Healthy living requires a great deal of planning. Most people do not consider sleep something they have to plan. The benefits of sleep outweigh the work required to plan for a good night sleep. When we focus on our goal to look better, to feel better, and to improve our memory the extra 10 minutes that are necessary to plan a good night sleep seem well worth it.  Let’s take some time to review the benefits you may not have thought about.

A good night sleep helps rebuild collagen this gives her skin more elasticity and less wrinkles. This helps improve our overall look and makes us feel younger. When we are feeling good we are willing to do more during the day. Sleep also helps contribute to being able to perform more activities. Those who play golf have noticed that when they get a proper night sleep their scores go down. This is because the brain works better when it is not sleep deprived. The benefit is that the increased exercise allows you to sleep better which then them helps you improve your gain more. Proper sleep also allows for better social function. When we are feeling healthy and well rested we are able to interact with other people on a higher level. We are able to make more successful judgments. We are able to accept more events that do not necessarily fall within the box that we consider normal disability to accept is in direct proportion to the amount of sleep that we have the night before.

A good night’s sleep also helps those that we are with during the day whether it’s our spouse, our children, or our current coworkers.  When we are sleep deprived we make poor decisions. When we have enough sleep we are able to access more of our brain more of our memories and more averred areas of judgment and so we are able to communicate better with those around us.

It is our job to ask our doctors when we are not getting enough sleep how to achieve optimal sleep. You must let him know if there is snoring teeth grinding movements or others or getting up to go the bathroom multiple times during the night.  Each of these issues can be handled if the physician knows about them.

Our ultimate goal is to be healthy and to be as active as possible for as long as possible. If we can also look good at the same time the entire better. It’s a simple step to get enough sleep so you can achieve all these benefits.

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. 

It was a typical night where I was trying to avoid homework from work and from school.  Dr Oz has a guest on who was talking about yet another controversial idea about medicine and sleep.  It included several different products to help sleep.  He did talk a little about routine but again focused on foods and supplements and homeotherapy.  In the end the information was not complete and did not take into account lifestyle and the overall goal of helping people sleep.

When we look we should truly be talking about routines.  Sleep routines just like when we were raising our kids help to create a good night sleep.  This does not include electrics such a television and cell phones.  And every routine needs to be individual to the person creating it.  It needs to be easy and it needs to help at the same time each night.  It also has to take advantage of the exposure to darkness that allows the body to secrete Melatonin.   

If we look at a child’s routine we see the bones of it.  You set a bedtime, usually a reasonable one, which will allow them to get enough sleep to be successful the next day.  You do a bath routine.  You know the things that tell a child it is bed time like brushing teeth, washing his face.  They change into comfy sleep clothes and climb into an inviting bed with 1 or two stuffed animals but no more.  Then you put a glass of water on the nightstand to help eliminate a complaint, you take time to help relax him or her by reading a story or singing a song, sometimes both.  You give a hug and keep to leave the child feeling loved and secure. 

So how do we move our life to this without making it boring?  I think that it depends on the person.  My mind tends to wander and get stuck in the worry mode.  For me I use one of three routines.  On bad days where I have anger or frustration that needs to be processed I will do yoga because deep breathing and movement helps me to unwind and relax.  However, if I am stressed about school and work than yoga does not work and I will try progressive relaxation because it helps me relax the muscles that tend to stay tense.  Finally if all else does not work I will listen to a guided imagery because sometimes I need to be led and that works for me.  I always read before bed because my brain likes to learn. 

Overall it helps to put your routine in words and adjust it until you find what the best is for you.  Than you have to do it.  The results will help you to sleep better with a shorter sleep onset time.  Ultimately better sleep will give you more energy during the day and increase your memory and improve your mood. 

As we start the New Year we always make resolutions or goals we would like to achieve during the year.  This past year we have all learned that sleep affects all aspects of your health and so you may want to add a better night sleep as one of your goals for the year.  The problem is how to approach this to make it practical.  Creating SMART goals are usually the most successful goals. 

Let’s look at some small changes you can make and add to your daily life that can improve your sleep.  These are not big things but small changes you can add to your routine and as you build one on the other you will find that you will sleep better and have more energy during the day.

·         Give you your electronics 40 minutes before bedtime.  The light given off by your electronics confuse your brain and make it believe it is daytime.  If you turn them off 40 minutes prior to bedtime you give you mind time to relax and allow Melatonin to be releases helping you to sleep.  Melatonin is released when you are exposed to darkness.  So turning down the lights, turning off the electronics and enjoying the quite time during the evening helps to allow this hormone to be released.

·         Practice diaphragmatic breathing.  One of the great ways to relax is to deep breathe.  Lie down, put your hands on your abdomen just below your ribcage as you inhale push out against your hands, as you exhale pull your abdominal muscles in.  This exercise helps you to increase your oxygen levels, increase your lung capacity and calm your brain due to your concentration on your breathing.  Doing this for 5-10 minutes as part of your bedtime routine will help you especially if you have transient insomnia, or insomnia caused by a particular issue.

·         Create a bedtime that is 15 minutes earlier to increase your sleep time.  Large changes in bedtime will most likely lead to insomnia but a small change such 15 minutes will allow you to increase your sleep time without adding time just staring at the ceiling.

·         Do not use the snooze button.  You will find that if you get up at the same time every day and do not linger in bed you will have more energy during the day.  It will also help you to not feel so

·         Add ten minutes of sunlight to your morning routine.  Open the curtains, sit out on the balcony, or take a walk.  Any of these ideas will help you to feel more awake and have more energy.  Your brain needs the light to tell you to be awake just like it needs the dark to tell it to go to sleep. 

These are just a few ideas to add to your life during the New Year.  It is not necessary to add all of these ideas or to add them all at once but when you are making a goal using the smart method is the best way to more ahead.  Each of these is measurable, sustainable, and very specific.  I know improving your sleep will make this year a great your for you.

I feel that part of my job as a healthcare writer is to cover issues that will affect you life.  Your choice of insurance is a big choice you are making during this time of year.  I was talking to someone who was saying how few of the people at her workplace choose to have health insurance, especially for their children.  This is a huge issue that affects a person’s budget as well as their health. 

Most people believe that insurance is essential.  I do not necessarily believe that.  I believe HSAs, health savings accounts, are a great way to plan for the future that may be option.  I also think that people do not take advantage of the states children’s health care programs that provide low cost HMOs, health maintenance organization programs, in Florida it is called Healthy Kids.  These coverages are designed to take care of emergencies   but provide minimal coverage for wellness care.  You can negotiate cash prices for visits or testing you may need.  For someone who does not have a chronic problem this could be a compromise between cost and coverage.

If you have a chronic problem this may not be the solution.  Sleep apnea may be the one chronic problem that this rule does not pertain to.  I will say this for several reasons.  Sleep studies are usually done once every three to five years.  If you are a cash paying patient you might be able to negotiate a lower price for the test.  Since the company does not have to wait for payment they might lower the price.  The one exception is that they cannot charge less than the reimbursement that Medicare due to the laws surrounding Medicare.  So it might benefit you to know the Medicare reimbursement. 

When you need PAP equipment or supplies I will be honest you can get them a lot cheaper than the insurance company’s negotiated price.  When pricing masks research the online sites and the sites that do drop shipping of supplies, this little bit of research could save you a significant amount of money.   They also tend to buy in bulk and have fewer employees so they have less overhead.  They then share the savings with those purchasing the equipment. 

As to whether sleep apnea will end up costing you more as a pre-existing condition or less because you are treating a health issues actually varies from insurance company to insurance company.  If you have been diagnosed with sleep apnea and you choose not to treat it than you will be treated as having a pre-existing condition and they could not cover other issues such as high blood pressure or diabetes as they are associated with the sleep apnea.  However if you are using your PAP than many of the insurance companies may ask for proof of use and will treat you as if you do not have a pre-existing condition.  You will have to shop around and ask questions about that particular plan’s policy.

When it comes to our children many of them do have sleep apnea and it can look like many things such as ADD, fatigue, hyperactivity, anger and learning disabilities.  If we looked at their sleep and have a sleep study they are usually treated initially with a tonsillectomy and if still needed PAP therapy or an oral appliance.  It is important that we need to help our children to be able to achieve their best and taking care of sleep problems is worth the cost of insurance.  If you can not afford your children’s coverage you need to ask your state what programs they have to help you cover them.  It is worth it in the end and will help them to behave better and be more successful in school

When you are looking at insurance you must take many things into consideration including the cost to you and the ability to balance your budget while paying the premiums.  But when choosing not to have coverage or you are choosing minimal coverage you must consider the effects it will have on chronic issues and your ability to pay for care. 

We all experience a night where we stare at the ceiling or cannot turn off our mind.  Transient insomnia is something we experience when we are living with a stressful situation or maybe just a long day.  The problem is that if you do not get a good night sleep you may find that it is difficult to concentrate, your hunger may increase, or you may experience more aches and pains. 

One of the exercises that you can use is to use imagery along with breathing exercises to help relax and go to sleep.  This exercise may also help with people who may be experiencing nightmares as well.

Let’s start with the breathing as this is what allows you to increase your oxygen levels and helps you to relax.  Take a slow deep breathe imagine filling your lungs from the bottom to top.  For women this is not as natural as you thing as we tend to be shallow breathers.  Once you have filled your lungs hold it for the slow count of four then slowly exhale to the count of 8.  This will also help you to increase the use of your longs.  The breath hold allows some of the small airways we do not usually use to open.

The second step is to use imagery.  Choose a place you want to be.  I personally am a warm white beach person or on a flower covered meadow person.  You choose an image that suits your personality.  Now focus on that image.  Image the smell of the air, the temperature of the sun, fell the grass under your feet.  The more you can focus on the details the more it will help you to relax. 

In my mind I travel to a valley between the mountains.  I am lying looking up at the sky watching the clouds pass through the sky.  I feel the grass under my hands and between my fingers.  I smell the sweet smell of violets and wildflower.  I can hear the wind across the pond and rustling in the leaves.  The more I concentrate the more relaxed I become.  Along with the slow deep breathing I can feel my muscles relax.  I allow myself to float along and eventually I drift off to sleep. 

This exercise was taught to me when I was in high school as a way to get past my test anxiety.  I found that doing this exercise for just three to five minutes really reduces my stress.  I use this on nights when I can not turn off my mind to ideas or to my family.  It allows me to drift and it does help minimize the nightmares I experience.

Are there exercises or imagery you use to help you to relax and unwind?

Not everyone who snores actually have sleep apnea.  In fact Upper Airway Resistance is an independent diagnosis that can disrupt sleeping but you do not stop breathing throughout the night.  The issues are not just that of the person who has the problem but those who live with them. 

Upper Airway Resistance, or AURS is when the back of the throat and soft palate is crowded and causes snoring or vibrations that can be very loud and disturbing. 

In children the solution can be as easy as removing the tonsils and adenoids allowing for more space and easier breathing.  This allows a child to sleep easier and reach slow wave sleep, the time in sleep growth and healing happens, to occur.  It also allow for an easier transition into REM sleep.  This normal sleep architecture helps children to learn and retain information as well as have less behavioral problem. 

In adults the solution is not always as easy.  The airway can be restricted due to issues such as deviated septum in the nose, being overweight or just age causing a relaxation of the tongue when we sleep causing crowding.  One of the easiest solutions is to sleep on your side or stomach.  This allows the tongue to fall forward when you sleep.  Another solution is to elevate the head of the bed.  Again this will help to support the airway and keep it open. 

Some of the more interesting solutions people have come up with that have been shown to work are mouth and tongue exercises. Using a didgeridoo, an Australian woodwind instrument, has been shown to help strengthen the muscles in the throat and help decrease snoring.   Singing has also been said to help. 

My final suggestion is that an oral appliance created specifically for you might be helpful.  Always use a dentist who knows how to create the best device for you.  They should know how to create more than one type of device.  They should also be a fellow of the American Board of Dental Sleep Medicine.  An oral appliance would allow the tongue and the jaw to be slightly repositioned to eliminate the snoring.

I always suggest that it will be helpful to talk to your doctor about your medical options.  Whether you use a traditional therapy or one of the non-traditional therapies I would suggest that you take care of this issue not for your health but also for those who you live with or vacation with.

 

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. 

You think that sleep is mostly about what you do right before you go to bed.  This is not the case at all especially for women.  There are many things that keep us from sleeping including what we eat, stress and how much we move.  If we make some plans we can improve our sleep by reducing out stress, improving our diets, maybe have a little time to work out and possibly save a bit of money. 

Plan your food.  Not just for the day but for the week.  Taking the time to do this little bit of planning and preparing takes a great deal of stress off you for the rest of the week.  The food does not have to be very fancy.  It can be as simple as yogurt and cereal during the week for breakfast a sandwich and salad for lunch and meatloaf for dinner.  The other benefit is the reduced fat and sodium will allow the food to digest better so you can sleep better.  If you have GERD or acid reflux you can plan your meals so that you are less symptomatic and it will not disturb your sleep.  If this is an issue, consider having your veggies and fruits early in the day and your lighter proteins at night.  If breakfast is your problem make muffin cup egg quiche.  They also will help to add a little veggie to your morning. 

Plan your exercise for the best time for you.  I am not a morning person.  The idea of getting up early to exercise and actually doing it made me unhappy and more tired.  Because I have planned my dinners and cooked some of them ahead of time I am able to go to the gym or to the park right after work and exercise.  You should also consider how it is going to affect your sleep.  Sometimes the rev you get from working out can keep you from falling asleep.  So keep in mind you want to have three hours to unwind after you work out.  This does not include exercises you use to unwind such as yoga, meditation or stretching.  Those exercises will actually help you since the will center your mind and allow you to relax.

Plan for the stressful situations for the week.  If you have to bring the kids to practice straight after work do not include that day as your workout day.  We cannot be perfect and we need to find our balance.  We can also plan how you are going to unwind afterwards.  It might be as simple as taking 10 minutes to read or journal after you put the kids to bed or a bubble bath or a hot shower before bed.  Both will help you to unwind and the shower will actually help your body prepare for sleep by helping to bring your body temperature down as you dry off, a signal to your brain that it is time to sleep.

As women we tend to be overschedule and not know how to say no to anything.  We do need to make the time for ourselves so we can sleep well so we can be more productive.  If we take that little bit of time once a week to plan we will have less stress.  It is not about being perfect but removing some of the situations that stress us out so we are able to live better.

It is summer and we love to relax on the weekends.  It is a great thing but keep in mind that a nap is good any day and time of the year if used correctly.  You can appreciate those lazy days and that nap you can take to recharge yourself for the rest of the day or it could make you feel tired and draggy for the rest of the day.

You can use a nap to recharge your batteries. There are a few rules about how to best take a nap

1.       A nap should be approximately 20 minutes long.  This allows you to get rest and reboot your brain, moving short term memories to long term memories.  It gives you bod that chance to get a little recovery time.

2.       Listen to your body’s clock to decide when you are going to take your nap.  Your body temperature drops during the afternoon around 3 pm.  That is the perfect time to take your nap as it is what your body is programed to do. 

3.       Your nap should be in your bed with the lights, television and electronics off just like when you are going to bed.

4.       Even if you do not think you are sleeping you may be.  The lightest stage of sleep, called N1 sleep, still allows you to recharge.

5.       If you have insomnia a nap is not your best choice.  Napping when you have insomnia will just aggravate the problem.

The quick nap will recharge you so the second half of your day will be more energetic.  It can allow you to reboot your brain and allow your body to recharge so you can achieve more.