Sleepless in a strange place: when counting sheep fails.

Many business travelers have found themselves counting every hole in every tile on their hotel room ceiling at night, and then having to keep their eyes open with toothpicks during meetings the next day.

It may be argued by some that the content of some meetings is a natural sedative, but sleep disorders specialist Dr. Jeffrey Lipsitz of the Sleep Disorders Centre of Metropolitan Toronto says there may be other causes to the problem.

"Some studies that have been done have suggested that, on a large scale in North America, sleep/wake issues cost an average of $100 billion a year, including accidents caused by falling asleep at the wheel, lost productivity and increases in health-care costs," he says.

The problem is actually two-fold, says Lipsitz.

The first is in relation to the issue of being sleepless in a hotel room at the end of a business day.

"There are a lot of common factors that disrupt a person's ability to sleep," says Lipsitz.

These things can include the stress of the trip and trying to sleep in unfamiliar surroundings. Anxiety about the trip and having to report back to one's boss afterwards, or simply everyday anxieties, can also have an impact. Indeed, some travel that involves switching time zones can also adversely affect a person's sleep patterns--a condition commonly referred to as jet lag.

"People require a good eight hours of sleep," he says. "For many, however, they'll try and get by with seven or six and even push it to five. They will be staying up late to prepare for the trip, doing work and packing so they're already starting at a deficit. Then consider how complicated the trip is. If it's a couple hours of driving, that's one thing, but when you get to flying some-where like a trip to London, you can see where the circumstances can be more complicated, your performance would suffer at each stage of the journey."

There are also issues involving the intake of caffeine to stay awake. Nicotine, along with other health issues that revolve around smoking, is also a stimulant. Then there are the fatty, nearly indigestible fast foods that are the staple for many a business traveler, says Lipsitz.

Exercise and healthier eating will help, he says. Many hotels offer health club facilities for people who are staying in the hotel. He also recommends eliminating those factors that lead to difficulty sleeping, such as drinking coffee past a certain time and cutting back on one's smoking. Scheduling meetings not to go too late into the evening, in order to provide business people with some "downtime" is also beneficial.

"People should set up regular times for themselves both in going to bed and in waking up," he says.

"Their anxieties should not come to bed with them, either."

Chronic sleepiness can be particularly problematic when one has to drive great distances.

Lipsitz says there have been frequent reports of accidents that have resulted from business travelers and others who have fallen asleep at the wheel.

About one-quarter of people in North America suffer from sleep apnea, for instance, a condition that disrupts a person's breathing when they sleep. A person can wake up tired, unaware they are having a problem breathing at night.

And yet, not enough family doctors are familiar with the symptoms of sleep apnea, know how to diagnose it or where to refer a patient, he says. Seventy per cent of people who suffer sleep problems also fail to report the problem to their family doctors.

"I've had people tell me they've suffered with sleep problems for 10 years," he says. "I've spoken to doctors about sleep disorders several times and I remember, going through medical school, sitting through three one-hour lectures on malaria and not one on sleep disorders. How many people here get malaria? Compare that to the number of people with sleep/wake disorders."

By ANDREW WAREING

Northern Ontario Business