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    Are You Sleeping Well?

    Ashtin Collins, RN, MSN, FNP-C Deaconess Sleep Center 03/09/2020

    Everything you do during the day has the ability to impact your quality of sleep, which is why it is important to maintain healthy sleep habits.

    Getting a good night's sleep is a critical part of living a healthy life.  Sleep is when our bodies repair themselves, and inadequate sleep has been linked to heart disease, stroke, diabetes, weight gain and depression.

    “Sleep hygiene” is a variety of different ideas and practices that help you have normal, quality sleep.  Sleep hygiene helps your body prepare to fall asleep, and helps you stay asleep.

    Here are some sleep hygiene recommendations:

    • Irregular Schedule: One of the biggest things that can affect our sleep is an irregular schedule.  Go to bed and get up at the same time every day—even on weekends.  If you do this, your body will get into a natural rhythm of sleepiness at bedtime and wakefulness in the morning.

    • Early Exercise: Physical activity during the morning or afternoon can help with sleep, but don’t exercise within a few hours of going to bed.  Gentle yoga or stretching is an exception, though; as it can help you wind down.

    • Light Exposure: Getting plenty of light during the day, and then removing as much light as possible at bedtime, helps set your body clock to sleep at the right times.

    • Alcohol Intake: Avoid alcohol if you have trouble staying asleep at night.  It may make you sleepy at first, but as your body starts processing the alcohol, it disrupts your sleep.

    • Meals: For the same reason, avoid a big meal within a few hours of bedtime. Your body will be aroused by digesting a large amount of food while you’re sleeping.

    •  Develop a relaxing bedtime routine. At least an hour before bed, start winding down.

      •  Having a comfortable bedroom is important.  Set the thermostat to let the house cool down a few degrees at night—not too cool, but cooler than daytime hours

      • Take a warm shower or bath.  As your body cools afterwards, it will help develop a sense of sleepiness.

      • Don’t get your brain too wound up right before bed. Don’t get engaged in a big conversation, watch a thrilling movie or read a suspenseful book.

      • Avoid screens—television, computer, phones and even e-readers—as the light they emanate is stimulating to your eyes and brain.

      • Turn off some of the lights in the house.

      • Have a regular rhythm to the last few minutes before going to bed. Brushing teeth, setting up the coffee pot, taking that day’s medications/vitamins, etc. can all help program your brain that it’s time to sleep.

    • If you have trouble falling asleep at night, here are several important tips to start with:

      • Avoid napping during the day.  You need to go to bed tired.

      • Avoid caffeine in the afternoon and evening.  (Remember, chocolate has caffeine!

      • Don’t use tobacco products, as nicotine is a stimulant, and interrupts sleep all night long.

      • Practicing good sleep hygiene is beneficial to everyone, of any age. It helps babies and small children establish a healthy sleep pattern that encourages growth and development.  And it helps teens and adults wake up ready to take on a day of learning, working and contributing.

    Note: No matter what sleep hygiene techniques you use, sleep disorders can affect the quality of your sleep. Below is a list of symptoms that can be signs of a sleep disorder, and should be discussed with your primary care provider.

    • Being excessively sleepy and tired during the day even after what seems like a full night of sleep.
    • Excessive snoring, especially if there are periods where you briefly stop breathing (this is noticed by sleep partners).
    • Having trouble falling—or staying—asleep for at least a few weeks.
    • Constantly moving legs at night, or having the urge to do so.


    Types of Sleep Disorders

    Obstructive Sleep Apnea

    One type of sleep disorder is obstructive sleep apnea (OSA), a condition when people have episodes of apnea that disrupt the normal cycles of sleep. Apnea is when you have an abnormal pause in breathing; in sleep apnea, episodes of apnea that are 10 seconds or longer are significant.  My colleague, Dr. Rebecca Hopper, Internal Medicine/Pediatrician, has published an article on obstructive sleep apnea.

    Children can also have OSA.  Poor sleep quality in children can lead to difficulties focusing in school, hyperactivity, behavioral problems and sleepiness. Signs of OSA in children may include snoring, labored breathing, and/or sleeping with their mouth open. Children with large tonsils are at the greatest risk for developing OSA, but other conditions such as craniofacial deformities, genetic (Trisomy 21), neuromuscular disorders, obesity, and family history all increase their risk also. Treatment can include a surgical procedure to remove the tonsils and the adenoids, a CPAP, or dental work.

    Insomnia

    Insomnia is another type of sleep disorder that can make it hard to fall asleep, hard to stay asleep, or cause you to wake up too early and not be able to get back to sleep. It can lead to fatigue, mood disturbances, attention, concentration or memory impairment- along with impaired social, family, occupational, or academic performance. Treatment options for insomnia may include CBT-I (cognitive behavioral therapy) and medications.

    Children can also suffer from insomnia, and it may present differently as they progress through life. Children ages 3 and older may present with sleep onset insomnia due to crying, stalling, refusal to go to or stay in bed, moving to parents’ bed at night, and inconsistent sleep routines. Pre-adolescents and adolescents may present with increased focus or worry about sleep, falling asleep elsewhere, poor sleep habits, and electronics use in bed.  The treatment for insomnia in children of all ages is the same - sleep behavior therapy (CBT-I).

    Parasomnias

    Parasomnias are types of sleep disorders that can happen right before you fall asleep, while you are sleeping, or as you are waking up.

    Here are some examples of parasomnias:

    • Sleepwalking
    • Sleep Terrors
    • Sleep Eating Disorder
    • REM Sleep Behavior Disorder
    • Sleep Paralysis
    • Nightmares
    • Bedwetting
    • Sleep Hallucination
    • Sleep Talking
    • Exploding Head Syndrome

    Sleep Movement disorders:

    • Restless Legs
    • Periodic Limb Movements


    Learn more from the Deaconess Sleep Center about healthy sleep and the sleep disorders that can affect your sleep quality at deaconess.com/sleep. You can also schedule a new patient appointment online.

    Source: American Academy of Sleep Medicine: International Classification of Sleep Disorders.

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