Got Sleep?

I think most of us have relaxing images that we associate with summer – whether they are realistic or not. Is there anything more relaxing than getting a good night’s sleep? So how is it going for you and perhaps your children this summer? Are you getting enough sleep? What is enough sleep anyway? According to sleep medicine specialist, Dr. Peter Fotinakes most people require eight hours and some can be good with 6½ - 7 hours per night.

Here are two easy questions to answer to know if you are getting enough sleep:

1) Do you wake up feeling rested?

2) Do you stay feeling alert throughout the day?

Doctors and researchers are finding that more than ever people are not answering “yes.”

Fotinakes trained at UC Irvine as a medical student and resident in neurology and became fascinated with the subspecialty of sleep medicine and went on to run the Sleep Disorders Center at UCI for 10 years. I interviewed him on the health habit of sleep.

Patch: Why don’t people take sleep seriously? Most people never bring it up but the other day when I did, everyone had something to say.

Fotinakes: Most people don’t think about it until they have problems. One of the most common for teens is burning the candle at both ends. Many teens stay up until 2 a.m. so they are essentially living in a different time zone and they can’t easily get back.

Fotinakes says when people lower sleep by one or two hours a day after a week, you can become like a narcoleptic. If it is for a short time, it can be made up.

Up until the 1950s, there was not a lot of research about sleep. Medicine was ignoring 30% of the time we are living. Sleep is not a quiet time; it is an active, vigorous time where problems that occur there extend into daytime.

In the 1960s, researchers connected problems at night like sleep apnea (when the airway closes and the person has to wake up to breath over and over again throughout the night) where each cycle puts strain on the heart and lungs and can lead to high blood pressure.

Patch: Do you see a lot of young patients?

PF: A common problem in children and adolescents is for a lot of sports, such as swimming, they practice at 5 or 6 a.m. doing an hour or two workout which throws off their circadian rhythm.

The natural circadian rhythm for teenagers is to go to sleep later and wake up later. When they wake up that early and then go straight to school, they may be in school a few hours before they actually wake up and start learning. Some districts have started high schools later and found that delinquency and tardiness went down. Although teens may catch up on some sleep on weekends, they should not change their wake up time by more than one or two hours or it will make getting up even more challenging. Sleep problems like insomnia are not only related to bad habits, but can be connected to anxiety, depression, or hyperactivity so we take a coordinated approach to treat the problem.

Excessive exercise

According to Fotinakes, excessive exercise is also a problem. The body temperature has a 24- hour cycle with a sudden drop in core and the onset of a sense of sleepiness at bedtime. Vigorous exercise too close to bedtime stimulates the core body temperature to be falsely elevated. In the evening, this may delay sleep onset.

Middle Age

Women: The most common cause in middle age women of sleep problems for middle aged women is perimenopause. Women sleep lighter and don’t associate it with menopause. They may be on medication for being anxious or depressed but may do better to go off  that and go on hormone replacement therapy which could help regulate sleep.

Men: After 35 years old, 50 percent of men snore and six percent of women do, too, but I am sure that percentage will go up for women. Snoring indicates a partial airway obstruction.

People in their 60s tend to go to bed earlier and wake up earlier.

P: What are your tips for good sleeping?

PF: Good sleep hygiene means trying to keep on a regular schedule and getting the amount that allows you to wake up rested. Alcohol, tobacco and caffeine too close to bedtime should be avoided and sleeping pills tend to accentuate the insomnia. If you take one every night, you can get into a rebound and withdrawal and poorer sleep cycle.

The good news: Just as we can rid all of the dangerous consequences of overweight (high blood pressure, high cholesterol, etc.) by losing the weight, Fotinakes informs that when people make changes and instill good sleep habits they can put themselves back at zero (risk for diseases related to poor sleep habits).

We should all be concerned with our sleep because lack of it can lead not only to depression, but to accidents and poor performance in anything we do. Other sleep problems, like apnea can have other serious consequences, so if you think someone you know may have it, they should get it checked out (we often are unaware of what we do in our sleep). Like any other health habit, it can take practice to get better at it. As our bodies and lives change, we may need to take new approaches to sleep health.