Ronald L. Kotler - 365 Ways to Get a Good Nights Sleep

FOREWORD BY Charles R. Cantor, MD, DABSM,
Medical Director, Penn Sleep Centers

365 WAYS TO
GET A GOOD
NIGHT'S
SLEEP

Ronald L. Kotler, MD, DABSM,
Medical Director, Pennsylvania Hospital Sleep Disorders Center,
and Maryann Karinch

Copyright 2009 by F+W Media, Inc.
All rights reserved.

This book, or parts thereof, may not be reproduced in any form without permission from the publisher; exceptions are made for brief excerpts used in published reviews.

Published by
Adams Media, a division of F+W Media, Inc.
57 Littlefield Street, Avon, MA 02322. U.S.A.
www.adamsmedia.com

ISBN 10: 1-60550-101-8
ISBN 13: 978-1-60550-101-7
eISBN: 978-1-44051-329-9

Printed in the United States of America.

JIHGFEDCBA

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365 Ways to Get a Good Nights Sleep is intended as a reference volume only, not as a medical manual. In light of the complex, individual, and specific nature of health problems, this book is not intended to replace professional medical advice. The ideas, procedures, and suggestions in this book are intended to supplement, not replace, the advice of a trained medical professional. Consult your physician before adopting the suggestions in this book, as well as about any condition that may require diagnosis or medical attention. The author and publisher disclaim any liability arising directly or indirectly from the use of this book.

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To my wife and soul mate, Jane Kotler;
She is always by my side.

To my children, Jennifer Kotler, Rachel Slama, and Drew Kotler;
They have taught me the meaning of unconditional love.

To my parents, Milton Kotler and Marion Kotler;
They have provided me with opportunity.

To my siblings, Kenneth Kotler, Mark Kotler, and Sherry Greenberger;

To my best friend, Dr. David Sherer;

And to all my patients, who have entrusted me with their
greatest gift, the gift of life.

Ron Kotler

To Mom, Karl, and Jim, who ease my mind
so I can get a good nights sleep,

and to Patti, David, Karen, and Judith who provide me with
comfy places to put my head when Im on the road.

Maryann Karinch

Contents

Acknowledgments

Thirty years ago, I entered medical school with a thirst for knowledge of the structure and function of the human body and a desire to apply that knowledge for the benefit of others who would become my patients. As the years passed, I had the good fortune of learning from many brilliant physicians and scientists. One such individual was Dr. Allan Pack at the University of Pennsylvania. Little did I know that Dr. Pack would become a world leader in the evolving science and practice of sleep medicine. In 1987, I had the privilege of joining the staff at Pennsylvania Hospital, the nations first, founded by Benjamin Franklin in 1751.

While my primary focus was as a pulmonary and critical care medicine specialist, I came to the Pennsylvania Hospital with a newfound interest in obstructive sleep apnea syndrome. At Pennsylvania Hospital, I met Dr. Charles Cantor, a neurologist who shared my interest in sleep disorders. Together, in 1991, Dr. Cantor and I started a one-bed sleep center at Pennsylvania Hospital. As interest in sleep medicine grew in the community, so did requests for patient evaluations and sleep studies. Our program rapidly grew to a four-bed sleep center evaluating patients seven nights a week.

Through the years, Dr. Cantor has generously shared with me his knowledge and wisdom. Together we have evaluated and cared for thousands of patients with various sleep disorders. This book is a reflection of the collaborative effort Dr. Cantor and I have shared for over twenty years.

I wish to thank Dr. Alex Mason for his major contribution to this book in the area of children. Through his years of work in the field of pediatric sleep medicine, he has shared important insights regarding younger patients and their parents. I want to thank my highly skilled typist, Florence Nygaard, for her insights. I want to thank my medical partners, Dr. Michael Casey, Dr. Eugene Lugano, and Dr. Paul Kinniry. They have made me a better physician. I wish to acknowledge Dr. James Kearney of Otorhinolaryngology. Dr. Kearney is a talented surgeon who has provided excellent care for many of my patients through the years. He has also contributed valuable insights into the surgical management of snoring.

Lastly, I want to thank my coauthor, Maryann Karinch. She conceived the idea for this book and shared with us her extensive experience in writing multiple other great works on various subjects.

Ron Kotler

Thanks to my mother, Ann, who taught me good sleep habits a long time ago. They seem to have stuck with me. Thank you to Jim for your moral support, patience and insights as I write, write, write. Thank you to my friends who always do what you can to help me rest well.

To my great partner in this adventure, Ron Kotler, who filled this project with intellectual energy and funthanks so much! And I very much appreciate the contributions of Charles Cantor, whose insights helped tremendously in this process, as well as Florence Nygaard, who helped get the manuscript in good order.

For the initial contributions to this work, I want to thank Ron Poropatich, an extraordinary physician and fine gentleman. I also send thanks to Jay Sanders for his keen medical insights, excellent guidance, and marvelous sense of humor. And to David Shererthanks for the reference! Ive always known you to give great advice.

For tremendous support and guidance, I thank Meredith OHayre and Andrea Norville, our editors at Adams Media, where there is a publishing team I regard highly and enjoy every time we go around the block together. I also want to acknowledge Carolyn Wills and Tess Richardson for their wonderful guidance.

Maryann Karinch

Foreword

Most of us take sleep for granted.

As individuals and as a species we have found ways to prolong our waking hours and to reduce the amount of time we spend asleep. For our ancestors, the relative length of the day and night was determined by the rotation of the earth. But we in the twenty-first century have uncoupled ourselves from this fundamental natural rhythm with artificial light, caffeine and medications, which allow us to manipulate our periods of sleep and wakefulness.