Sleep Archive

Using a CPAP machine is beneficial for people with obstructive sleep apnea, but if the machine isn’t kept clean it could lead to an illness. There are sanitizing systems available, but cleaning the parts by hand is just as effective.

It may be as simple as adjusting the dose, avoiding alcohol, or taking the drug at a different time of day.

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One of the most commonly reported side effects of some medications is drowsiness. "Many people report tiredness or fatigue as a side effect from their medicines. However, there are things you can do to minimize the feelings of daytime sleepiness," says Laura Carr, a pharmacist at Harvard-affiliated Massachusetts General Hospital.

Typical offenders

Common culprits that cause sleepiness include antidepressants; antihistamines, found in sleep aids or medicines that treat allergies; anti-emetics, which are used to control nausea and vomiting; antipsychotics and anticonvulsants, which can be used to treat seizures or depression; drugs to treat high blood pressure, including alpha blockers and beta blockers; benzodiazepines and other sedatives, which are commonly used for anxiety or insomnia; drugs for Parkinson's disease; muscle relaxants; and opioids and other prescription pain medications. Many over-the-counter medicines may also make you drowsy, such as remedies for insomnia, allergies, nausea, vomiting, or diarrhea.

Bacteria and mold can accumulate in various parts of the device. But regular equipment cleaning reduces risks.

Continuous positive airway pressure (CPAP) can be hard to get used to. The mask may feel bulky, or it may feel strange to have air blowing in as you try to breathe. That keeps many people from using a treatment that may, in fact, be a lifesaver (see "What is CPAP?").

People also can be put off because they've heard that a dirty CPAP machine can make you sick. Is that true? "Yes, if you don't clean the machine regularly," says Dr. Lawrence Epstein, a sleep expert at Harvard-affiliated Brigham and Women's Hospital.

Ask the doctors

Q. I often wake up with a sore neck in the morning. What can I do to prevent this?

A. Poor sleep habits can cause neck pain or make it worse. Simple changes can make it less likely that you will wake up in pain in the morning.

Trying to make up for not getting enough sleep during the week by sleeping longer on weekends has been found to have negative effects such as weight gain, expending less energy, and increased calorie intake during evenings.

The FDA has issued its most serious category of warning about three sleep medications due to reports of injuries related to their use. Aside from next-day drowsiness, these medications can cause sleep behaviors that may be dangerous.

On call

Q. I've always been a night owl, but now really drag in the morning. Is it too late to adjust my sleep-wake times?

A. It's never too late to reset your sleep-wake schedule. In fact, by doing so, you can improve your quality of life and potentially your overall health.

Research we're watching

If you leave lights shining or keep the television on while you sleep, it could affect your waistline, according to a study published online June 10 by JAMA Internal Medicine. The study found an association between exposure to artificial light during sleep and weight gain in women.

The research team looked at questionnaires completed by more than 40,000 women, which asked, among other things, whether the women slept with lights on nearby or in the same room. The researchers also recorded the women's height, body mass index (a measure of weight in relation to height), and waist size at the time they entered the study and then five years later. They found that women who slept with a light or television on in the room were 17% more likely to have gained 11 pounds or more during the course of the study. They did not find a similar effect when women used a small night light or had a light on outside the room that shone in. It's not clear why exposure to artificial light was linked with weight gain, but researchers speculated that it might affect sleep quality.

Lifestyle changes may not always be enough to control biologically driven body changes.

You spend hours in the gym every day. You eat nothing but grilled chicken, fish, and salads. Yet the numbers on the scale don't budge — or worse, they slowly creep up, along with your waist measurement.

Welcome to menopause.

"The change" actually does bring changes for many women, including weight gain that can resist even the most diligent efforts to reverse it, says Dr. Fatima Cody Stanford, instructor in medicine at Harvard Medical School.

Ask the doctor

Q. How much sleep do we really need, and what happens if we get too little or too much?

A. We spend about a third of our lives sleeping, so you've asked an important question.