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. 

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 all deal with pain at some point in our life.  However, when we are dealing with chronic pain the issue becomes compounded because it will interfere with our sleep.  This can cause the issue to become compounded and for the pain to increase.

The first issue with pain is the inability to get into deeper sleeps.  Pain will actually interfere with the slower brain waves causing sleep disruptions that we may not be aware of.  This slower wave sleep, also known as Delta Sleep, is when our body releases hormones such as Human Growth Hormone.  If we are unable to reach that level of sleep then our body does not have the ability to heal itself or can take significantly longer than we expect it to. 

The second issue is that sleep deprivation increases our perception of pain.  There is really not much to say on this issue other than you can see the vicious cycle this can create for someone learning to deal with chronic pain. 

The third issue is the side effect of many of the medications people take for pain.  It can change the ability to sleep, the stages of sleep a person is able to achieve and the level of fatigue a person feels throughout the day.  Many medication can also cause insomnia. 

The last issue is that when we deal with pain it will limit our activity.,  This will limit our need for sleep.  It will also cause napping during the day that will again cause difficulty going to sleep at night.  This daytime fatigue will also limit our time outside and our exposure to the sun.  This lack of sun will causes decreases in vitamin D.  It has been found that low levels of Vitamin D causes us to experience increased levels of pain.

All these issues combined together will continue to increase the pain and health issues a person is experiencing rather than healing.  Taking the time to take a short walk, get some sun and working with your doctor to manage your sleep will help you to get better than much faster.

We talk about our weight all the time.  We try new food plans, we take up different exercise programs and we say positive affirmations until we are blue in the face.  We ask our doctors for help and they tell us to try harder, eat less and exercise even more.  When was the last time you were asked how well you sleep?  Our quality of sleep affects our weight more than we can ever imagine. 

 Why You Need to Get 7-8 Hours

We run on less and less sleep so we can get more done and connect to more people.  This lack of sleep has a harsh effect on our brain.  It will not only effect how we make decisions, deal with emotions and are able to concentrate but it will also affect our appetite.  Sleep deprivation causes us to make rash decisions.  This can lead to more volatile emotions and negative emotions like stress and anger.  This leads to stress eating.  It can also lead to eating foods that are high in fat, sugar or salt. 

Sleep deprivation also increases the feelings of hunger.  People who are sleep deprived will eat more frequently to help keep them awake.  Again the foods they choose tend to be high in fat, salt and sugar.  This just makes it harder to stay on your choice of food plans.

Sleep Disorders Affect Your Weight

Sleep apnea has been associated with many health problems but the biggest problem where your weight is concerned is the effect it has on your hormones.  In particular you Cortisol levels tend to be elevated and stay elevated throughout the night.  The stress response every time you stop breathing or have difficulty breathing as obvious by snoring your body responds with the fight or flight reflex and Cortisol is produced and stays elevated   High Cortisol levels keep you from being able to lose weight. 

Treating sleep apnea and snoring requires you to talk to your doctor about the problems you are having sleeping.  You will want to explain all your symptoms not just that you are having difficulty sleeping.  People with sleep apnea do not always snore so do not assume that you do not have sleep apnea if you do not snore. 

There are many doctors who will say “well, if you lose weight you will not have sleep apnea and snoring” but in order for you to be successful with the weight loss you really need to treat this problem.  Your body does not like to be stressed and if you are changing your food and your exercise but you are still stressing your body every night you will not be successful at losing weight.  You need to be your best advocate.

Do Not Underestimate the Small Stuff

Weight loss is a challenge under the best circumstances.  There are little things you can do to help you to make the weight loss journey a little easier.  Sleep is one of the biggest influences that require very little specific work.  Making sure you sleep 7-8 hours a day and that the sleep quality are two of the little changes you can do that will help you achieve your goal.

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  An article was released about teens and the effects of caffeine and technology is having an effect of teens and their sleep.  I know I live this issue daily.  I have a teen son and a daughter who is just in her 20s.  The problem is that we have not created a culture that supports teens and their needs.

 

This article was timely as this week my son took his yearly standardized tests.  He has to get up at 6am to get ready for school so he can arrive just before 7am.  He will then sit in the testing room he is assigned to and will take a test that will determine his future.  Of course what they are not thinking about as these students enter the school is that more then half of the students walk on campus with an energy drink, diet soda or Starbucks in their hand.  They are all yawning, dragging their feet and look like they could use two more hours of sleep.  When they normally attend class at least 3-4 of the students will want to put their head down during at the very least 1 period.  These are not fresh, excited students.  These are sleep deprived people that our culture is trying to get to fit into a cheapest easiest way to give them an education.  We have not created an education that is designed for them to become successful educated individuals that can perform at their optimum. 

 

Add to this early more education some new parts to our culture.  Their diets include processed food, chemical substances, and stimulants like caffeine.  They are exposed to light 24 hours a day and their brains are stimulated from the time they wake up until the time they go to bed.  They are in the computer, playing video games or watching television.  They have 2-3 hours of homework they need to do when they come home.  They also have outside activities.  Things like my son’s Boy Scout meeting will last from 7-10:30 at night.  We have not set them up for optimal sleep we have set them up to be sleep deprived. 

 

It is difficult to tell a 5’10” boy that it is bed time at 9 or 10 pm.  The world has not stopped or even slowed down by then.  He still has homework he wants to tweak, friends to chat with or challenge on a game, or just wants to watch a show he knows everyone will be talking about at school the next day.  He gets tired around 11-12pm and is sound asleep no later then 1am.  On the weekend he sleeps until 11am and sometimes a little longer.  His friends are the same way. 


I believe that we have to look at what our children need, how to create a healthy environment for them and then nurture that.  Is sending our children to school at 7am really in their best interest?  One of the local school districts changed the time for the high school children from 7 to 9.  Next year they are changing it back because it interferes with after school work and activities.  Did they even bother to look at the student’s attendance, grades or test results?  They did not. 

 

So what is the result of sleep deprivation with our teens?  It is multifold, sleep deprivation can increase the incidence of depression, increase the symptoms of ADD, increase the chances of obesity.  It interferes with learning and storing information into long term memory. 

 

Now we need to explain to our teens why a sleep routine, turning off all electronics and going to bed early I so important.  We need to overcome peer pressure so that our children understand that this is the norm.  We need to be examples for them.  We need a very strong sleep routine that includes turning off the computer and the television.  We need to make time for the family to sit and eat together and read together.  These changes will help them during the tough teen years.  We need to help them reach their true potential.