WIDE AWAKE: LIVING WITH SLEEP DISORDERS

Wide Awake

Living with Sleep Disorders

Ita Yankovich

Staying awake all night learning is the pinnacle of Shavuos. While everyone has their strategy for making it through (see Word on the Street), for millions of Americans with sleep disorders—more than 50 million, according to the National Sleep Foundation—a sleepless night isn’t an annual tradition, it’s a constant reality.

For those living with conditions like insomnia or sleep apnea, the struggle to get a full night’s rest can take a serious toll—physically, mentally, and emotionally. Sleep, something most take for granted, becomes a nightly battle with wide-reaching consequences.

Awake and Awaiting

“If I had to stay awake for 24 hours, it wouldn’t be an issue,” says Etty, a 68-year-old medical billing specialist from Midwood. Etty says she has always been high-strung and anxious. The combination of caring for her aging parents, children at home, and a daughter who just had her first baby exacerbated those tendencies.  “I first chalked up my insomnia to those life stressors and figured it would get better once things calmed down, but it didn’t,” she says.  Even after her parents passed away, her daughter settled into motherhood, and her other children became more self-sufficient, Etty’s nights were spent tossing and turning in frustration.

Etty’s nighttime impacted her daytime. She had trouble focusing at work, was snappy with her family, and always felt like she was in a brain fog. “I was perpetually yawning and tired during the day and looked forward to climbing into bed at night, but then I couldn’t fall asleep,” Etty says, describing the feeling of insomnia as, “no matter how comfortable you get, what you think about, how many times you count backwards from 100, or how long you read, your body will simply not allow you to fall asleep.” 

 The lack of sleep wreaked havoc on her body. “It aged me.  My skin looked terrible. No amount of makeup could conceal my dark circles and bags under my eyes, “ she says. After trying everything from soothing music and noise machines, scented candles, herbal teas, and vitamins, Etty knew she needed to see a doctor. 

Always Tired

No amount of sleep was enough for Chaim*, a repairman from Marine Park, who found himself drifting off during random moments of the day, even during work or meals. He sheepishly admits that he would frequently doze off in shul during the Rav’s drasha, which would be very awkward since his nap was accompanied with loud snoring.  “It was embarrassing to be jolted awake surrounded by smirking people,” he relates. “My wife complained that my snoring disturbed her sleep, and I would wake up sweaty and gasping for air,” he recalls.  Chaim’s breaking point came one winter night when he called his wife on his commute home from the city at 6 P.M., telling her he would be home shortly. She became increasingly alarmed when it was close to 10 P.M. and he hadn’t arrived yet. Her frantic calls to his phone went unanswered.  She was on the verge of calling Hatzoloh or Shomrim when he walked through the door close to 11 P.M.  Chaim had dozed off at a red light, and the next thing he knew, three hours had passed. 

Chaim knew he needed to seek professional help. “I was always either falling asleep, sleeping, or waking up from a nap. I would take a two-hour nap, go downstairs for a snack, and then fall asleep on the couch mid-snack. I was moody and easily irritated,” he says. Chaim felt he was missing out on life. When the family went out, he would fall asleep. When the kids had a play or recital, he would miss key moments and didn’t have the energy to engage in activities.   Being overweight didn’t help either, and Chaim suspects that that is what triggered his sleeping issues.   

Diagnosing the Doze

Once Etty and Chaim had had enough of their sleep issues, they sought guidance from their physicians; the findings were contrasting. 

Their doctors performed thorough physical exams, electrocardiograms, and routine blood work, checking for tumors and hormone imbalances (especially thyroid). For Etty, the results were inconclusive; she was perfectly healthy despite her sleep deprivation.  Her doctor referred her to a sleep specialist for further investigation into her diet, lifestyle, genetics, medications, family history, and sleeping habits.  The specialist had her keep a sleep journal to track her nighttime routine for a few weeks.  After reviewing the entries, she was diagnosed with primary insomnia, which means that the condition happens on its own, not because of another underlying medical condition. 

As Chaim suspected, his excessive weight was a catalyst for several health issues such as high glucose, hypertension, cirrhosis, GERD, and gout. His blood test revealed that his red blood cells were elevated, and he had secondary polycythemia, a blood condition caused by hypoxia, long periods of low oxygen levels. His physician prescribed a sleep test, or nocturnal polysomnography. “I thought I would have a hard time falling asleep in a foreign bed hooked up to beeping wires while a stranger watched me,” shares Chaim, “but I fell asleep in no time.”  The polysomnography monitored his brainwaves, heart rate, breathing, and other activity, such as leg and arm movements. The results showed that his sleep was disturbed 61 times per hour, which the somnologist, a health care professional specializing in diagnosing and treating sleep disorders,  found alarming. The test confirmed what everyone suspected: Chaim had sleep apnea, a breathing disorder in which the airway repeatedly closes or narrows throughout the night, restricting airflow and oxygen. 

Snooze Blues 

Etty’s doctor prescribed Zolpidem; when that didn’t help, she tried 200 mg of Temazepam followed by 75 mg of Hydroxyzine.  When side effects such as weight gain kicked in, Etty turned to holistic alternatives such as lavender oil, soy, chiropractic treatment, hypnotherapy, vitamins, and supplements. Yet the more she pursued sleep, the less she slept. “I spent months following sleep hygiene rules, taking supplements, and forming strict bedtime routines,” says Etty. “Nothing helped. I was at my lowest point.”  Sleep became an obsession. She called it her “scratch” – the more she tampered with it, the more it demanded her attention. 

Chaim was prescribed a Continuous Positive Airway Machine (CPAP). The device is commonly given to those suffering from sleep apnea since it enables the wearer to get better quality sleep by delivering a steady stream of pressurized air through a mask worn over the nose or nose and mouth to keep the airways open during sleep. This prevents the airway from collapsing and causing breathing pauses, a common symptom of sleep apnea.  Chaim detested the CPAP for all the inconveniences it came with. Besides being bulky and loud, after a few months, he developed a nasty rash on his face from the wires irritating his skin, suffered from perpetual dry mouth and eyes, and for the first time ever, got TMJ and intense migraines.  “I felt like I was in worse condition than before,” he recalls.    

Dairy Dreams

At her wits’ end, Etty ditched all medication and natural remedies and did nothing. Knowing that ignoring sleep issues can have detrimental adverse medical and psychological effects, she consulted with her doctor. She ultimately decided that instead of wasting her time and energy trying to fall asleep, she would maximize her awake time.  Instead of staring at the ceiling in bed, Etty used the time to catch up on work, cook for the next day, complete a puzzle, read a book, chat with friends in different time zones, and even finish the entire Tehillim.  

Today, although she is not cured of her insomnia, she has been getting a steady four to five hours a night, which she says is sufficient for her.   Etty looks forward to Shavuos as an opportunity to further her growth in Yiddishkeit. She has compiled a stack of books on Megillas Rus and Pirkei Avos to enhance her long night.  “If I’m going to be up, I might as well be productive,” she says. 

For Chaim, last Shavuos was the first time since his yeshivah days that he could stay up and learn all night. Through sheer determination and willpower, he lost more than 100 pounds without any medical or surgical intervention, and his sleep apnea slowly began to vanish, together with his other health issues.  “I was sick and tired of being sick and tired,” he says. Like Etty, he wanted to stop the medication and improve his health naturally. Initially, his doctor was skeptical but agreed to slowly wean him off for three months as a trial to see if he would improve on his own. Chaim took the challenge seriously.  He took his health into his own hands and started a rigorous exercise and diet regimen.  “I felt better with every pound I lost,” he says.  He noticed that his bouts of gout became more infrequent. His glucose and blood pressure returned to normal levels, and he wasn’t napping throughout the day. He had more energy, and his nighttime sleeping drastically improved to the point where he no longer needed the CPAP machine.   And as the pounds began to shed, so did his denial that perhaps he was in a bit of depression, which was what made him check out of life.   “Now, when the Rav speaks, I actually am alert and pay attention,” he says. He is looking forward to Shavuos and plans to visit several Marine Park shuls to hear the Ravs’ drashos. 

Sidebar

1 in 3 adults worldwide have insomnia. Are you one of them?

Here is what Brooklyn, NY board-certified neurologist and sleep medicine specialist Dr. Ryan Williamson had to share.   

 Are sleeping disorders on the rise? If so, why do you think that is?
Yes, sleep disorders are increasingly common. Contributing factors include rising stress levels, increased screen time (especially before bed), disrupted routines, and poor sleep hygiene. The COVID-19 pandemic also led to a surge in insomnia, often called “coronasomnia,” due to anxiety and lifestyle changes.

Is there a link between mental health and sleeping disorders?
Absolutely. Sleep and mental health are deeply interconnected. Conditions like anxiety, depression, and PTSD often disrupt sleep, while chronic sleep issues can worsen mood disorders. Poor sleep affects emotional regulation, concentration, and resilience, creating a cycle that can be difficult to break.

What is the danger of ignoring sleep issues?
Ignoring sleep problems can lead to serious consequences including weakened immunity, increased risk of heart disease, weight gain, high blood pressure, and cognitive decline. Untreated sleep apnea, for example, can significantly raise the risk of stroke and heart attack. 

How can a parent determine if their child has a sleeping disorder?
Signs include frequent difficulty falling or staying asleep, excessive daytime sleepiness, loud snoring, bedwetting beyond the usual age, or behavioral changes like irritability or inattention. If these persist, a pediatric sleep evaluation is recommended.

What are some natural remedies one can attempt to treat a sleeping disorder?
Natural approaches include establishing a consistent bedtime routine, limiting screen exposure before bed, reducing caffeine intake, and creating a cool, dark, quiet sleep environment. Practices like mindfulness, meditation, and light physical activity (walking or yoga) can also promote better sleep. Melatonin supplements may help in some cases but should be used with medical guidance.

Signs of Possible Sleep Disorders

Routinely taking more than 30 minutes to fall asleep.

Constant tiredness and irritability during the day, even after getting seven or eight hours of sleep.

Awakening several times during the night and remaining awake, sometimes for hours.

Frequent and long naps during the day.

Difficulty concentrating at work or school.

Falling asleep at inappropriate times.

Loud snoring, breathing, or gasping noises while you sleep.

Irresistible urge to move your legs, or a tingling or crawling feeling in the legs, particularly at bedtime.

Needing a stimulant, such as caffeine, to keep you awake during the day.

 Get a Good Night’s Sleep 

Be consistent: keep bedtime and wake time fairly consistent each day, including weekends.

Be active during the day: Aim for at least 20 to 30 minutes of vigorous exercise daily.

Limit caffeine and alcohol. They can make it more difficult to sleep.

Create an atmosphere conducive to sleep by taking a warm bath, listening to soft music, or using other relaxation techniques. 

(*Data supplied from New York Presbyterian Hospital)