back of my mind. And if I have one night when I don't get a full night's sleep I dread if I know that's going to happen I just dread it and I just feel awful the whole day and getting to where I need nine hours. It used to be eight or eight and a half or or even less before she was born. So what I've been calling about is I've tried to move my bed time back I go to bed at like 1:30 or 2:00 and I don't have a fight employment because we home school. So that enabled me to stick with this but I don't want to. And I've tried moving it back like when we set the clocks ahead back in the when is that fall in the fall. I don't set mine back

and I try to stay on that same schedule and then actually going to bed earlier but I pretend I don't know this. But after awhile that fades away it's just like they're something that. Keep nudging me and it's not a decision I make I don't know if it's just a bad habit or whether there's something biological or physical going on. So you want to get back onto a regular sleep schedule. Well if I were yes if I were able to say go to bed by at midnight and get up at 8:30 or 9:00 that would be so much more workable than getting up at 10:30 I've missed most of the morning. And I've tried very hard but something just I don't and I don't know what that something is. So I think over the course of a few weeks I'm back to it might last for a week or two maybe two weeks and then I'm back. You know I just move that if I have one night when I get off that schedule then that's usually the death you know. Dr. Cartwright you want to respond to that. Well I would defer to my colleagues too because this is a complicated one.

There are a couple of things strike me though that she's going to bed late and waking up late and really needs to use the bright sun that's coming back to Chicago to help her wake up early or open her drapes first thing and get outside as fast as she can even walk around the house once will help. Just exposing herself to the bright sunlight will help reset the body clock back. If she can walk take a walk with with a pet or with a child in a stroller. That's even better to get some bright sun early in the day will help reset the clock. All of us have a little trouble when Chicago is so gloomy for so long in the winter time with the problem of getting enough rights. But I want to Dr. Mendelson to respond to her lack of confidence in being able to sleep seems to be a major issue.

And he said the sky interest on this. Well sometimes the worry about not sleeping can contribute to the not sleeping and what Gypsy's described as a very good example of that I think there are techniques that one can learn working with a behavioral psychologist or psychiatrist to learn to remove that kind of worrying about the sleep. My guess is that at this point instead of that being a helpful thing it's actually a little bit part of the problem. OK gypsie thanks very much for your call we're going to try to get to a few more before the end of the hour. Let's talk to Carol good morning Carol you're on WBEZ. Oh hi hi. I had wanted to ask about my husband have a real problem. Generally he says his work is stressful you get all me have up or down to watch the Newton Falls before you and I try to wake him up but you know he doesn't wake up very early man I need my rest and he'll wake up around

11 o'clock and be full of energy and will have missed out on you know participating with the family and then he'll stay up from 11 o'clock till you know 1:30 2:00 o'clock in the morning because he's not tired. I keep telling him you know just try and stay awake a little longer and you know then go to bed sort of a normal hour and you know my suggestions seem to be helping any you have any thoughts. This may be more of a diplomatic problem than an actual problem but electric prods are good when people actually think that in a way it was standout. You know exactly why don't you take a walk if you are evening walk and force him to do that because it is I am sure he is extremely tired and the need for sleep does kind of become an overwhelming thing at that hour. But it is what I tell my patients to do you know is you know you really want to sleep if you special if you sit down this couch you know please get up and walk

around when that urge comes because it will go away after an hour or so. Just get out and take a walk. And it does even around the house. Take a walk. It does seem like especially if you come home from work and you're tired already and then you eat anything that's even a little bit heavy. That did least there's a period where you feel like you just can't possibly do anything except fall asleep but if you don't know it if you don't I'll sleep utils will come back I guess that the energy from the food will finally get to you and you'll you'll get back if you can just sort of avoid it but it is sure is tempting you know where to go right to sleep. Yeah OK well Carol I hope that helped. That's one of the parts of it I mean you know if I can call it the state of the life that he heard the next day and then come the week and he's got this built up that he and he wants the flea pill known and I thought I mean you think them x. I mean if you don't feel this is really unhealthy for one to be sleeping the way I mean or if it's just a disadvantage. Both It's a disadvantage for you and the family and it's not very good for him

right. Because while he is also faced delaying his sleep piece he's moving his whole rhythm to be late at night and late in the morning which is a bad idea. And he really should expose himself to the bright light and on Sunday morning and the kids are so little of it here in Chicago we should expose ourselves to it whenever we possibly can. Well Carol thanks very much for calling I hope that that helped. We're just about out of time here but I do want to thank my guests for coming in today Dr. Phyllis D Director of the Sleep Disorder Center at Northwestern University Medical School. Dr. WALLACE Mendelson who is professor of psychiatry at the University of Chicago and director of Sleep Research at event core central hospital and doctor also Dr. Rosalind Cartwright director of the sleep disorder service and Research Center at MIT to get it right this time Rush Presbyterian St. Luke's Medical Center. Thanks very much to all of you for coming in. You're welcome.

Thank you thank you. I want to also thank Joshua Andrews for producing and directing and seaborne ass kissing Carol freedoms for engineering. Tomorrow on the program we'll be talking with Buzz Bissinger author of a prayer for the city it's a look inside the ministration of Philadelphia's mayor Edward Rendell during four very difficult years in the life of that city and also don't forget film club on a Friday our topic this week is history and films historical films. How good are they so i hope you tune in for that. That's Friday. This is Odyssey I'm Gretchen health. And you're listening to WBEZ Chicago.