Drs. Oz & Roizen: 4 Sleep Problems—and 4 Sleep Solutions
➽ You need your sleep, so we’ve answered your biggest questions on the topic.
Q: I’m a terrible snorer, which is driving my wife crazy. My doctor has ruled out sleep apnea, but should I consider surgery?
A: Not until you’ve explored all other options. To understand the solutions for snoring, you should first understand the cause—snoring happens when something obstructs the flow of air somewhere along the passageway in your nose and mouth.
One possibility is mucus. If you often have a stuffy nose or drainage in your throat (from persistent colds, sinus infections or allergies), that gunk can clog your pipes and make you a seriously loud sleeper. If you suspect this is the problem, try rinsing with a neti pot (use distilled water to avoid potential infection) before bed, applying sticky strips that prop your nostrils open and/or using a humidifier in your bedroom to see whether those measures do the trick.
If not, the issue could be excess fat in the throat that pushes in, narrowing the passageway. If you’re overweight, losing 10 or 15 pounds could increase airflow and reduce snoring by 30 to 50 percent.
Fit as a fiddle? Something else may be making the muscles in your throat relax too much when you sleep, blocking air. Alcohol or sleep meds can make this happen, so skip ’em to keep your tissues tight. You might consider trying to sleep on your side: Back-sleeping can cause the tongue to relax into the throat, narrowing the airway.
It’s also smart to ask your doctor about trying a mandibular advancement splint, a device designed to gently pull your jaw forward to open the back of your throat. These appliances have advanced quite a bit recently, so you won’t necessarily feel like you’re wearing headgear to bed—it’ll be more like an orthodontic retainer.
If these tactics fail, you could have a structural problem that may require surgery. One example is a deviated septum, which means the thin “wall” between your nostrils is slightly askew, blocking airflow in one side of your nose. While certain drugs can treat deviated septum-related problems, only septoplasty surgery can deliver a permanent fix. The surgery is typically an outpatient procedure, but your doctor will probably use general anesthesia. Recovery can take a while, so ask lots of questions to ensure the procedure is right for you.
Another possibility is that your tonsils, adenoids, uvula and/or other throat tissues could be surgically removed. This is also a procedure that shouldn’t be taken lightly—while it tends to be effective, many who undergo it say the pain and recovery were so unpleasant that they wouldn’t do it again.
An additional option is the pillar procedure in which your doctor inserts small rods into your soft palate to “stiffen” it and prevent that overly relaxed tissue we mentioned earlier. This is a somewhat easier surgery, but you still should do plenty of research and ensure your doctor has lots of experience performing it.
Bottom line: If your doctor has ruled out sleep apnea, it means that snoring isn’t endangering your health, but it is screwing up your life (you know what they say about a happy wife!). Surgery could be a legit option, but only as a last resort to avoid being exiled to the couch.
Q: Is it true that you shouldn’t eat right before bed? I have trouble sleeping when I’m hungry!
A: Yes and no. (Don’t you hate that?) You certainly shouldn’t go to bed starving: A rumbling stomach can wreak havoc on your ability to fall or stay asleep. A small—less than 200 calories—snack that combines whole grains with a bit of protein is ideal. That’s because the protein will help keep you full through the night, and the complex carbs may help increase the amount of tryptophan available to your brain, which produces the feel-good hormone serotonin, which then helps your body produce calming melatonin. Whole-wheat crackers with almond butter are great, as is a small bowl of whole-grain cereal with milk. Bananas are a good bet, too, because they contain potassium and magnesium, both of which may help you sleep better.
But some foods (and drinks) before bed can interfere with quality sleep. Large, spicy or fatty meals eaten near bedtime can all cause acid reflux and raise your core temperature, both of which make it harder to sleep. And aged cheese, red wine and processed meats can contain tyramine, a compound that can cause the brain to release norepinephrine, a stimulant. Basically, keep your snack small and simple, and you’ll catch every one of those 40 winks.
Q: I travel long distances for work, so what are the best ways to beat (or, even better, avoid) jet lag?
A: Avoidance is ideal. We’re fans of preparing your body for a trip in advance to make your adjustment to a new time zone easier. Starting a few days before you leave, tweak your sleep schedule according to the direction you’ll be flying. Heading east? Go to bed a little earlier each night and wake up earlier each morning. Going west? Start burning the midnight oil and sleeping in. That way you won’t be totally wired—or totally beat—and screw up your sleep before those big meetings.
If you can, opt for a flight that lands no later than the early evening so you have time to exercise when you arrive (exercising right before bed can raise your core temperature, which interferes with sleep). A workout is a great way to recover from hours of sitting on a flight and to tucker yourself out before bed. Eat a light dinner or snack (avoid caffeine and alcohol), and go to bed by around 10 p.m. whether you feel sleepy or not. During the day, you can ease the adjustment by eating light, healthful food; moving as much as possible; drinking plenty of water; and getting some sunshine, especially in the morning.
It’s also smart to acknowledge that some of what we chalk up to “jet lag”—especially when it comes to work travel—is really stress or anxiety. You’ve probably got something important happening wherever you’re going, and you’re sleeping in an unfamiliar place, so you may toss and turn, worrying about whether the alarm will go off at the right time, how long it will take you to reach the conference center, and if you remembered to pack everything you need in your briefcase. That’s why we also suggest making your hotel room as dark, quiet and comfortable as possible (bring a sleep mask and download a white noise app); setting your phone alarm as well as the room’s clock to be sure you’ll wake up on time; and spending a few minutes before bed triple-checking that everything is organized for the next day.
If you’re really struggling, it’s OK to occasionally pop a sleeping pill. Doxepin (sold as Silenor) has only a few side effects.
Q: I’m an insomniac but prescription sleep meds scare me, so I use Benadryl to help me nod off. Is this safe long-term? Should I switch to something natural, like melatonin?
A: Believe it or not, Benadryl could cause worse side effects than some prescription meds, so it’s worth looking into alternatives. Antihistamines like Benadryl may help you fall asleep because the active ingredient, diphenhydramine, causes drowsiness.
But it won’t necessarily help you stay soundly asleep all night, and you’re very likely to have a “hangover” the next day—you may feel sleepy, slow or clumsy, and you won’t be on top of your game at work. Plus, Benadryl can cause urinary retention, constipation and a dry mouth and throat. What’s the use of a few minutes of extra sleep if you feel lousy the next day?
Because you are (understandably) anxious about prescription-strength drugs, we recommend trying some natural methods. (We’re assuming you’re already practicing smart sleep hygiene and exercising regularly to make sure you’re good and tired by bedtime, right?)
There are some small but intriguing studies that suggest lavender therapy can calm your system and get you to sleep naturally. Try turning on an aromatherapy diffuser an hour before bedtime or sprinkling a few drops of lavender essential oil onto a tissue and placing it under or next to your pillow.
Melatonin also has some encouraging evidence behind it: Try 1 to 3 milligrams before bedtime to determine whether it helps. The caveat here is that melatonin may interfere with your sex drive. So if melatonin helps you, reserve it for nights when you’re having serious trouble sleeping.
The truth is, though, that some sleep trouble is hard to fix without a prescription, especially if it’s a side effect of depression or anxiety. Ask your doctor about doxepin (sold under the trade name Silenor), which has substantial data supporting its ability to help people stay asleep once they fall asleep, with relatively few side effects.