Good Night, Sleep Right!
by Jessica Park
As a kid, you resisted going to bed. Now that you’re grown up, you set your own bedtime, but when it comes to how much sleep you need, your body still makes the rules. Sleep lets your body and brain restore itself so you’re ready to go the next day. And, like a balanced diet and regular exercise, sleep is vital for a healthy lifestyle.
“If you are sleep-deprived, you are neglecting a major component of your health,” says Tareq Abu-Salah, MD, a sleep medicine specialist with Boone Pulmonary Clinic. Sleep medicine specialists diagnose and treat patients with insomnia, sleep apnea, restless legs disorder, sleepwalking, narcolepsy, and other conditions that disrupt sleep.
Most adults need about 7 to 8 hours of sleep every night, but most of us don’t get enough. Ambitious schedules, stress and electronic devices make it easy to skimp on sleep.
Interrupted sleep also makes you exhausted. During sleep, your brain cycles through different stages, including REM and deep sleep. When your brain wakes up, your cycle is interrupted and you can miss those restorative sleep stages.
Too little sleep can affect your mood, judgment, decision-making and concentration. Poor sleep can also make you gain weight, because it affects the hormones that regulate appetite.
“Sleep deprivation makes people hungry all the time,” Dr. Abu-Salah explains. “It's difficult to lose weight when you are sleep-deprived. You mainly crave junk food when you are sleep-deprived, not healthy food.”
Sleep deprivation also increases your risk for heart disease, high blood pressure, depression, stroke, diabetes and raises the likelihood of getting into an accident at work or behind the wheel.
Practice Good Sleep Hygiene
Better sleep habits can help you get the rest you need.
“One thing that will help you have a good quality of sleep is to have a fixed schedule for sleep, going to bed and getting up at the same time, and giving yourself anywhere from 7 to 8 hours of sleep at night,” Dr. Abu-Salah says. He also advises not changing your schedule on weekends, not sleeping in for longer than an hour on your days off, and avoiding naps during the day.
Limit caffeinated drinks in the afternoon and evening.
Avoid drinking alcohol a few hours before bedtime, because alcohol may make you drowsy, but will later interrupt your sleep. Dr. Abu-Salah explains that if you have your last drink around 9 p.m., hours after the alcohol is metabolized, it produces a stimulant effect, leaving you wide awake at 4 a.m.
Create a quiet, comfortable environment in your bedroom. Block out as much outside noise and light as you can.
Build and keep a strong mental association between your bedroom and sleep. Don’t watch TV, study, work or surf the Internet while in bed. And if you find it hard to fall asleep right away, don’t keep tossing and turning.
Dr. Abu-Salah says, “One of the most important things we tell patients is, if they can’t fall asleep within 15 to 20 minutes, instead of staying in bed with their mind racing from one topic to another, they need to get out of bed, go to a different room, sit down and read a book that they don’t find exciting. Once they start dozing off, then they can go back to bed. This way, their mind connects the bed only with sleeping.”
Sleep Apnea
Health conditions can also disrupt your sleep. Obstructive sleep apnea is the most common sleep-related breathing disorder. If you have sleep apnea, your airway is obstructed, partially or completely, for short, recurring episodes during sleep. People with severe sleep apnea can have several hundred episodes a night. These episodes reduce the amount of oxygen in your blood, causing your brain to wake up so you can get more air. While you may not know you’re waking up, your sleep is still interrupted and you’ll wake up feeling unrefreshed.
“Think of a mother who has just had a baby,” Dr. Abu-Salah says. “Although she may technically be in her bed for 7 to 8 hours, she feels tired in the morning because her sleep was interrupted.”
Untreated sleep apnea can lead to life-threatening cardiovascular conditions, including higher risk of stroke, metabolic conditions, and psychological disorders like depression and insomnia. While snoring and excessive daytime sleepiness are common symptoms, a sleep study is required to definitively diagnose sleep apnea.
Diagnosing Sleep Disorders
Dan Custer, Boone Hospital Center neurodiagnostics supervisor, has been with the sleep lab since it opened in the early 1980s. In the sleep lab’s control room, he pulls up a screen with results from a recent sleep study.
“In the beginning, everything was recorded by hand, on specialty paper the size of this desktop. Each sheet recorded 30 seconds,” Custer says. “Back then, this room would’ve been filled with paper.”
Instead of a thick book of paper, Custer points to an array of color-coded graphs on his monitor: “The patient is awake here; they fall asleep here; and they start having an event here. When their oxygen saturation falls 4% or greater, see how their EEG picks up as they’re aroused from sleep.”
An outpatient sleep study, or polysomnography, measures brain wave activity, heart rhythm, eye movement, muscle activity, air flow, oxygen saturation, body position, and snoring. This intensive study requires an overnight stay, attended by a certified polysomnography technician. Many sleep disorders can be diagnosed with this study.
At Boone Hospital’s sleep lab, you stay overnight in a private room with an adjustable Sleep Number® bed and private bathroom. Before falling asleep, you can watch TV or use Wi-Fi. One thing you won’t find in a sleep study room – an alarm clock:
“We don't want our patients watching the clock. That impairs their ability to sleep,” Custer explains. “We try to make the experience as comfortable as we can. People might think, when we put wires on them, that they're not going to get a good night's sleep here, but a lot of people report that they sleep better on the night they stay in the sleep lab. And if they need any help, there's always somebody here for them.”
Sleep apnea can also be diagnosed with an at-home sleep study. For an at-home study, you visit Boone Hospital’s sleep lab to practice wearing and using the home recording equipment, which records airflow, oxygen saturation, pulse and snoring. After a night or two of sleeping in your own bed, you return the equipment to the hospital and have your data collected for review. After you have a sleep lab or at-home study, the technologist prepares your results for a board-certified sleep medicine physician to review so they can diagnose and discuss any necessary follow-up care.
Boone Hospital’s sleep lab also provides sleep apnea treatment with continuous positive airway pressure (CPAP) titration to determine the right amount of pressure for a personal CPAP device. A polysomnography technician sees in real-time how you respond to treatment and can make immediate adjustments so you sleep better.
Having literally seen the effects of poor sleep on others, Custer recognizes the importance of sleep for a healthy lifestyle: “Some people think if you get less sleep, they’re actually doing the right thing. They think they can get by on 5 hours of sleep, but most people can't. Over time that gets them in trouble.”
If you have problems going to sleep, staying asleep or staying awake during the day, even with 7 to 8 hours of sleep and lifestyle changes, talk to your doctor. If needed, your primary care physician can refer you for a sleep study.