Sleep – Medcine Shoppe in Norton

http://medicineshoppenorton.us You're not just a patient; you're part of the family. Mon, 08 Apr 2013 16:41:46 +0000 en-US hourly 1 https://wordpress.org/?v=5.5.14 Eight Hours: Myth or Reality? How Much Sleep Do You Really Need? http://medicineshoppenorton.us/eight-hours-myth-or-reality-how-much-sleep-do-you-really-need/ Wed, 19 Jul 2006 20:45:39 +0000 http://medicineshoppenorton.us/?p=303 By Michael Breus, PhD, ABSM

and Stuart J. Meyers, MD

If the sleep fits…

Although many factors influence how much sleep you really need, most young adults report sleeping about seven and a half hours on weekday nights and eight and a half hours on weekend nights. And the common recommendation is eight hours a night. But individual needs vary greatly. There are so-called short-sleepers and long-sleepers — those who need as little as five and a half hours to as much as about nine and a half hours.

How much sleep you require depends on several factors including:

Your inherited genetic need

Your sleep hygiene (those daily activities you control, from drinking coffee or alcohol to smoking and exercise)

The quality of your sleep

Your 24-hour daily cycle known as the circadian rhythm

For example, smoking, drinking, and exercise can affect your sleep dramatically. What you actually do in bed (like reading or watching TV) and how much exposure to light you have (looking at that bright computer screen til midnight) will also significantly alter both the quality and quantity of your sleep. They all interact to determine how long you need to sleep to wake up feeling refreshed and remain alert throughout the day.

How did we get the age-old recommendation that we need a solid eight hours of sleep? In a classic study, researchers placed a volunteer in windowless, light-controlled room for 30 days. The light was on for 16 hours and off for eight hours, but the study participant could also turn the lights on and off at will.

Before the experiment began, the subject routinely got about six and a half hours of sleep. During the first night of the experiment he slept eight hours, the second night 10 hours, the third night 12 hours, and the fourth night 14 hours. Over the next several days, he began to reduce the number of hours slept, eventually falling to a steady eight hours and 13 minutes. This experiment was performed repeatedly with all types of people, with similar results, and this is where the recommendation of eight hours comes from.

Your Sleep Debt

OK, so how do you determine how much sleep you really need?

First, let’s look at your bank account — your sleep bank account, that is — and see if you have a debt to pay. Throughout the day, you take out about eight hours from this account, generating a sleep debt. Over the course of the night, as you snooze, you replenish your account. If you sleep only, say, six and a half hours, you still owe one and a half hours. If you do this for five nights in a row, you have lost an entire night’s sleep! You will then need extra sleep over the next few days to replenish your sleep debt.

How much sleep do you get — do you have a sleep debt? Do this simple test: Starting on a Sunday, do not drink alcohol or caffeine; do not smoke; go to sleep about the same time every night; and get an uninterrupted seven to eight hours of sleep for the next six nights. Then, on Saturday morning, sleep in. See how long your body will let you sleep. If you sleep longer than you did during the week — then you have a sleep debt. So you should consider getting more sleep each night to replenish that sleep debt. Hey, not so easy, you say. Well, give it a try and do the best you can. Why?

Not getting the proper amount of and the best quality sleep may have serious consequences. Many studies have shown that sleep deprivation adversely affects performance and alertness. Reducing sleep by as little as one and a half hours for just one night reduces daytime alertness by about one-third. Excessive daytime sleepiness impairs memory and the ability to think and process information, and contributes to a substantially increased risk of sustaining an occupational injury.

The bottom line is that you should wake up feeling relatively refreshed, and you should generally not feel sleepy during the day. If this is not the case, you may have an unrecognized sleep disorder and should see your doctor or a sleep specialist.

Medically Updated: July, 2006

Published April 1, 2003

SOURCES: Sleep Medicine, Kryger, Meir, et al., Third Edition, 2000. Sleep: “Excessive Daytime Sleepiness and risk of Occupational Injuries in Non-shift Daytime Workers,” Vol. no. 3. Sleep: “Dose-response Relationship Between Sleep Duration and Human Psychomotor Vigilance and Subjective Awareness,” Vol. 22, No. 2. Sleep: “We Are Chronically Sleep Deprived,” Vol. 18 No. 10. The Promise of Sleep, by William Dement.

]]> 10 Tips to Get Better Sleep Set yourself up to get a good night’s sleep. http://medicineshoppenorton.us/10-tips-to-get-better-sleep-set-yourself-up-to-get-a-good-nights-sleep/ Wed, 21 Jan 2004 20:43:58 +0000 http://medicineshoppenorton.us/?p=301 By Michael Breus, PhD, ABSM

and Stuart J. Meyers, MD

We all have trouble sleeping from time to time. But you can make it easier to get a good night’s sleep every night with these simple steps.

Cut caffeine. Simply put, caffeine can keep you awake. It can stay in your body longer than you might think — up to about 14 hours. So if you drink a cup of coffee at noon and are still awake at midnight, that might be the reason. Cutting out caffeine at least four to six hours before bedtime can help you fall asleep easier. If you have already had too much caffeine, try eating some carbohydrates like bread or crackers to help reduce the effects.

Drink alcohol in moderation. Alcohol may initially help you fall asleep, but as your body clears it from your system, it can also cause symptoms that disturb sleep, like nightmares, sweats, and headache. Drink one glass of water for every alcoholic beverage consumed to try to reduce these symptoms.

Relax before bedtime. Stress not only makes you miserable, it wreaks havoc on your sleep. Develop some kind of pre-sleep ritual to break the connection between all the day’s stress and bedtime. These rituals can be as short as 10 minutes or as long as an hour.

Some people find relief in making a list of all the stressors of the day, along with a plan to deal with them — this can act as “closure” to the day. Combining this with a period of relaxation — perhaps by reading something light, meditating, aromatherapy, light stretching, or taking a hot bath — can also help you get better sleep. And don’t look at the clock! That “tick-tock” will just tick you off.

Exercise at the right time for you. Regular exercise can help you get a good nights sleep. The timing and intensity of exercise seems to play a key role in its effects on sleep. If you are the type of person who gets energized or becomes more alert after exercise, it may be best not to exercise in the evening. Regular exercise in the morning even can help relieve insomnia, according to a recent study.

Keep your bedroom quiet, dark, and comfortable. For many people, even the slightest noise or light can disturb sleep — like the purring of a cat or the light from your laptop or TV. Use earplugs, window blinds or curtains, and an electric blanket or air conditioner — everything possible to create an ideal sleep environment. And don’t use the overhead light if you need to get up at night; use a small night-light instead. Ideal room temperatures for sleeping are between 68 and 72 degrees Fahrenheit. Temperatures above 75 or below about 54 can disrupt sleep.

Eat right, sleep tight. Try not to go to bed hungry, but avoid heavy meals before bedtime. An over-full belly can keep you up. Some foods can help, though. Milk contains tryptophan, which is a sleep-promoting substance. Other foods that help promote sleep include tuna, halibut, pumpkin, artichokes, avocados, almonds, eggs, bok choy, peaches, walnuts, apricots, oats, asparagus, potatoes, buckwheat, and bananas.

Also, try not to drink anything after 8 p.m. This can keep you from getting up to use the bathroom during the night.

Restrict nicotine. Having a smoke before bed — although it feels relaxing — actually puts a stimulant into your bloodstream. The effects of nicotine are similar to those of caffeine. Nicotine can keep you up and awaken you at night; it can stay in your body as long as 14 hours. It should be avoided particularly near bedtime and if you wake up in the middle of the night.

Avoid napping. Napping can only make matters worse if you usually have problems falling asleep. If you do nap, keep it short. A brief 15-20-minute snooze about eight hours after you get up in the morning can actually be rejuvenating.

Keep pets off the bed. Does your pet sleep with you? This, too, may cause you to awaken during the night, either from allergies or pet movements. Fido and Fluffy might be better off on the floor than on your sheets.

Avoid watching TV, eating, and discussing emotional issues in bed. The bed should be used for sleep and sex only. If not, you can end up associating the bed with distracting activities that could make it difficult for you to fall asleep.

Published January 26, 2004

]]> Sleep Dos & Don’ts “Sleep Hygiene” Solutions for Better Sleep http://medicineshoppenorton.us/sleep-dos-donts-sleep-hygiene-solutions-for-better-sleep/ Tue, 01 Apr 2003 20:48:32 +0000 http://medicineshoppenorton.us/?p=307 From having occasional difficulty sleeping to insomnia, there is a lot you can do to get a better night’s sleep, feel refreshed when you awake, and remain alert throughout the day. It’s called “sleep hygiene” and refers to those practices, habits, and environmental factors that are critically important for sound sleep. And most of it is under your control.

There are four general areas important to sleep hygiene:

Our circadian rhythm, or 24-hour cycle

Aging

Psychological stressors — those factors that can cause difficulty falling asleep and disturb the quality of your sleep.

Common social or recreational drugs like nicotine, caffeine, and alcohol

Circadian Rhythm

We all have a day-night cycle of about 24 hours called the circadian rhythm. It greatly influences when we sleep and the quantity and the quality of our sleep. The more stable and consistent our circadian rhythm is, the better our sleep. This cycle may be altered by the timing of various factors, including naps, bedtime, exercise, and especially exposure to light (from traveling across time zones to staring at that laptop in bed at night).

Aging

Aging also plays a role in sleep and sleep hygiene. After the age of 40 our sleep patterns change, and we have many more nocturnal awakenings than in our younger years. These awakenings not only directly affect the quality of our sleep, but they also interact with any other condition that may cause arousals or awakenings, like the withdrawal syndrome that occurs after drinking alcohol close to bedtime. The more awakenings we have at night, the more likely we will awaken feeling unrefreshed and unrestored.

Psychological Stressors

Psychological stressors like deadlines, exams, marital conflict, and job crises may prevent us from falling asleep or wake us from sleep throughout the night. It takes time to “turn off” all the noise from the day. No way around it. If you work right up to the time you turn out the lights, or are reviewing all the day’s events and planning tomorrow (sound familiar?), you simply cannot just “flip a switch” and drop off to a blissful night’s sleep.

One must develop some kind of pre-sleep ritual to break the connection between all the stress and bedtime. This is perhaps even more important for children. These rituals can be as short as 10 minutes or as long as an hour. Some find relief in making a list of all the stressors of the day, along with a plan to deal with them, as it serves to end the day. Combining this with a period of relaxation, perhaps by reading something light, meditating, or taking a hot bath can also help you get better sleep. And don’t look at that clock! That tick-tock will tick you off.

Social or Recreational Drugs

Social or recreational drugs like caffeine, nicotine, and alcohol may have a larger impact on your sleep than you realize. Caffeine, which can stay in your system as long as 14 hours, increases the number of times you awaken at night and decreases the total amount of sleep time. This may subsequently affect daytime anxiety and performance. The effects of nicotine are similar to those of caffeine, with a difference being that at low doses, nicotine tends to act as a sedative, while at high doses it causes arousals during sleep.

Alcohol may initially sedate you, making it easier to fall asleep; however, as it is metabolized and cleared from your system during sleep, it causes arousals that can last as long as two to three hours after it has been eliminated. These arousals disturb sleep, often causing intense dreaming, sweating, and headache. Smoking while drinking caffeine and alcohol can interact to affect your sleep dramatically. These sleep disturbances may be most apparent upon awakening, feeling unrefreshed, groggy, or hungover.

It is important to realize that not getting the proper amount of and the best quality sleep may have serious short-term and long-term consequences. Many studies have shown that sleep deprivation adversely affects performance and alertness.

Reducing sleep by as little as one and a half hours for just one night reduces daytime alertness by about one-third. Excessive daytime sleepiness impairs memory and the ability to think and process information, and carries a substantially increased risk of sustaining an occupational injury. Long-term sleep deprivation from sleep disorders like apnea have recently been implicated in high blood pressure, heart attack, and stroke.

All that said, here are some sleep hygiene tips to help you relax, fall asleep, stay asleep, and get better sleep so that you wake up refreshed and alert.

Avoid watching TV, eating, and discussing emotional issues in bed. The bed should be used for sleep and sex only. If not, we can associate the bed with other activities and it often becomes difficult to fall asleep.

Minimize noise, light, and temperature extremes during sleep with ear plugs, window blinds, or an electric blanket or air conditioner. Even the slightest nighttime noises or luminescent lights can disrupt the quality of your sleep. Try to keep your bedroom at a comfortable temperature, not too hot (above 75 degrees) or too cold (below 54 degrees), as it can disrupt your sleep as well.

Try not to drink fluids after 8 p.m. This may reduce awakenings due to urination.

Avoid naps, but if you do, make it brief,no more than about 25 minutes about eight hours after you awake. But if you have problems falling asleep, then no naps for you.

Do not expose your self to bright light, if you need to get up at night. Use a small night-light instead.

Nicotine is a stimulant and should be avoided particularly near bedtime and upon night awakenings. Having a smoke before bed, may feel relaxing, but it is actually putting a stimulant into your bloodstream.

Caffeine is also a stimulant and is present in coffee (100-200 mg), soda (50-75 mg), tea (50-75 mg),, and various over-the-counter medications. Caffeine should be discontinued at least four to six hours before bedtime. If you consume large amounts of caffeine and you cut yourself off too quickly, beware; you may get headaches that could keep you awake.

Although alcohol is a depressant and may help you fall asleep, the subsequent metabolism that clears it from your body when you are sleeping causes a withdrawal syndrome. This withdrawal causes awakenings and is often associated with nightmares and sweats.

A light snack may be sleep-inducing, but a heavy meal too close to bedtime interferes with sleep.

Do not exercise vigorously just before bed, if you are the type of person who is aroused by exercise. If this is the case, it may be best to exercise in the morning or afternoon (preferably an aerobic workout, like running or walking).

Does your pet sleep with you? This, too, may cause arousals from either allergies or their movements in the bed. Thus, Fido and Kitty may be better off on the floor than on your sheets.

Good sleep hygiene can have a tremendous impact upon getting better sleep. You should wake-up feeling refreshed and alert, and you should generally not feel sleepy during the day. If this is not the case, poor sleep hygiene may be the culprit, but it is very important to consider that you may have an unrecognized sleep disorder. Many, many sleep disorders go unrecognized for years, leading to unnecessary suffering, poor quality of life, accidents, and great expense. Since it is clear how critical sound sleep is to your health and well-being, if you are not sleeping well, see your doctor or a sleep specialist.

Medically Updated: July, 2006

Published April 1, 2003

]]> Sleep: More Important Than You Think Chronic Sleep Deprivation May Harm Health http://medicineshoppenorton.us/sleep-more-important-than-you-think-chronic-sleep-deprivation-may-harm-health/ Tue, 01 Apr 2003 20:47:03 +0000 http://medicineshoppenorton.us/?p=305 By Michael Breus, PhD, ABSM
and Stuart J. Meyers, MD

Not sleeping enough and not sleeping well is not OK. As a matter of fact, there is quite a price to pay. It may surprise you to learn that chronic sleep deprivation, for whatever reason, significantly affects your health, performance, safety, and pocketbook.

There are many causes of sleep deprivation. The stresses of daily life may intrude upon our ability to sleep well, or perhaps we trade sleep for more work or play. We may have medical or mental-health conditions that disrupt our sleep and be well aware that we are sleep-deprived.

However, it is critically important to realize that sleep deprivation is very often due to unrecognized sleep disorders. After a typical night’s sleep, you may not feel restored and refreshed and be sleepy during the day, but be totally unaware that you are sleep-deprived or have a sleep disorder. You might think, “it’s just the stress of work or the kids,” or you might have “always felt this way” and had no idea that you should feel differently. This lack of awareness compounds the consequences, because so many people remain undiagnosed for years.

That said, let’s look at the consequences of sleep deprivation.

In the short term:

Decreased Performance and Alertness: Sleep deprivation induces significant reductions in performance and alertness. Reducing your nighttime sleep by as little as one and a half hours for just one night could result in a reduction of daytime alertness by as much as 32%.

Memory and Cognitive Impairment: Decreased alertness and excessive daytime sleepiness impair your memory and your cognitive ability — your ability to think and process information.

Stress Relationships: Disruption of a bed partner’s sleep due to a sleep disorder may cause significant problems for the relationship (for example, separate bedrooms, conflicts, moodiness, etc.).

Poor Quality of Life: You might, for example, be unable to participate in certain activities that require sustained attention, like going to the movies, seeing your child in a school play, or watching a favorite TV show.

Occupational Injury: Excessive sleepiness also contributes to a greater than two-fold higher risk of sustaining an occupational injury.

Automobile Injury: The National Highway Traffic Safety Administration (NHTSA) estimates conservatively that each year drowsy driving is responsible for at least 100,000 automobile crashes, 71,000 injuries, and 1,550 fatalities.

The good news for many of the disorders that cause sleep deprivation is that after risk assessment, education, and treatment, memory and cognitive deficits improve and the number of injuries decreases.

In the long term, the clinical consequences of untreated sleep disorders are large indeed. They are associated with numerous, serious medical illnesses, including: High blood pressure

Heart attack

Heart failure

Stroke

Obesity

Psychiatric problems, including depression and other mood disorders

Mental impairment

Attention Deficit Disorder (ADD)

Fetal and childhood growth retardation

Injury from accidents

Disruption of bed-partner’s sleep quality

Poor quality of life

Studies show an increased mortality risk for those reporting less than either six or seven hours per night. One study found that reduced sleep time is a greater mortality risk than smoking, high blood pressure, and heart disease. Sleep disturbance is also one of the leading predictors of institutionalization in the elderly, and severe insomnia triples the mortality risk in elderly men.

Remarkably, sleep loss may also be a contributing factor to obesity. John Winkelman, MD, PhD, medical director of the Sleep Health Center at Brigham and Women’s Hospital and assistant professor of psychiatry at Harvard Medical School sums up this finding up nicely: “What most people do not realize is that better sleep habits may be instrumental to the success of any weight management plan.” And Michael Thorpy, MD, director of the Sleep-Wake Disorders Center at Montefiore Medical Center in New York adds, “Any American making a resolution to lose weight … should probably consider a parallel commitment for getting more sleep.”

It is also important to realize the huge scope and prevalence of these disorders; more than 85 sleep disorders are recognized by the American Sleep Disorders Association, affecting more than 70 million Americans. Up to one-third of Americans have symptoms of insomnia; however, less than 10% of those are identified by primary care physicians. Sleep-related breathing disorders represent a spectrum of abnormalities that range from simple snoring to sleep apnea (repeated episodes of cessation of breathing during sleep). As highly prevalent as they are, most cases remain undiagnosed and untreated.

Chronic snoring, for example, is associated with an increased incidence of heart and brain-related diseases. It is present in about 45% of the US population, with up to half of those affected having sleep apnea.

The prevalence of sleep apnea is on par with diabetes and asthma. Twenty-four percent of adult men and nine percent of adult women, or more than 20 million Americans, are estimated to have some degree of obstructive sleep apnea. Only a fraction of these have been diagnosed and treated by a physician.

Sleep apnea is a primary risk factor for high blood pressure; as many as 40% of those people are undiagnosed and untreated for high blood pressure. Effective treatment of sleep apnea in patients with high blood pressure leads to a substantial reduction in stroke risk.

Patients with moderate to severe sleep apnea perform as poorly as drunk drivers and have up to a 15-fold increased risk of motor vehicle accidents.

With the wealth of information and treatment options available for sleep deprivation, much of the suffering, illness from the many related diseases, increase in accident rates, and effects on productivity, performance, concentration, and memory can be avoided. Increased awareness is the first step, for us individually and the healthcare community. Some researchers suggest that sleep deprivation should be recognized with the same seriousness that has been associated with the societal impact of alcohol.

Medically Updated: March 2006

Published April 1, 2003

SOURCES: Sleep: “We Are Chronically Sleep Deprived,” Vol. 18 No. 10. Sleep Medicine, Kryger, Meir, et al., Third Edition. 2000. Sleep: “Excessive Daytime Sleepiness and Risk of Occupational Injuries in Non-shift Daytime Workers,” Vol. No. 3. Heart Disease , Vol. 4 No. 5. Sleep “The Cost of Sleep-Related Accidents,” Vol. 17, No. 1. National Center on Sleep Disorders Research. Sleep: “Health Care Utilization in the 10 Years Prior to Diagnosis in Obstructive Sleep Apnea Syndrome Patients,” Vol. No. 22. Journal of Clinical Hypertentions, Vol. 4 No. 6. Journal of the American Board of Family Practice, Vol. 15 No. 2. Sleep: “Sleepiness-Related Accidents In Sleep Apnea Patients,” Vol. 23 No. 3. AM Rev Respir Dis: “Automobile Accidents Involving Patients with Obstructive Sleep Apnea,” Vol. 138. Am J Respir Crit Care Me: “Simulated Driving Performance in Patients With Obstructive Sleep Apnea,” Vol. 154. Circulation: “Effect of Nasal Continuous Positive Airway Pressure Treament on Blood Pressure in Patients with Obstructive Sleep apnea,” Vol. 107. News release, “Planning to Lose Weight in the New Year? Experts Say, Think Sleep. Studies Show Sleep Loss May Sabotage Success of No.1 Resolution,” Sanofi-Synthelabo Inc. , Columbia University, Dept.of Otolaryngology, Head and Neck Surgery web site http://www.entcolumbia.org/osa.htm

]]>