It took falling asleep while seeing a patient for Helena dermatologist Jeff Goldes to admit he was seriously sleep deprived.

Luckily for Goldes, that patient was a person he'd known for decades, so the repercussions were minimal -- mainly that his eyes were opened to how severe his lack of sleep had become.

"I was in denial about it," he said. "I realized I had to face reality."

Goldes, 54, had convinced himself he was just like any typical doctor who could fall asleep anywhere after burning the midnight oil. He'd slept at wedding receptions, professional meetings and movies.

"I think it was really embarrassing for my family," Goldes said. "I could fall asleep on concrete."

An annoying side effect was the inevitable snoring, whether he was in the living room watching television or at the theater during an action movie -- not to mention the roar penetrating through the walls of the bedroom.

No rest for the weary

Goldes's story isn't that uncommon. Nearly 30 percent of Americans are habitually snoozing fewer than six hours a night, according to the Center for Disease Control and Prevention. That's far under the recommended seven to nine hours.

Sleep experts with the National Sleep Foundation say when people don't get adequate sleep, the accumulated sleep deficit can be difficult to "pay back" if it becomes too significant.

The resulting sleep deprivation has been linked to health problems such as high blood pressure, negative mood and behavior, decreased productivity and safety issues in the home, on the job and on the road.

LaDawn Whiteside of Helena couldn't drive to Billings in daylight without pulling over to nap along the way.

She had so much neck and upper back pain it felt like she was packing around 20 pounds on her shoulders. Most mornings by 8 a.m. she just wanted to crawl under her desk and go to sleep.

Her children said her nighttime snoring could be heard three houses down.

"I got tired of saying I was tired all the time," she said.

It was never hard for Whiteside, 46, to fall asleep. She would hit the hay by 10 p.m. and would sack out about three seconds after her head hit the pillow. But it wouldn't stay that way.

After she'd spent years walking around in a tired state of consciousness, a sleep study determined Whiteside was waking up every two minutes, all night long.

"My body was always moving and twitching to keep me breathing," Whiteside said.

Studying sleep

One of the first steps to determine remedies for people with sleeping problems is to participate in a sleep study in which they are hooked up to dozens of electrodes measuring oxygen levels, face tension, chest and leg movement, brain waves and pulse. Patients are monitored throughout the night by sleep technicians who record observations and evaluate behaviors.

Sleep allows the brain to slow down so the body can be restored to meet the challenges of the coming day.

Carl Hallenborg, a pulmonologist and sleep physician at St. Peter's Hospital, describes sleep as "the fountain of youth."

While health advocates are pushing fruits, vegetables and exercise, sleep experts are encouraging restorative sleep.

Air seems to be the culprit for many living in a twilight state of fatigue and exhaustion.

"The majority of sleep issues having to do with sleep fragmentation is because of a struggle to breathe," said Yvette Worman, co-owner of Helena Sleep Diagnostics. "This is a problem of mechanics. There is something in the way of air flow."

The illness of obstructive sleep apnea is far more pervasive than doctors once thought.

Obstructive sleep apnea is the most common type of apnea, a condition in which breathing stops repeatedly during sleep. According to the American Sleep Apnea Association, obstructive sleep apnea "is caused by a blockage of the airway, usually when the soft tissue in the rear of the throat collapses and closes during sleep."

Hallenborg said sleep apnea was once thought of as a problem suffered for the most part by those who are morbidly obese, but that has changed.

"Over time, researchers are determining that sleeping issues may be the cause of obesity and not the other way around," Hallenborg said. "Seventy-five percent of people with sleep apnea are thin."

There are a slew of sleep aids available, some over the counter, some prescription and some psychological.

Treating insomnia with medication is the most common treatment for sleep problems, according to the National Sleep Foundation, which also says 25 percent of Americans take some type of medication every year to help them sleep.

Others look to hypnosis.

Patrick Marsolek teaches self-hypnosis for those who want to target specific life changes -- smoking, sports and performance, stress, weight loss and sleep.

"It can be very effective because people learn how to relax and relieve stress," Marsolek said.

'Darth Vader'

One remedy works for more than half of Hallenborg's patients. That is a machine providing continuous positive airway pressure, or CPAP.

The CPAP is a device worn while sleeping that delivers a stream of compressed air to a nasal pillow, nose mask or full-face mask so that unobstructed breathing becomes possible.

It's not the prettiest piece of nightwear and takes some time to get used to.

Whiteside was reluctant to try the CPAP.

"I was afraid," she said. "I didn't want that thing on my face. I didn't want to deal with the inconvenience and routine of it."

Goldes said he tore it off his face screaming the first time he tried it on.

He gave it a second shot just as business hours were closing. He asked his staff not to bother him and locked himself in his office. He was awakened by his family pounding on the outside of the building 10 hours later.

Goldes said since using the CPAP machine he's been "reborn."

"Everything is better," he said. He has lost weight and lowered his blood pressure. "I can participate in life more."

Whiteside's life has dramatically changed, too, and she's accepted the fact that her children call her Darth Vader.

"It makes life better," she said. "I had stopped enjoying life."

The pressure from her neck and shoulders is gone, and her vision has improved because her eyes don't have to work as much to stay open. Mostly, though, Whiteside said she's not depressed anymore.

"Every moment of every day was a struggle because I was tired," she said. "My whole outlook on life is better."

Get some rest

The American Academy of Sleep Medicine says most adults need eight hours of sleep a night, but surveys show that about one in five adults in the U.S. fall short.

Here are some of the academy's tips for getting a good night's sleep:

Establish a regular schedule for going to bed and waking up and try to stick to it on vacations and weekends. This will train your body when to fall asleep.

If you don't fall asleep within 20 minutes, leave the bedroom and do something relaxing like listening to soft music or reading until you feel sleepy.

Create a bedroom that is dark and quiet with the temperature a little cool.

Eliminate distractions like televisions, computers and ticking clocks.

Exercise early in the day, ideally at least six hours before bedtime.

Don't go to bed hungry, but don't eat a big meal late at night.

Avoid drinking alcohol within six hours of bedtime and stay away from coffee and caffeine after lunch.

Nap if you'd like to, but not after 3 p.m.

Make sure your mattress is giving you the right support and comfort. Mattresses become saggy after five to seven years.

Reporter Alana Listoe: 447-4081 or alana.listoe@helenair.com