There was an article recently that stated that 9 million people are receiving prescriptions for sleeping pills.  This shows the true issue with healthcare in America.  We want an instant solution and we do not want to do any work.  We also do not consider that medication does not give us the same type of sleep natural sleep gives the body. 

The issue is why do we need to take pill to sleep and is there another solution that works just as well as a pill? I am not saying that there is not a reason for some people to take sleep medication.  But it should not be the first choice to treat, poor sleep and fatigue.  The physician treats disease and disorder they do not promote wellness.  It is most likely that your doctor is as tired and has as poor sleep habits and is walking around as fatigued as their patients. 

The first step is to decide if you have a sleep disorder?  If you have an answer to the STOPBANG survey of greater than 3 than you need to talk to your doctor:

1. Do you SNORE loudly (louder than talking or loud enough to be heard through closed doors)?
2. Do you often feel TIRED, fatigued, or sleepy during daytime?
3. Has anyone OBSERVED you stop breathing during your sleep?
4. Do you have or are you being treated for high blood PRESSURE?
5. BMI more than 35?
6. AGE over 50 years old?
7. NECK circumference > 15.75 inches?
8. Male GENDER?
 

The next step is to look at your sleep routine.  Our brains are computers in that they need a routine to slow down and allow our body to release the hormones that promote sleep.  A routine is not put on my pajamas and go to bed.  It should be 20-45 minutes prior to going to bed.  It also should generally occur 7 days a week at the same time each night.  Our brain does not know weekdays and weekends it just knows the 24 hours of the day.  Choose a specific bedtime.  Do the same activities each night for the 45 minutes prior to going to sleep.  These should be activities that will help you to unwind.  I do ten minutes of yoga because it helps me to relax and allows me to concentrate on my breathing so my mind will stop racing with ideas.  Create a routine that works for you that does not include television or computers.

Electronics are the new biggest issue to increase our inability to sleep.  Cell phones need to be away from the bed.  The light stimulates the brain to not release Melatonin.  In order for our brains to transition from wake to sleep we need exposure to dark.  Cell phones prevent that.  When we check our cell phones during the night we again stimulate the brain confusing it as to whether they it is supposed to be awake or asleep. 

Exercise is another factor to help sleep.  Studies show that exercise over the long term helps to increase sleep and its quality.  That means that if you work out in the morning it might not help with that particular night’s sleep but that if you work out three days a week for a month your sleep will start to improve.  You have to decide what exercise you can fit into your life.  There is no right or wrong it is about increased movement. 

There are many other ways to help you improve your sleep without turning to a pill as your first resource.  It is essential that we look at healthcare for what it is disease management not wellness management.  It is important for you to do your research and to understand how important it is for you to make an informed decision about healthy sleep and how you can achieve it.  If ultimately you need it than a sleeping pill might help.  Just remember pills have side-effects you may not be aware of. 

We talk about living healthier, exercising and eating whole foods.  We still do not take sleep and a sleep routine seriously.  We are still looking for the instant pill or the idea that will say that less sleep is better.  What the studies say is that poor sleep contributes to health issues across the board. 

·         The studies that lead to contribution to colon, prostate and breast cancer all involve both sleep deprivation and sleep disorders that prevent sound sleep.  These to conditions can be helped with therapy and possible treatment of a sleep disorder.

·         Studies have shown that children have difficulty learning and learning proper behavior due to poor sleep, lack of sleep and snoring.  We really do need to teach our children and teens that sleep is as important to health and good grades as studying.

·         Studies have proved that we still only help 20% of those with sleep disorders.  However that does not include the family that was affected by the disorder.  If husband or wife cannot sleep because of loud snoring, leg movements or acting out dreams than you have more than one person affected and we need to consider all who are affected as patients.  Sometimes the treatment may be time and space.

·         Weight and sleep are interconnected.  This is the vicious cycle the higher your weight the worse sleep disorder breathing will be, the worse the sleep disorder breathing the more difficult the body has at maintaining weight. 

With all those issues you would think insurance companies and doctors would be asking more sleep questions and explaining proper sleep.  The issue is they are not educated in the importance of proper sleep.  In fact if you look at a medical student’s time you will see they do not live what they preach.  This is a time where you need to take control.  You need to go to your doctor with written questions, maybe a three to four day diary with symptoms. 

Explain your desire to not just take a pill but to truly fix the problem and you may get some strong feedback.  Doctors like to know a straight ahead question they can fix and that would be a sleep disorder. 

The change has to start with an informed patient or at the very least a patient with relevant questions.  This way we are able to work with the insurance company.  Our goal ultimately is to get a good night sleep with the least amount of medication.  I believe we can achieve that if we work as a team.

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.