This has been a big year in sleep. The research and knowledge the public has about the importance of sleep has been mind boggling. I have been amazed at the new ideas shared and the growth of new ideas in therapy.
The connection to sleep deprivation and sleep apnea as an independent contributor to diseases from aging to cancer to diabetes to heart disease and glaucoma has really brought to light that sleep is essential. Some of the connections have to do with the continual decrease in oxygen caused by sleep apnea. Sleep deprivation has contributed to memory issues, and other issues of brain disease.
The use of therapies for sleep apnea and sleep deprivation have improved and take into account changes in lifestyle. The use of weight loss, cognitive behavioral therapy and oral appliances to treat mild apnea and PAP intolerance has improved and become more widely available. The idea that using more than one therapy to treat a person is something that really has helped to look more holistically at sleep disorders.
Some of the research also found that we are constantly walking around sleep deprived. Our teens and young adults are so plugged in that they are texting in their sleep. We have done a poor job of associating sleep with good grades and productivity to our young adults.
But to me the most exciting thing is the number of sites out there to educate people about sleep. Doctors, technologist and therapists have been working on changing the average American's view of sleep and its role in our health.
If we can continue to make sleep a priority and understand how much healthier we will be if we get a good night sleep we will have a great New Year.
For the last several months I have played the role of the caregiver. It feels like somewhere along the line you get lost among the myriad of medications, doctor’s appointments and just the general care and cleaning up. Then there is the isolation and loneliness that comes with it. I did not realize how it sneaks up on you and overcomes you.
As my husband got ready for his surgery and his ultimate progression of his illness to one where he is almost not able to care for himself, I have put my life on hold and forgot to take care of me. It started with little things, putting off exercising then there was not going out to activities and finally I stopped even eating healthy and instead tried to find my pleasure in food. I was so tired at the end of the day trying to do everything for everyone in my family I would fall into bed exhausted only to remember there was more to do.
But what kind of help can I be if I hate coming home, I feel sick all the time and I am always exhausted. This is no way to live a life. There has to be at least a little balance. Sleep cannot be secondary, exercises cannot be secondary and healthy eating and sunlight cannot be secondary. All these things will give the caregiver strength to help those that they love and are helping.
I know today I got up and went for my 1.5 mile wog. I am not fast enough to call it a jog but it made me feel better. It gave me more energy and it reminded me that I need to feel good. I need to feel healthy. I need to sleep better. I need to be able to study for my classes and bring a positive attitude to my students and patients.
Being a caregiver is a hard job. But remember you cannot give what you do not have. Do not stand alone. Reach out and remember there are others out there to help you or at the very least cheer you on.
As you try to change your lifestyle you will find that you do well for a while and then something out of the ordinary happens and you fall back to your old ways. This is true whether you are changing you sleep routine, getting used to PAP therapy or trying to lose weight. Any change comes with setbacks. It is when you look at those setbacks and decide to move past them and start again that you really are making progress.
With PAP it usually comes this time of year when you get a cold or the flu and you just can bot wear your mask. You usually go about 7-10 days which is how long a cold usually takes to pass. Now there is no reason you cannot wear your PAP and turn up the humidifier or maybe use a full face mask instead of a nasal mask or pillows to get through this tough time. But most people just decide to go without and then forget to go back to using their mask. What I can tell you is that it is up to you to start using it again and if you need encouragement ask for it. If not from your family than from a friend or a coach than someone who will be your best cheerleader so you will feel the encouragement of getting healthy. Another trick is to write it down. Journaling during any behavior change will always help you. It gives you visual encouragement but it will also show you the triggers you have when you are not making the change you want.
Holiday season and the children being on vacation are notorious times when sleep routines go out the window. I will never say you should always follow your sleep routine but remember that vacations will be much more fun if everyone is well rested and out brains do not know the difference between holidays and school or work days. There is one thing you can take advantage of during this time. Find out what your natural wake up time is. If my alarm is not set and I go to bed at 10pm I will naturally wake up at 6:30am. If I worked out really hard the day before I will naturally wake up at 7:30am. This allows me to adjust my sleep times to make sure I get the amount of sleep I need. I usually want to wake at 5:30am so I can exercise before work, than I know I need to go to bed at 9pm. This has forced me to learn how to use my DVR so I can record those shows I will miss but want to see.
One of the ways to change your health is to lose weight. This will affect your sleep and if you are on PAP it might help to reduce your pressure or maybe not need it at all. No matter what it will help you to sleep better if you are eating healthier and exercising more. This time of year is brutal on food plans and I will be the first to admit my plan has fallen to the wayside. But making a lifestyle change is as much about the failures and how we handle them as it is about the successes. I have learned through this failure that I tend to want to eat more when I am over tired or when I am experiencing pain. This falls right into the research that is coming out almost weekly about sleep. The problem with the research is they offer no solutions. My solution is simple I turn to friends and I journal so I can see not only what I was craving and eating but if there was a specific activity that triggered the behavior or was there a specific food that trigger the behavior. Then it is right back to what I know makes my body feel healthy.
I find that the more natural the food the better I feel. I also find that I am healthier with a high protein, low processed carb diet. I like apples and yogurt and tomatoes and cucumber as my go to foods. I could probably live on egg whites and chicken given the opportunity. But that is my body and I am sure that others have suggestions as to what makes their body feel like it is working optimally. I would love for you to share your ideas about what you do to feel optimally healthy. Do you do certain exercises, eat a certain way, or get a specific amount of sleep? Any habit that works for you may give someone else an idea to trial. We are a community of people working for optimal health. My goal is to help you add sleep to that routine but any changes that help are always welcome.
A recent study of women found that about 50% of the women in the study had sleep apnea. Other studies show that even mild sleep apnea has a more significant effect on a woman’s health. Yet women are not having sleep studies and worry less about their sleep than men.
If you want to keep your health and you want to get more done pay attention to the symptoms. That mental fog that you may be experiencing could be because you are sleep deprived. The same is true with morning headaches. Sleep deprivation and the changes in oxygen levels throughout the night can cause you to have issues with your memory as well. We all know someone who is constantly misplacing their keys or forgetting appointments. Maybe it is because they are not getting enough sleep on a regular basis.
Our hormones also affect our sleep. The changes in our hormones throughout the month can cause changes in our body rhythms and our body temperature. This can cause temporary insomnia or difficulty maintaining sleep. There are some solutions to this including keeping the room cooler or take a warm shower before bed. This will help you feel cooler and your body to know it is time to sleep.
If you are feeling anxious, nervous or moody it could be that you are feeling sleep deprived. We tend to not get enough sleep. This leads to less of an ability to control emotions. It also can lead to eating more because the part of our brain that says we are full is slower to react. If you do not plan for your 7-8 hours sleep each night than maybe consider taking a 20 minute nap in the afternoon. This will help your to refresh your mind so you can feel clear headed.
Women also tend to have issues with limb movement and cramping. This could be due to hormones, anemia or low levels of vitamins. It can also be contributed to sleep apnea if there are significant awakenings and decreases in oxygen.
As women we have a great deal of responsibility to take care of the family and our jobs. We tend to put ourselves last. Taking care of our health and our sleep actually makes us a great role model for our family and allows us to have the energy we need to get it all done.
You have already figured out that fatigue can be caused from sleep apnea but correcting sleep apnea does not automatically correct fatigue. You have been sleep deprived and had poor sleep for a very long time and you will probably need to take a look at several other things along the way to make sure you have the energy you want to have on a daily level. Let’s look at the main causes of this problem of fatigue and then we will discuss some creative solutions.
The first thing you should do is ask yourself when you are feeling the most fatigue. Are you tired when you get up, in the middle of the afternoon or possibly the early evening? Also does this fatigue last a long time or is it a short transient experience?
· Look at your medications and when you are taking them. If you are taking something for pain it can cause issues 20-30 minutes after you take it and may last several hours. You could also be taking an antidepressant that could be causing you fatigue. Are you taking a cough suppressant again that can be causing fatigue. If you are taking a stimulant too late at night that might preventing you from getting enough sleep.
· Do you have another condition that is robbing you of a restful sleep? Limb movements, GERD and bruxism, also known as teeth grinding, could be causing you to continue to have disrupted sleep and increase your level of fatigue.
· What are you eating and when are you eating it. Is the meal large and high in carbohydrates or protein or is it a moderate sized balanced meal? Do you have diabetes and have issues during certain times of the day or night? All of these could be contributing to your fatigue.
· Are you getting enough exercise?
· Do you have a history of a mood disorder? Many of them can cause issues with sleep patterns and levels of fatigue.
· Have you gotten enough sunlight and vitamin D? This can also contributed to afternoon and evening fatigue.
You have an idea of what could be contributing to your levels of fatigue now let’s look at some solutions to the tiredness you might be experiencing. Some of the solutions can be used as a stop gap to a specific experience and some are habit changes you might want to try and make to help you over the long term.
· Take a minute and do some deep breathing exercises. It can be diaphragmatic breathing or it can be slow inhale, hold and slow exhale. You can do an 8 count of a 4 count whatever deep breathing exercise you try will increase your oxygen level to the brain and help you to feel more energized and focused.
· Go for a walk. This can help with two of the issues. It will allow you to get some sunlight which will stimulate the brain that it is time to be awake and exercise helps to stimulate the body to have more energy. The other great effect is that exercise will allow a person to sleep better.
· Take a nap. A short 20 minute nap will allow you to recharge and reboot your brain so that when you wake up you are able to focus and learn more.
· Talk to your doctor about your medications. Sometimes you can be having a side effect not just to a single medication but it could be the interaction between two medications. Many people have more than one person prescribing medications. It is in your best interest to make sure that your primary care physician knows all the medications you take so they can make sure you’re at optimal health without side effects.
· Get enough sleep. We live in a 24 hour a day world and we are making sleep less of a priority. Some people say well I have never slept longer than 4-5 hours therefore that is all I need. This is just not true. Our body needs 7-8 hours of sleep. You need to plan for that long. If you do not get enough sleep the side effects to your body are significant.
· Get enough water to drink. Chronic dehydration will cause fatigue. A great example of this is that hot summer day at the beach where all you want to do is sleep as soon as you get home. Well imagine your body having that kind of stress all the time. That would cause a great deal of fatigue. So drink enough water you will have more energy.
These are just a few solutions. If you continue to have fatigue you should talk to your doctor. There can be some medical conditions that can cause fatigue. Your doctor can test you for low vitamin level, low iron levels, or anemia, or issues such as chronic fatigue syndrome or fibromyalgia.
No matter what the issues occasionally we all experience fatigue but do not let yourself or your goals get derailed because you continue to have problems with staying awake during the day.
_ Research about sleep and its association with health problems have abound over the past year. Yet even with all this research many people do not know when to approach their doctor if they have questions. Even if they do have questions they wonder when medication will help and when to ask if they need a sleep test. The more informed you are the more likely you will get the care you need.
If you are snoring during the night and it is loud enough to keep someone else awake you should talk to your doctor about having a sleep test. Snoring can be a sign of sleep apnea which is a blockage of the upper airway when you fall asleep. This causes disrupted sleep, increased work of breathing, decreased oxygen levels and increase pressure on the heart. Not everyone who snores has sleep apnea but it is something that should be discussed.
Not everyone who has sleep apnea snores. There are other issues that can be indications of sleep apnea. If you wake up to go to the bathroom more than 2 times a night that is something that you should discuss because it might be sign that you have sleep apnea during REM sleep, or when you dream. If you find yourself tossing and turning all night long than you should tell your doctor when you go in for your yearly physical.
If you are taking medication and you are experiencing insomnia than you should take the time to talk to your doctor. Many medications including over the counter medications have insomnia as a side effect. It can also be the effect of mixing medication or supplements. Whenever you see your physician you should not just tell them what medications you are taking but also any vitamins, supplements or over the counter medications you take. If you have not changed medication than you should keep a sleep diary for 2 weeks before you see your doctor. If there is anything affecting your sleep he or she will be able to have a good idea or you may see something in your routine you can change that will help you to sleep better.
If you are having insomnia issues and they have lasted longer than a few weeks. You might want to talk to a sleep coach or look into cognitive behavioral therapy to help evaluate sleep and to help you to change some of the behaviors that are causing the insomnia. New research has found that CBT is more effective than medication.
Many people who think they are depressed or are very fatigue may have a sleep disorder that they are missing. We many not notice out own snoring or disrupted sleep but we do notice the effects of sleep deprivation. Taking a simple Epworth Questionnaire will let you know if you should have your sleep evaluated due to fatigue. Since this questionnaire is subjective it is very important that you are honest not just with the doctor but with yourself. If you come home from work every night and sit in your recliner and go to sleep even if you slept 7-8 hours that is not normal. If however you get sleepy around 3pm, but you have no real difficulty staying awake, that is a normal part of our body's internal clock and does not need to be evaluated.
The best thing about evaluating your sleep is that if you do have a sleep issue and it is treated you will feel better and have more energy. You may not have known that your sleep was being effected but a little self evaluation is always helpful before visiting your physician. It will help you to keep yourself healthy and have a much more productive time when you do have to see your doctor.
The commercials show a family all smiles enjoying a meal laughing and enjoying great conversation. They all look relaxed happy and well rested. The truth is that the holidays can be a stressful, depressing and hectic time of year. However, with a little planning and setting a few priorities you can enjoy your holidays and not look like you just trained for a marathon.
Make bedtime a priority. You will feel better if you go to bed at the same time every night. This does not mean you should never go out and enjoy a night out with friends, but this should not be an every night. Sleep deprivation will make you fuzzy, grouchy and tired the next day. You can sleep in the next day and you will make up for some of the lost sleep.
Take time to unwind. With all the excitement going on during the holidays we take very little time to relax and unwind. This is the time of year when a sleep routine is most helpful. Take twenty minutes to relax, read a little, journal, an do a little stretching to help you unwind. It will be one of the best ways for you to fall asleep faster.
Get some exercise in the morning. A little physical activity in the morning will help you start off the day with a little more energy. It will be even more helpful if you can spend that time outside. The light and the increase in oxygen and blood flow will help you to be more focused during the day.
Drink your water. Dehydration can keep your mind fuzzy and increase you stress. If you are dehydrated you can also have muscle cramps that can keep you up at night. It is one of the easier things to keep you healthy.
Don't sweat the small stuff. A little planning and the acceptance that some things will go wrong during the holidays will allow you to enjoy the holidays with less stress. The holidays are not about perfect place setting but about laughing and hugging. These will help you to relax and when it is time to go to bed you will find you will be able to fall asleep faster.
The goal of the holidays is to all your to enjoy food, fun and family. Whether it is Thanksgiving, Hanukkah or Christmas take some time out to enjoy it and make sure that you plan your sleep time into your day.
There are so many myths about sleep and so many people who believe that the rules apply to everyone but them. The truth of the matter is that our bodies need so much sleep and they are designed to work with our environment. This includes the fact that it is light out during the day and dark at night. So here are five myths about sleep that everyone thinks do not apply to them and why you should not ignore them.
1. I do not need 7-8 hours of sleep. There are a small group of people who are short sleepers and trust me you probably are not one of them. Life everything 7-8 hours is an average. But our bodies need this much sleep so we can go through the different stages of sleep. If you do not get enough sleep you will not wake refreshed. During the first third of the night you will be in slow wave sleep which is where your body heals and grows. The last part of sleep is when you have your extended REM cycle, when you dream, this allows your brain to reboot. If you wake too early you miss out on the last REM or worse you will wake during it.
2. I need the television on to sleep. This one is so untrue it hurts. Television is actually designed to wake you up by using the flashing of light and dark. If you have a sleep disorder that causes you to wake during the night or that keeps you from maintaining sleep having the television on will keep you from returning to sleep. Again the light will stimulate you and keep you from going back to sleep. You do not need the television to go to sleep. You need a stronger sleep routine prior to going to bed so you can go to sleep faster. If you are waking during the night you should talk to your doctor because it may be a symptom of another issue that is not being treated.
3. If I stay up all night and cram for work, a test or anything I will do better. The truth is our minds move things from short term to long term memory when we sleep. So if you give up sleep you will not recall information as easily or as quickly. Also sleep deprivation causes issues such as poor memory recall and the inability to concentrate.
4. I can make up my missed sleep by sleeping in on the weekends or on weekdays. There is an element of truth to this but our body is not designed to constantly miss sleep and then make it up a week or two weeks later. Our body craves routine. This is why you should have the same bedtime every night. That does not mean you cannot go out once in a while but a routine of regular sleep is what will help you achieve optimal health.
5. Alcohol helps you to sleep better. Although a drink can help you to go to sleep faster over the night it will actually cause disruption of your sleep. Your body goes through a certain cycle of sleep and alcohol keeps the second half of the night from going the way it should. Instead you will have multiple awakenings and will not be able to go into dream stages properly. If you do drink you should stop three hours before going to bed so it will not affect your sleep.
Sleep is probably one of the easiest ways to help you be healthy. However if you do not take it seriously you can develop problems from sleep deprivation. Create your routine, go to bed at the same time each night and make sure you get enough sunlight in the morning and you will soon see that you will have more energy and a sharper mind.