MARCH 1, 2016
Are you getting enough sleep?
You may be surprised to know that not only does your answer indicate whether you feel rested or tired throughout the day, it also has significant implications for your overall health.
Chronic lack of sleep is a significant health and safety risk affecting approximately 70 million Americans, according to the U.S. Centers for Disease Control and Prevention. Sleep deprivation can lead to serious injury or death. According to the National Institutes of Health, drowsy driving contributes to 100,000 car accidents and 1,500 fatalities each year. In fact, research indicates that driving while sleepy is as or more dangerous than driving while intoxicated.
In addition to the obvious dangers of a sleepy person driving or operating heavy machinery, chronic sleeplessness is a known risk factor for numerous serious health conditions. “Getting an adequate amount of sleep on a nightly basis is a key element of a healthy lifestyle,” says Dr. Brad Putty, a Trauma Surgeon. “Insufficient sleep not only makes you less sharp and productive in your daily activity; over time, it can contribute to a host of health problems, including cardiovascular disease, diabetes, obesity, and depression.”
Why We Need Sleep
Along with eating, drinking water and breathing, sleeping is considered a basic human need. Adequate sleep is essential to our physical and emotional health, as well as our mental acuity.
Sleep cycles are regulated by our internal body clock, known as the circadian rhythm. Throughout the day, a compound in the brain called adenosine increases, eventually signaling to the body that the time to sleep again is drawing near. This process is complemented by the natural environment, which also helps tell our body that we need sleep soon. As day becomes night and natural light disappears, our bodies begin to release a hormone called melatonin, which helps to trigger sleep.
There are two main types of sleep – rapid eye movement (REM) and non-REM. Non-REM sleep is the period in which deep sleeping occurs, while dreaming generally takes place during REM sleep. People generally go through three to five REM and non-REM cycles of sleep per night.
How Sleep Protects our Health
When we sleep, our brains prepare themselves for the workload the following day. Sufficient sleep promotes learning, creativity, concentration and problem-solving; lack of sleep hinders those skills. Insufficient sleep over a period of time can adversely affect the brain, compromising our skills. Worse, chronic lack of sleep can contribute to depression, risk-taking behavior and even suicide.
As we sleep, not only does our brain benefit, other parts of our body do, as well. Sleep helps the heart and blood vessels repair themselves. This is one of the reasons that inadequate sleep increases the risk for heart disease.
Additionally, sleep promotes balance in the hormones which affect the appetite. Inadequate sleep can lead to a person feeling hungry, even when the body does not need more food. Sleep also helps regulate insulin levels – insufficient sleep can cause blood sugar levels to rise, increasing the risk of diabetes.
Keys to Getting a Good Night’s Sleep
For many people, improving the duration and quality of their sleep is well within their control. Some of the easiest ways to improve your sleep are:
- Get enough sleep. Adults should sleep between 7-8 hours per night.
- Go to bed and wake up at the same time every day. If you go to bed later and wake up later on the weekends, try to keep the variance from your weekday schedule to one hour or less.
- Keep your bedroom dark and quiet, with the temperature at a comfortable level.
- Don’t eat a large meal right before going to bed. Avoid drinking fluids in the hour before bed so that you don’t have to go to the bathroom in the middle of the night.
- Turn off the TV and put the phone, tablet and computer away. Doctors recommend that you avoid any “screen time” for one hour before going to bed. Just as darkness triggers the release of melatonin, the light from an electronic device can suppress the hormone, making it more difficult to fall asleep.
“One of the problems we see a lot is that too many people are always connected – to their email, their text messages, social media or a TV show – which makes them way too over-stimulated to go to sleep,” says Dr. Sunny Glenn, an OB/GYN. “And when they do go to sleep, their sleep quality is poor because of over-exposure to electronic media.”
Common Sleep Disorders
While many people simply do not get enough sleep due to busy schedules or poor sleep habits, some people who suffer from chronic sleeplessness have a sleep disorder that requires medical attention. The most common sleep disorders are:
Insomnia is the inability to fall asleep or stay asleep. There are two types of insomnia, acute and chronic. Acute insomnia can be triggered by a life event. The common question, “What keeps you up at night?” as a way of asking what someone’s worried about is a reference to acute insomnia. Worry, stress or even excitement over a happy or positive event can interfere with someone’s ability to fall asleep or cause a person to wake up too early. Acute insomnia can sometimes last days or weeks, but it is by definition temporary and will resolve itself in time.
In contrast, chronic insomnia lasts for a month or longer and can be brought on by a separate medical condition, a medication or a sleep disorder. “If you find yourself unable to get enough sleep on a regular basis, you should definitely see a doctor,” according to Dr. Oyeyemi Fabuyi, a Sleep Medicine physician. “A physician can help determine if there is an underlying medical condition causing the insomnia or, if needed, treat the insomnia itself.”
Sleep apnea occurs when a person’s breathing is paused during sleep. The pause may last for a few seconds or longer and ends when the person snorts or gasps. Sleep apnea is often passed off as someone who snores loudly but is actually a serious health condition.
Sleep apnea occurs when the airway becomes blocked. When the brain realizes that there is inadequate oxygen flow into the body, it sends a signal to the throat to choke or snort in order to get air moving again. Blocked airways can occur for different reasons, but one common cause of sleep apnea is obesity, as added fat tissue can constrict the windpipe.
Sleep apnea can be challenging to diagnose, as its symptoms only present when a person is sleeping. Your physician may refer you to a sleep specialist, who can conduct a sleep study to determine the correct diagnosis. A sleep study is generally conducted in a “sleep lab” where patients go to sleep while sensors monitor heart rate, oxygen levels, brain activity and other vital signs. This data helps the physician determine if there is a sleep disorder that needs to be addressed. Alternately, the physician may send the patient home with a portable monitor that will record vitals and sleep patterns.
Sleep apnea can be treated in a variety of ways. In obese or overweight patients, losing extra weight can sometimes resolve the problem without further treatment. Sleeping on the side instead of the back will also help keep the airways open; there are special pillows available that promote side-sleeping. If additional steps are required, a sleep specialist may prescribe a mouthpiece to help keep the airway open. For moderate to severe cases of sleep apnea, a Continuous Positive Airway Pressure (CPAP) device may be used. With a CPAP device, the patient wears a mask that gently blows air into the throat, preventing the airway from closing during sleep.
In some cases, surgery to remove excess tissue in the mouth or throat may be an option to treat sleep apnea. “No matter how sleep apnea is treated, it’s important it be addressed,” says Dr. Todd Samuelson, an Ear, Nose and Throat physician. “If left untreated, sleep apnea can increase the risk of hypertension, diabetes, heart arrhythmia, stroke, diabetes and heart failure. Additionally, patients who have their sleep apnea diagnosed and treated report feeling more rested and healthier.”
Restless Leg Syndrome
Restless Leg Syndrome (RLS) has been described as an unpleasant creeping feeling that originates in the lower legs and causes aches and pains throughout the legs. The painful sensation can interfere with a person’s ability to fall asleep and is relieved by moving the legs. Sometimes, RLS can be caused by a medical condition or medication. Pregnancy and kidney failure are both associated with RLS. RLS is generally treated through lifestyle changes and in some cases, medication.
Change Habits before Medication
“While there are medications available that will help people sleep better, that’s usually not where we start,” says Dr. Mohan Sathyamoorthy, a Cardiologist. “Many people can sleep better simply by going to bed and waking up at the same time each day and avoiding meals and electronic devices before going to bed. And be sure to get between seven and eight hours of sleep per night – your body and your mind need it.”
If these steps don’t improve your sleep, see a physician who can help determine if you have a sleep disorder or another health condition that may be interfering with your sleep. Remember, sleep is how we recover from our day and prepare for the next, so don’t cut corners on your sleep. Make sure you get enough of it – your body and brain will thank you the next day.
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