Sleep problems are a nightmare, but better rest--and improved health--can be yours.
Tossing, turning, desperately hoping to drift off—most people know the feeling. About a third of us have trouble sleeping or feeling refreshed while awake. “That’s about 110 million Americans,” says Carol Ash, DO, Chief Medical Officer at Robert Wood Johnson University Hospital (RWJUH)
Rahway and a board-certified physician in sleep medicine. “Poor sleep is a huge problem.”
Reasons for sub-par slumber can vary, and can be physical, stress-related, environmental or a result of poor diet and habits. “It’s important to understand the nature of your sleep problem so you can effectively consider what to do about it,” says Dr. Ash.Poor sleepers often mistakenly think their first move should be getting a prescription for a sleeping pill. “Medication should be a last resort,” says Ramamurthy Bangalore, MD, Director of Sleep Medicine at RWJUH Rahway. That’s because sleep drugs are sedating but generally don’t address underlying causes of poor slumber.
“Sleeping pills can be like putting on the brakes when you still have your foot on the accelerator,” says Dr. Ash. “And if you have a breathing disorder, a pill is not very helpful.”
Finding the cause
The most commonly diagnosed sleep disorder is obstructive sleep apnea, a condition in which excess tissue in the throat blocks the airway, interfering with breathing. Start with questions, the foundation of a sleep assessment. Do you snore? Sometimes wake up gasping? Experience acid reflux or irregular heartbeat? Find yourself sleepy or lethargic during the day? These may be signs of obstructive sleep apnea.
“Your doctor will take a history and do a physical exam to find other clues,” says Dr. Bangalore. “For example, being obese or having a neck size greater than 17 inches in men and 16 inches in women may put you at higher risk.”
A home or in-lab sleep study can provide objective measurements to confirm a suspected diagnosis of sleep apnea. While sleep apnea can be medically treated with a breathing device, losing weight can be effective as well. “Just a 10 percent drop in body weight may get rid of your problem,” says Dr. Ash. A doctor or sleep specialist can also rule out, or treat, underlying medical conditions that may interfere with sleep, such as overactive thyroid, restless leg syndrome or iron deficiency. “If you’re anemic, a simple fix such as boosting iron intake may improve sleep,” says Dr. Bangalore.
Better sleep habits
For many, poor habits are the culprit that undermines a restful sleep. Experts recommend these steps:
Declutter your bedroom.
“Get everything out of there that’s not associated with sleep,” Dr. Ash says—and don’t stop with TVs and electronics. “Clutter of any kind brings your world into the bedroom instead of making it a sanctuary.”
Reinforce cues that tell your body sleep is coming.
Go to bed and get up at the same times every day to strengthen the body’s sleep/wake rhythm. Go through a consistent wind-down routine with a relaxing activity such as deep breathing exercises.
Don’t lie in bed for more than 15 minutes.
“You should associate bed with sleep, not counting sheep,” says Dr. Bangalore. “Get up, go to a different room and do something quiet, and don’t come back to bed until you feel ready to sleep.” The paradox of getting up when you want to sleep helps build a sleep debt that ultimately makes drifting off easier.
Take a small, 5-mg dose of melatonin (a natural hormone, available over the
counter) 90 minutes before bedtime.
It may help you drop off and stay asleep, especially if sleep has become out of sync with daylight due to jet lag or shift work. All these efforts will have a big payoff, experts say. “If you sleep well,” Dr. Bangalore says, “your overall health should improve.”
How sleep affects health
Why humans need sleep has long been a mystery. Recent research suggests that sleep helps the body regulate and repair DNA, controlling the activity of genes that are responsible for a wide range of processes in the body. “If you don’t get adequate sleep, newer studies show that you are not just tired but physically different,” Dr. Ash says. “We’re starting to learn that not sleeping well can exacerbate virtually any disorder.”
Poor slumber has been linked to hypertension, heart rhythm disturbances, stroke, weight gain and impaired immune function. Sleep also appears to help the brain build connections between neurons and clear itself of potentially harmful proteins that build up during the day. “Poor sleep may put you at higher risk of neurological diseases like Alzheimer’s and Parkinson’s,” says Dr. Ash. A small 2018 National Institutes of Health study found that losing just one night of sleep led to an increase of beta-amyloid, a brain protein linked to Alzheimer’s.
Another 2018 study even found that poor sleep makes you feel less social—and appear more socially unattractive to others. Says Dr. Ash, “It’s becoming more and more clear that sleep plays a vital role in health and well-being—both physical and mental.”
To schedule a sleep study through RWJUH Rahway, call 800.SLEEP RX (800.753.3779). Test results are interpreted by a board-certified sleep specialist.