When my wife and I go grocery shopping for ingredients for our healthy meals we have a list of “staples.” These are the common items we use everyday which are often components in our meals for the week.
Similarly, when patients of all ages (more so those over the age of 50) come to see me, we focus on their “staples,” or their chronic medical problems. We frequently review lab work and conditions such as high blood pressure, diabetes and high cholesterol. Sometimes as our visit concludes, patients bring up an additional concern. They have an “add-on”—sleep problems! Unfortunately, for patient and physician, sleep disorders are complicated, potentially very serious, and they take more than just a few minutes at the end of an office visit to evaluate.
Sleep Issues by the Numbers
Statistics tell us that sleep issues affect many people in the United States.
- 35% of Americans don’t get the recommended seven hours of sleep each night. Americans currently get 6.8 hours of sleep on average each night.
- In 1910 the average person slept nine hours per night.
- Roughly 20% of Americans have a sleep disorder.
- Since 1985, the percentage of adults getting less than six hours of sleep each night has increased by 31%.
- Sleep deprivation costs the U.S. $411 billion annually.
Common Sleep Complaints
Though extremely common (I also hear from family and friends about their sleeping difficulties!), sleep issues can be influenced by a wide range of factors. The complaints I hear most often are:
- Difficulty falling asleep
- Falling asleep, but waking up at 2 a.m. and not being able to get back to sleep
- Lack of quality sleep and inadequate duration
As I address the problem, I point out the seriousness of sleep issues. Disrupted sleep, especially if due to sleep apnea, results in the overproduction of cortisol and adrenaline (epinephrine). Cortisol is a stress hormone which contributes to an inflammatory response in our bodies. This potentially leads to coronary artery disease and several other serious medical problems such as elevated blood pressure, elevated blood sugars, and sticky platelets.
In addition, sleep issues can cause a disruption in the chemicals which help control our appetites. This is one of the reasons that makes it hard for individuals with sleep disorders to control their weight.
Don’t let the discussion about sleep be an afterthought when you visit your physician. Schedule a separate appointment to discuss your sleep problems or arrange a visit with a physician who specializes in treating patients with sleep disorders. Collaborate with your physician to put together a plan to improve your sleep.
Medications are generally not the answer! Sure it’s okay to go to the internet to get some ideas. In particular, if you have not done so already, find information about GOOD sleep hygiene (did you know there was such a thing?). Experiment with some of these suggestions and keep a log/journal regarding sleep adjustments. Share this with your doctor as it can establish a baseline for a sleep plan that may work for you.
In my next blog about sleep, I will describe the biggest problems I see regarding common sleep disorders, namely insomnia and sleep apnea.
To a long and healthy life,
David Bernstein, MD