Puzzled by your sleep woes?
Most patients who can't sleep don't have sleep apnea, the bread and butter of sleep labs. They don't have restless legs. They don't have any condition that can be weighed, measured and treated after a night or two hooked up to machines that track them through the night.
The next option for patients who have unexplained insomnia that goes on for weeks, months or years may be a sleep program at St. Luke's Idaho Elks Rehabilitation Services in Boise. Sleep lab doctors sometimes refer patients to this unusual program, which promises to teach patients the skills they need to fall asleep and stay asleep in six to eight sessions.
The Elks program can offer the best medicine — hope — through a personalized program aimed at helping people relax, stick to a sleep schedule and get their minds and bodies ready for sleep. None is a magic pill on its own, but together they have power, said Michael McClay, a medical psychologist affiliated with the program.
Untreated sleep problems can shipwreck patients' lives. "It can destroy marriages," McClay said. "People who don't sleep well lack energy, lack sex drive," McClay said. "They're irritable, all the kinds of things that can lead to conflict in relationships."
About 1,000 people go through the Elks program each year, McClay said. About 92 percent of them say it worked, he said.
Frauke Florian, 46, is one of the program's success stories. "I have had sleep problems as long as I can remember," she said. Stress is her trigger. The way she sees it, some stressed-out people eat more. Her stress reaction is to sleep less, sometimes much less — an hour or two a night.
The Boise wife and mother first sought help in 2003. "It was getting to the point where I couldn't do much during the day anymore." It worked. She returned for a booster shot of treatment in 2006.
Florian entered a sleepless season earlier this year, after her husband lost his job of more than two decades. But he found work, and Florian found sleep.
When new patients first start seeing McClay and learn he is a psychologist, they fear the worst: They are crazy and need head-shrinking. "I have to clarify with them that we don't do the regular shrinky-type stuff," he said. "We are doing sleep therapy."
McClay tailors therapy to each patient. It often includes teaching patients new behaviors, ways to control bodily functions such as heart rate or muscle tension through biofeedback, relaxation techniques or hypnosis.
The first step in the program is a detailed sleep history, including a review of medical records from patients' doctors. The goal is to identify sleep stealers such as chronic pain, headaches or depression. Once other causes of sleeplessness are treated, doctor and patient develop a detailed schedule aimed at sleeping.
Some patients find McClay's advice familiar and insist they have tried it before, but, McClay says, they haven't done it systematically. "Unless you do it in a coordinated manner where you control everything about the sleep environment, then you won't get results."
For starters, you don't have to go to bed early, listen to classical music, read or take a warm bath, if those things are irritating instead of soothing. Florian, for example, runs a cold bath during the hottest days of summer. "I take the water straight from the cold water tap, which means it is very, very cold, and I stay in there as long as I can bear it, sometimes up to 20 minutes (the body becomes numb after a while)," she wrote in an e-mail. "That seems to bring my core temperature down just enough to make me comfortable to go to sleep."