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| The price of a good nights sleep | |||||||||||||||||
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Restless Americans are spending billions on pills, pillows, mattresses and therapies. Here's what all this sleep medicine can cost -- and 10 free ways to get some rest. By Melinda Fulmer Bill Baka has tried just about everything for his insomnia. The Marysville, Calif., electrical engineer has taken prescription sleep aids, herbs, supplements, even Xanax in his quest for more sleep. Hes tried earplugs, blackout curtains and therapy. Tens of thousands of dollars later, 57-year-old Baka is getting a full nights sleep -- once every three days. For the estimated 70 million people with sleep problems, it seems no price is too high for a good nights slumber. Sales of prescription sleep aids are expected to almost double to $4.3 billion in 2010 from $2.4 billion last year, according to Natexis Bleichroeder analyst Jon LeCroy, as more prescriptions are issued for new and more expensive drugs.
Sleep centers, which diagnose the 80 separate sleep disorders, are averaging a 10-week wait for appointments, said Richard Gelula, chief executive officer of the National Sleep Foundation, as more baby boomers are struggling with slumber. And purveyors of other sleep-related products, including dietary supplements, herbs, pillows and sound machines -- even biofeedback and sleep-inducing music -- are reporting booming sales as an overstimulated generation tries to solve its sleep problems. The industry of sleep Theres a whole market of over-the-counter things, an industry of sleep, springing up, said Rafael Pelayo, assistant professor at Stanford University School of Medicine, who treats patients at Stanford's sleep disorders clinic. Related news and commentary on MSN Money
According to the 2005 National Sleep Foundations Sleep in America poll, only 49% of the 1,506 Americans surveyed said they got a good nights sleep most nights. Another 26% said they only got good sleep a few times a month or less. While many consumers are simply taking one of the name-brand sleep aids, such as Ambien, Lunesta or Sonata, to nod off, others cant get their doctor to even discuss the problem, Pelayo said. Sleep medicine is a new specialty, and very few doctors have training in the area. When a patient says, Im not sleeping well,' the doctor says, Hey, I dont sleep that well, either,'" Pelayo said.
This gap in treatment is creating a huge opportunity for entrepreneurs like Robert deStefano, president and co-founder of Sleep Garden, an upstart distributor of holistic sleep treatments. A former ad man and chronic insomniac, he founded Sleep Garden last year, to sell drowsy music, sleep-inducing yoga DVDs and special zMovies to lull people to sleep. We wanted to provide something that was an alternative to over-the-counter sleeping pills, deStefano said. If you have insomnia, you do not need to medicate. You simply need to recalibrate. The zYoga video guides pajama-clad exercisers through a series of downward dogs, forward bends and twists to relax the mind and body in the minutes before going to bed. We have great rituals of waking up, deStefano said, including having that cup of coffee and reading the morning paper. But few people, he said, carve out some time after the workday to unwind. Short excerpts of the companys zMovies, with relaxing nature images and music, have been picked up by American Airlines as in-flight entertainment and by the Fairmont Hotel in Washington, D.C., as a sleep channel for hotel guests. An aging population, with more aches and pains, is also boosting sales of expensive mattresses made of shape-conforming Tempur-Pedic foam and expensive air mattresses such as Select Comforts Sleep Number Bed, which can run $5,000 for a king-size bed. Indeed, on the strength of these new types of mattresses, the number of mattress sets over the $1,000 price level increased to 21.4% last year, up from 14.5% four years earlier, according to the International Sleep Products Association. Its just skyrocketing, said Lori Lawson, owner of four Back Shop & Sleep Centers in the San Francisco Bay area, of her Tempur-Pedic sales. Even as Tempur-Pedic has added more and more distributors to sell the mattresses, Lawson said, her sales have increased. Lawson, who suffered a back injury more than a decade ago, swears by her own Tempur-Pedic bed, purchased in 1993. Its like an old tennis shoe, she said, in the way it molds to her body. But even with the finest mattress, it can be difficult for some people to get to sleep. Many of the hot-selling sleep products are aimed not at helping the sleepless, but at muffling a snoring spouse. Special throat sprays, anti-snoring pillows and u-shaped adhesive chin strips designed to keep the mouth from gaping open are now selling briskly on the Web, as are ear plugs and other devices designed to drown out the offending snorer. Treatment for sleep apnea However, the most profitable and fastest-growing segment of the sleep industry deals with another condition characterized by snoring: sleep apnea. With this disorder, estimated to affect 18 million Americans, a person stops breathing and wakes briefly during the night -- perhaps hundreds of times -- usually because soft tissue in the back of the throat has blocked the airway. This constant waking leaves the sleeper sluggish during the day, with no knowledge of why he is so sleepy. Because treatment of this condition is more expensive, requiring an overnight stay at a sleep center and fitting for a special continuous positive airway pressure machine (CPAP) and mask to prop open airways, plus follow-up visits, it is attracting a greater number of practitioners. Dr. Bradley Eli, a San Diego dentist who operates Sleep Treatment and Research (S.T.A.R.) Institute, believes sleep-treatment facilities will proliferate as quickly as teeth-whitening offices in the past several years. (The treatment of) sleep is still in its infancy right now, Eli said. But, he said, just as more and more people who never thought about whitening their teeth are now doing it, more and more people are saying, Its not OK for me to not be able to sleep.
And more people, he said, are seeking treatment as they learn the role lack of sleep plays in other medical conditions, including depression, heart disease and obesity. Eli abandoned his dental practice several years ago and set up his business treating sleep-apnea patients with referrals from sleep-diagnosis centers. Eli and his staff help patients -- at seven different locations -- find a CPAP machine, adjust it to a comfortable level and follow up to make sure it is working. The business, he said, is a lot more lucrative than other types of sleep problems, costing around $10,000 a patient for the combination of equipment and visits, all of which is covered by insurance. It is so lucrative that one Bay Area sleep clinic recruited seniors at a recreation center in San Jose to undergo a variety of expensive tests for a payment of $100. These tests were then billed to Medicare. Law-enforcement agents shut down the clinic after a raid in 2004. Treatment of insomnia and other sleep disorders isnt quite as attractive to medical practitioners, Eli said. Insurance companies only allow billing under a psychological code, and that pays pretty poorly. But the margins on insomnia remedies are still attractive enough for small-business owners such as Daniel Flemming, a Colorado chiropractor who operates thegoodsleepstore.com, a site dedicated to sleep-enhancing products such as magnesium supplements, $27 flax-filled sleep masks and white-noise machines. What really works The profit potential is there, says Flemming, who nets about $1,500 in profits a month without outside advertising. Its a very stable business, he said, and one that is growing so quickly, it will soon make spinal adjustments a sideline for him. While many of the self-help treatments offered for insomnia are probably not harmful, Pelayo said, they are largely untested and therefore far from a sure thing. DeStefanos zMusic, for instance, which claims to bring sleep 60% faster and extend sleep by 30%, derives its claims from a study of just 22 people. Most products simply offer sufferers the placebo effect, Pelayo said, creating the belief that they can help you sleep. And while dietary supplements and herbs like valerian can be temporarily sedating, people often develop a tolerance to them and they stop working as well. People are looking for ways to turn off their brain, he said. But turning off your brain is not normal, deep sleep, he said. Pelayo and other sleep experts believe that too many people are taking prescription sleep aids cavalierly, putting themselves at risk for car accidents, memory loss and other side effects. A good nights sleep cant be bought with a prescription or a special pillow, Pelayo said. It must be learned, and that takes time. You have to change the way you think about sleep, Pelayo said. Most insomniacs, he said, grasp at remedies, trying one thing after another in an attempt to get sleep. Pretty soon, he said, these sufferers feel that they must have custom-made ear plugs, a special pillow and a sound machine running at all times to get any sleep. They also become more vigilant in making sure conditions are right and their body is relaxing. This vigilance ultimately translates into less sleep, Pelayo said. Ironically, insomniacs usually sleep more deeply when they spend less time resting in bed waiting for sleep. Sleep restrictions like keeping patients out of bed for all but a set number of hours are part of cognitive behavioral therapy (CBT) programs, which Pelayo feels are most effective at treating insomnia. CBT also incorporates counseling, lifestyle changes and a program of relaxation therapy. Its no quick fix, like Ambien or Lunesta, but he said it usually improves most patients sleep in two months. To find a doctor accredited in sleep medicine, consumers can turn to the American Board of Sleep Medicine. For those who cant find a certified sleep physician in their area, or who dont want to see a sleep doctor, several Web sites offer sleep therapy, including MySelfHelp.com, which allows users to follow a CBT program developed at Harvard Medical School, including a sleep diary, course of reading and prescribed behavior modification and sleep restriction. | |||||||||||||||||
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