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| The Basics | The price of a good nights sleep
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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. | 10 free ways to sleep better | 1. Eliminate all caffeine, chocolate and other stimulating substances in the afternoon and evening. Check with a pharmacist to make sure none of your prescription drugs are keeping you awake. Dont drink alcohol or smoke cigarettes before going to bed.
2. Exercise regularly, but not within two hours of bedtime.
3. Don't watch loud, suspenseful television shows or troubling news reports before bed. Read a book, take a warm bath or have a glass of warm milk.
4. Maintain a consistent sleep schedule. Go to bed and wake up at the same time every day. Eliminate naps.
5. Go to bed only when sleepy. Get up if you cant fall asleep within 15 to 20 minutes.
6. Set your thermostat between 60 to 68 degrees. A cool, but not cold, temperature helps most people to sleep better.
7. Use your bed only for sleep and sex. Dont watch television, read or fill out paperwork in bed.
8. Eliminate as much as noise and light as you can from the room. Close the blinds, turn off the TV and tell that snoring spouse to roll over on his or her side. If you have a fan, turn it on to drown out street noise.
9. When your head hits the pillow, imagine a relaxing setting or favorite memory, rather than thinking about sleep.
10. If that doesn't work, try a relaxation exercise, such as tensing and relaxing each section of your body from head to toe as you breathe deeply. Or try counting backward from 100. |
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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