Eyes wide open — insomnia

Brandon Combs calls himself a vampire.

But the 31-year-old Avon resident isn’t sporting pointy teeth and a rivulet of blood leaking from his mouth — he just mimics their night-owl sleep preferences. Combs can’t sleep and has struggled to enter REM-land since he was 13 years old. Most nights he doesn’t go to sleep until between 2 and 4:30 a.m.

“I lay there and look at the ceiling and start counting the divots. I’m at 957 thus far,” he joked — kind of.

Combs’ is one of an estimated 70 million Americans affected by sleep problems and disorders, according to the National Institute of Health. Forty million of those people chronically can’t sleep. Insomnia is the most common sleep complaint and affects at least 1/3 of the population.

The longest Combs’ has ever gone without sleeping is about 74 hours, he said.

“God that sucked. I started getting sick around day two. It wasn’t like I was a tweaker, either — no alcohol, no chemicals — I was just awake.

“Everthing gets fuzzy and tingly. You kind of lose perspective at that point, and it feels like you’re watching a cartoon,” Combs said.

When Combs’ worked as a security guard, his insomnia served as a bonus for his employer — he could stay awake easily through the long night shifts. Now he’s a tattoo artist at Eagle-Vail Ink Lounge — not exactly a 9-to-5 gig, but not a night job, either.

Magic pills?

Even when Combs does sleep, which generally is only possible after swallowing 4 to 8 extra-strength Unisom tablets (you’re supposed to take one pill, Combs said) the sleep isn’t exactly restful. He wakes up fairly often and worries — “about anything — deaths, stress from work, our upcoming move, relationships in general, stuff from my past. I once lost sleep over something I did in the second grade.”

For nearly four years Combs’ took prescription sleeping pills every night. When he moved from Vegas to Vail he decided to get off the prescription pills and started taking over-the-counter sleep aids instead. Combs has no idea if the switch is better for his body, but as a recovering alcoholic, he said he didn’t like the idea of being addicted to the prescriptions. Now, influenced in part by his girlfriend, Combs’ is trying some natural sleep remedies, including teas and herbal supplements. It’s too early to tell if they’ll work for him, he said.

A costly condition

People aren’t exactly counting sheep anymore to help them sleep. Direct costs — money spent on treatment, healthcare services, hospital and nursing care — are estimated at $14 billion annually. Add the indirect costs — work loss, property damage for accidents and transportation to the doctor — and the bill is over $40 billion a year, according to the National Sleep Foundation (www.sleepfoundation.org).

“Women, the elderly and people with chronic health conditions are most at risk for insomnia,” said Beth Bidwell, manager of the Sleep Center at Exempla Lutheran medical center in Wheat Ridge. The sleep center is only one of the two accredited centers in the Denver metro area. Though the six doctors at the center see people with all types of sleep disorders, including narcolepsy and insomnia, their focus is diagnosing and treating sleep apnea, defined as a disorder in which breathing is briefly and repeatedly interrupted during sleep. With a focus on patient education and community awareness, Bidwell said they travel to recreation centers, women’s groups, senior centers and 9Health Fairs to talk about healthy sleep.

Sleep facts The word “insomnia” comes from the Latin in (“no”) and somnus (“sleep”), so it literally means “no sleep” or the inability to sleep. The four major symptoms of insomnia are: — Difficulty falling asleep. — Waking up too early and not being able to fall back asleep. — Frequent awakenings during the night. — Waking up feeling unrefreshed. When insomnia symptoms occur more than a few times a week and impact your daytime functions, you should discuss it with your doctor. *Source: The National Sleep Foundation. For more information check out www.sleepfoundation.org.

Take the T.V. out of the bedroom

There are some simple changes in your daily routine and habits that can help you sleep, Bidwell said.

“(We recommend) things like going to bed at the same time every night and getting up at the same time every morning, no exercise, caffeine or alcohol within three hours of bedtime,” she said.

Watching television in bed is another no-no.

“The flashing lights get through eyelids and disrupts your sleep. You also might be having subtle arousals purely by volume changes when commercials come on. You might not even know it’s happening except you feel tired in the daytime,” Bidwell said.

A cool, dark and quiet environment is the most condusive to sleep, Bidwell said.

There’s no clear cut test to identify insomnia, Bidwell said. When someone comes in complaining of insomnia, the doctors suggest going back to the basics with the healthy sleep tips.

“Right now we live in a world that never turns off — we have the 24-hour Internet; people can stay up all night watching TV. There are so many ways to mess with your sleep,” she said.

A sleep diary is often times helpful Bidwell said. In the diary you keep track of things like what you ate and did before bed, what time you went to bed, what time you got up and what, if anything, woke you in the night.

“We sometimes see a pattern that can be corrected,” Bidwell said.

Often times Bidwell said the doctors will refer a patient with chronic insomnia to a therapist. Behaviorial treatments, which teach you new sleep behaviors, have been shown in some studies to be equally or more effective than sleep medications.

Before Tracee Metcalfe, an internal medicine doctor at Colorado Mountain Medical, will write a patient a prescription for sleeping pills, she said she tries to find out why the person can’t sleep — in part quizzing them about their sleep habits and trying to find out if the insomnia is a result of depression or anxiety, or possibly sleep apnea or restless leg syndrome. Some of her patients have problems sleeping at high altitude, she said.

“Only then I’ll try a sleep aid — they’re just not a good solution because they can be addictive. You shouldn’t use them every night,” Metcalfe said.

Because chronic insomnia has been linked to things like obesity, depression and high blood pressure, Metcalfe said it’s very important to talk about it with your doctor.

Caramie Schnell can be reached at 748-2984 or cschnell@vaildaily.com.

Healthy sleep tips — Avoid naps during the day — even if you’re tired. — Don’t stay in bed for more than 20 minutes after waking up — “It can make the bed a stressful place,” local Internal Medicine Doctor Tracee Metcalfe said. “I suggest getting up and doing something and then coming back when tired.” — Go to bed at the same time every night and get up at the same time every morning. — Don’t exercise less than three hours before bed. — Stay away from laptop computers and computer games before bedtime. — Make sure you’re exposed to bright light during the day. If you work the nightshift, try to make sure you’re around bright light. The minute you leave work put on dark glasses and avoid light exposure before you can get home and get in bed. — Travel or working a late or early shift can disrupt your body’s circadian rhythms, making you unable to get to sleep when you want to. The word “circadian” comes from two Latin words: “circa” for “about” and “dia” for "day." Your circadian rhythms act as internal clocks, guiding such things as your wake-sleep cycle, metabolism and body temperature. *Source: Dr. Tracee Metcalfe, The Sleep Center at Exempla Lutheran Medical Center in Wheat Ridge and The National Sleep Foundation.