A Good Night's Sleep
Darlene Holte, 41
Darlene Holte, 41, is a full-time research-grant administrator at the University of Wisconsin, in Madison. She lives in Stoughton, Wisconsin, with her husband, Greg, a steel-press operator, and their children Brent, 12, and Tara, 7.
Her sleep struggle: "It's very frustrating to lie awake at night, desperately wanting to fall asleep. Every little thing bothers me: The light on my bedside clock is too bright, the sound of the water softener cycling, my son's TV, the cat's having a late-night snack, even my husband letting off steam -- he inhales, then puffs the air out of his mouth. Then I start thinking about all the things I need to do. Insomnia has caused me to become addicted to caffeinated diet sodas just to stay alert during the day. I yawn constantly, my thought processes are slow, and I often have trouble with recall. Most nights I only get four to five hours of sleep. I thought this was normal until I tried Ambien last year. Within five minutes after the first one, I was sleeping like a baby. Although it stopped working -- I don't use it anymore -- it made me realize that it wasn't normal to have trouble falling asleep or to wake four to five times at night."
The sleep expert: Michael Flatley, MD, medical director, Waukesha Memorial Hospital Sleep Disorders Center, Greater Milwaukee area
Diagnosis: Classic chronic insomnia
"Our first meeting made it clear that Darlene got too much caffeine too late in the day -- four to six cans of soda, until 5 p.m. -- so she didn't get sleepy until fairly late at night. I advised no caffeine after noon -- not just coffee and soda but chocolate.
"When Darlene did get to bed, she suffered from what we call 'excessive thoughts' -- staying awake thinking too much about problems and then getting even more anxious because she couldn't fall asleep. This kept her from the seven and a half to eight hours of sleep that she needed. I told her to schedule a 'worry time' before bed to write down the things she's anxious about so she doesn't have to worry about them when she should be sleeping.
"She also slept late on weekends to try to make up her sleep deficit. I advised her to avoid daytime naps and practice sleep restriction: Go to bed and wake up at the same time each day; don't get in bed until you're sleepy; if you can't sleep, go into a different room -- one that's dimly lit -- to read or watch TV until you are."
Slumber solution: "I left my first meeting with Dr. Flatley, in December, feeling very optimistic. Because I was afraid of getting headaches from going off caffeine cold turkey, I decided to wean myself off slowly -- on the first day I stopped after 3 p.m. and felt pretty good. The next day I stopped at 2 p.m. By the end of the first week I had reached noon -- still no headaches! And I was already beginning to feel sleepy at 9:30 p.m. -- quite a bit earlier than usual. I'd never have thought that stopping caffeine could make that big of a difference. Writing my to-do 'worry' list and having milk plus peanut butter and toast before getting in bed also helped me sleep because I had a history of waking in the night from hunger. In less than two weeks I was going to bed at 10, falling asleep within 20 minutes and getting up at 6 in the morning.
"I feel more alert and mentally aware. Being tired earlier in the evening is going to take some getting used to because I usually can't get anything done until after my children are in bed. But getting up at 6 a.m. on weekends means that I can get these things done before the kids start their day. Even staying up on Christmas and New Year's Eves didn't affect my ability to sleep. What did was drinking a caffeinated soda at about 5 p.m. one day. I couldn't sleep at my usual 10 p.m. After 30 minutes of tossing and turning I got up, had a small snack, and didn't get back to bed until midnight.
"I can't believe how much better I am functioning at work! I always thought that I was operating at a pretty high level, but I can do even more. What I learned from Dr. Flatley helps me fall asleep much more quickly -- even when I was exhausted after taking my Girl Scout troop to the Madison Children's Museum."